How the Caribbean MD program is structured
The standard four- to four-and-a-half-year Caribbean MD program splits into two phases:
- Basic sciences (4–5 semesters) on-island - anatomy, physiology, biochemistry, pathology, pharmacology, and organ-system courses, ending in a Step 1 review.
- Clinical sciences (~72–80 weeks) at affiliated teaching hospitals - cores plus electives.
Most schools require a Step 1 pass before starting core clerkships. Step 1 has been pass/fail since 2022 but remains gate-keeping for clinical placement.
Core rotations and electives
- Internal medicine - 12 weeks
- Surgery - 12 weeks
- Pediatrics - 6 weeks
- Obstetrics and Gynecology - 6 weeks
- Family medicine - 6 weeks
- Psychiatry - 6 weeks
The remaining 20–30 weeks are electives used for specialty exploration, audition rotations at target residency programs, and required sub-internships. Sub-I performance and US letters of recommendation weigh heavily in the Match.
ACGME-affiliated teaching hospitals
ACGME accredits US residency programs, not medical schools - but hospitals hosting ACGME residencies are almost always active teaching sites with structured clerkships. A school's named ACGME-affiliated sites is a strong quality signal because students train alongside residents and attendings in accredited teaching environments.
When comparing schools, look for the number of named hospitals per core specialty, geographic spread, and whether the school publishes the list.
US state approvals for clinical clerkships
California, New York, and Florida each run their own review of foreign medical schools for clinical clerkships. Accreditation alone (CAAM-HP or ACCM) does not automatically grant approval in any of these states.
The four schools with all three state approvals - SGU, Ross, AUC, and Saba - are commonly called the "Big Four." Others have partial approvals. Always verify on the Medical Board of California, NYSED, and the Florida Board of Medicine directly.
Rotations outside the United States
- United Kingdom - NHS teaching-hospital affiliations, more common at Saba, Ross, and SGU.
- Canada - limited by provincial regulations; a small number of hospitals accept Caribbean students, mostly in electives.
- India - Texila American University has an established Indian-hospital pipeline for portions of the clinical program.
Non-US rotations can be valuable but do not always count toward US state approval or the Match. Plan the sequence with your school's clinical-placement office.
Questions to ask before enrolling
- How many ACGME-teaching hospitals do you have affiliation agreements with - can I see the list?
- Which US states approve your program for clinical clerkships?
- Is passing Step 1 a hard prerequisite for cores?
- How are core rotations assigned - lottery, geography, academic performance?
- What is the average gap between finishing basic sciences and starting cores?
- Do you support scheduling audition rotations and Sub-I placements?