I agree. Getting an integrated plastics spot from a caribbean school is extremely difficult. Best bet is to either apply as a transfer student to a US allopathic or apply to the best academic gen surg spot you can get and apply plastics as a fellowship. In fact, I don't know of anyone or even heard of anyone that match integrated plastics directly from a caribbean school. That being said, I have several good friends and have personal experience in those who have transferred from caribbean schools to US allopathic schools and matched integrated plastics. good luck!