BenjaminWard (Student)
I keep hearing that clinical rotations happen in the US but nobody actually explains where or how competitive the placements are. are we talking big academic hospitals or just community places? do schools arrange everything or do you have to figure it out yourself?
BrandonLane (Aspiring student)
Can answer this from SGU. school arranges core rotations through affiliated hospitals. Mostly community teaching hospitals across new york, new jersey, florida, illinois, georgia. not mass general or johns hopkins but community hospitals is where most of medicine actually happens so the exposure is solid
the hard part is you dont get to pick where. Could be new york one block, rural georgia the next
LilyPatterson (Student)
exactly. the romantic idea of training at big academic centers is mostly just that. even lots of US MD students do significant time at community affiliates
the geographic unpredictability is the real issue. if you have a partner or family obligations that part gets stressful fast
Victoria88 (Aspiring student)
do students pay their own housing during rotations? heard it can get really expensive especially in cities like new york
BrandonLane (Aspiring student)
yes and nobody talks about this enough. during clinical years youre paying tuition AND your own housing in whatever city youre rotating in. New York rotations can run an extra 2000 to 3000 a month on top of tuition. Some hospitals have subsidized housing but its not guaranteed
build this into your total cost of attendance. it adds up a lot over two clinical years
AmeliaReed (Student)
jumping in from the admin side. coordinate placements at a community teaching hospital that works with SGU, Ross, AUC and Saba regularly. the placement is managed between the school and hospital admin. students at accredited schools dont cold call hospitals for core rotations
elective rotations are completely different though. students have to arrange those independently and it is much more competitive
MiaRoss (Student)
this needs its own thread honestly. getting audition rotations at competitive programs is where caribbean students hit a real wall. i emailed over 40 programs for a cardiology elective and heard back from maybe 6. you need strong step scores and good letters just to get considered
Zachary (Alumni)
40 is low honestly. i sent 70 plus for general surgery audition rotations and landed 3. but those 3 were everything. one of them led directly to my match
audition rotations for caribbean students are not optional for competitive specialties. your steps open the door but the audition rotation closes the deal
Charlotte14 (Student)
nothing against caribbean students personally but the system you are all describing is objectively harder than what US MD students experience. geographic randomness, cold emailing dozens of programs for electives. just want prospective students to understand this clearly before deciding
LilyPatterson (Student)
nobody is arguing that. ofcourse its harder. but for a lot of us the choice wasnt caribbean vs university of michigan. context matters
Hailey (Student)
I’m currently in my 3rd year at Saba, so sharing from my own experience.
Clinical placement has actually been more organized than i expected. I was placed in New York for internal medicine and Florida for pediatrics and the clinical placement office has been pretty consistent with communication.
The hardest part is definitely the moving. Ive relocated 4 times in about 14 months, which gets exhausting, but overall I’m doing okay. The rotations have been solid so far, and I’ve had good feedback from my attendings.
Jason00 (Student)
went through the caribbean route 15 years ago, now supervise residents. quick note on quality
the community hospitals where caribbean students rotate are the same hospitals where many DO and some MD students train. attendings dont change based on your school. what changes is subspecialty access and research. for primary care, IM, and psychiatry, caribbean training is absolutely enough preparation. competitive specialties are harder but not closed
LeahCole (Student)
Step scores matter a lot, especially if you’re coming from a Caribbean school.
Im at SGU and applying derm this cycle. My Step 1 was 256 and Step 2 was 262 and honestly those scores are what opened doors for me. A lot of programs are going to look at your scores before they really focus on your school name.
that doesn’t mean the school doesnt matter at all especially later when programs are ranking applicants. but strong Step scores can at least get your application seriously reviewed.
so if youre aiming for something competitive from the Caribbean you really cant treat Step prep casually. Your scores are basically your biggest leverage.
Rileyyy (Student)
from what i’ve seen placement at accredited caribbean schools is more structured than people think
schools usually have formal agreements with teaching hospitals in the US and those get reviewed regularly as part of accreditation requirements
for core rotations students are scheduled through the school system so you’re not just left alone trying to find required placements by yourself
electives and audition rotations are different though those are usually on the student to arrange but the school still helps with things like letters contacts and guidance
so yeah its not perfect but its definitely more organized than a lot of prospective students assume
AaronButlerr (Aspiring student)
yeah this is true for the bigger accredited caribbean schools where it gets risky is with smaller schools that dont really have strong hospital networks or proper affiliations
students from those schools can end up having to figure out placements on their own and sometimes rotate at sites that may not help much when it comes to residency
so if youre choosing a caribbean school dont just look at tuition or location make sure its accm accredited and has established us hospital affiliations
The difference in clinical placement support between a well known school and a lesser known one is honestly huge
ChristiannFos (Student)
This thread has been incredibly informative as someone just starting 1st year. a few practical takeaways Im noting for myself based on everything shared here:
core rotations are school arranged at affiliated community hospitals across the US, mainly NY, NJ, FL, IL, AZ and GA
budget separately for housing and transport during clinical years, easily an extra $1,500 to $3,000 per month
elective audition rotations require proactive outreach start building your CV and Step prep early
step scores are non-negotiable if targeting competitive specialties
stick to ACCM accredited schools with established hospital networks
thank you all especially the faculty and practicing physicians in this thread. this is exactly the kind of unfiltered advice that should be in every Caribbean medical school orientation packet
BenjaminWard (Student)
Wow, this exceeded everything I was hoping for when I posted this question. The combination of student, faculty, coordinator, parent and attending perspectives here gives a genuinely complete picture. My main takeaways are that placement infrastructure at accredited schools is more organised than rumoured, but the financial and logistical demands of clinical years are real and underreported. Going to do a much deeper cost analysis before making my final decision. Grateful for this community.
LillianStone (Aspiring student)
Something I want to add about the elective rotation process that nobody mentioned. Start building your audition rotation list during your second year of basic sciences, not when you enter clinicals. The programs you want to do audition rotations at often have waitlists months or even a year out. If you show up at the start of third year and try to book competitive audition rotations, you will find the spots already gone. I sent my first batch of emails to rotation coordinators in semester four and still only landed half of what I wanted.
Scarlett (Student)
LillianStone (Aspiring student) wait, you email rotation coordinators directly from the school? Like cold outreach to hospital programs? I had assumed the school handled all of that. This is clarifying something I was totally confused about.
LillianStone (Aspiring student)
Scarlett (Student) for core rotations yes the school arranges those. The school has affiliate agreements and you get assigned. But for audition rotations, which are the electives you do specifically to be seen by a program you want to match at, that is almost entirely on you. You identify programs you want to impress, find the rotation coordinator contact on their website, and send a professional email asking about sub-internship or audition rotation availability. Your school can provide a template and a letter of good standing but the outreach is yours.
