Quoted: How to improve?

[Doodledog]

A student asks:

I am 36 and have applied unsuccessfully to US med school 2x. In between the first and second attempt, I received my MPH (GPA 3.7) from a high ranking US school and have been working as an infectious disease epidemiologist for an underserved urban population for over 7 years. I recently re-took my MCAT 7P, 11V, 10B. I applied widely and was interviewed at a high ranking US school but no where else. I have ECs and research and three great letters from professors at my school in addition to my public health experience. My UG GPA is a 2.9 and science is even lower, so I understand AdComs not giving me the time of day, but I graduated over 14 years ago. Since my GPA is so low, I have not had much success with post-bac or SMPs either. So, is it just too late for me? I feel like I am running out of time. I was accepted to a Caribbean School and I am contemplating going. If I thought there was something I could do to get into a US school, then I would try and do it. I have family and I am the sole source of income so just going back to school part-time to take classes would not be feasible since I would not be able to take out loans.

So, my questions are:
1. Try again for US or Caribbean school?
2. If I try again, SMP or post-bac? Since my UG GPA is low, I am thinking post-bac.
3. Even if I get my GPA up over 3.0, does it really matter? My GPA is not going to be competitive unless I do another B.S.

At the poster's request, I have edited out the actual name of both the poster's school and the Caribbean School to which they were accepted, which is one of the higher ranking, better known Caribbean schools.

This is a difficult question that no one can clearly answer. There can be no general consensus as no one admissions committee member can know what others will do. Still, given your past unsuccessful efforts, if you are comfortable with the match lists of the Caribbean school to which you have been accepted, this may be a reasonable route for you. No one knows whether you will obtain a match in the field of interest for you, but there are no guarantees for anyone. I post this so others may comment, although this general theme is often discussed on SDN.

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[NotAProgDirector]

As an IM program director, I can comment on what will happen after you complete a Carribean school. The Carribean schools work on a different system than the US med schools -- the US schools screen tightly, and hence most people getting in graduate and match (>95% for sure). The Carrib schools have looser admissions, and tend to have people fail out much more commonly.

So:
1. If you go to a Carrib school and do well, especially on the USMLE's, you should match into an IM program. Assuming from your background that you are interested in ID, that's a non-competitive specialty now (although in 6+ years, when you'd be applying, who knows?)

2. If you do not do well with standardized tests, and do poorly on the USMLE's, you may not match at all. This will leave you with med school tuition and no way to pay it back.

There are no easy answers, as Tildy mentioned above. You may not match geographically where you want, so you should assume that this is a 7 year commitment (4 Med Sch + 3 IM) of being flexible.