Caribbean medical schools have long been decried as diploma mills for the rich and undeserving; they are strictly for-profit institutions serving American kids rejected by U.S. medical schools, yet they rely on hospitals in the U.S. to provide the necessary clinical experience in the third and fourth years of a medical education. Recently, however, an effort has begun in New York City to limit their access to local hospitals since there are only a certain number of spots available for such field work, and charges of elitism are flying. Yet how did foreign and domestic medical schools come to be competing for the same spots in domestic hospitals?

Because Caribbean medical schools are first and foremost businesses, they take just about anyone able to pay, especially those rejected by more prestigious American schools. At an elite institution like Weill Cornell Medical College in New York City, donors from investment banker Sanford I. Weill to real estate developer Isaac Toussie provide a lot of money, reducing costs to around forty-five thousand dollars a year. Compare that to the Caribbean ones, where it can cost up to sixty thousand dollars!

Now, due to such high fees, Caribbean medical schools can easily pay New York City hospitals to take on their students for the practical clinical experience required of an accredited medical education – ahead of Weill Cornell’s, or NYU’s, or that from any other New York medical school.

This is the business of a medical education today.

Traditionally, hospitals agree to mentor, in effect, a medical school’s students because they like to be associated with prestigious names. And though Caribbean institutions are not prestigious, they have tons of money, which is a most important consideration, naturally.

And what hospital administration could possibly refuse such funds, particularly with this economy?