100% agree with Gunner. In my experience (> 15 years), one has to actually work at failing OMM/OMT, and my DO colleague's theory and practical questions can be rather a PITA for my students.
One of the points of the merger was to squeeze out the IMGs. FMGs are different animals and have very good training. Do not think that the random PD will suddenly have open arms for IMGs. Once again, quoting the wise gyngyn:
The pool of US applicants from the Caribbean is viewed differently by Program Directors. The DDx for a Caribbean grad is pretty off-putting: bad judgment, bad advice, egotism, gullibility, overbearing parents, inability to delay gratification, IA's, legal problems, weak research skills, high risk behavior. This is not to say that all of them still have the quality that drew them into this situation. There is just no way to know which ones they are. Some PD's are in a position where they need to, or can afford to take risks too! So, some do get interviews.
Bad grades and scores are the least of the deficits from a PD's standpoint. A strong academic showing in a Caribbean medical school does not erase this stigma. It fact it increases the perception that the reason for the choice was on the above-mentioned list!
Just about everyone from a Caribbean school has one or more of these problems and PDs know it. That's why their grads are the last choice even with a high Step 1 score.