Medical education in the Caribbean: variability in educational commission for foreign medical graduate certification rates and United States medical licensing examination attempts

Acad Med. 2009 Oct;84(10 Suppl):S13-6. doi: 10.1097/ACM.0b013e3181b38d1c.


Background: The purpose of this study was to investigate demographic characteristics and performance outcomes of Caribbean-educated physicians.

Method: The study included almost 20,000 Caribbean-educated students/graduates who registered for an exam leading to Educational Commission for Foreign Medical Graduates (ECFMG) certification during the study period. We summarized United States Medical Licensing Examination attempts and ECFMG certification rates (1996 to January 21, 2009), by country of medical school.

Results: The proportions of females and non-U.S. citizens attending medical schools in the Caribbean are increasing. Average exam attempts for certified individuals ranged, by country of medical school, from 1.19 to 2.84 for Step 1, from 1.20 to 2.13 for Step 2 Clinical Knowledge, and from 1.01 to 1.42 for Step 2 Clinical Skills/ECFMG Clinical Skills Assessment. Approximately 14,000 (74.2%) individuals achieved certification, and success rates ranged, by country, from 19.1% to 91.5%.

Conclusions: There is significant variability in the average number of exams taken and ECFMG certification rates of Caribbean-educated physicians.

MeSH terms

  • Adult
  • Caribbean Region
  • Certification*
  • Education, Medical*
  • Female
  • Foreign Medical Graduates*
  • Humans
  • Licensure, Medical*
  • Male
  • United States