The increasing number of health professions students, coupled with a shift to ambulatory care and shorter hospital stays, has created a shortage of clinical training sites around the world. The authors present data on accreditation, quality, cost, and student indebtedness related to medical schools in the Caribbean-schools that some view as taking clinical training sites in the United States away from U.S. medical schools. Accredited medical schools around the world may benefit from considering a mechanism for global educational exchange to meet the challenge of clinical training.