If you have the tools to be a doctor you can do it Caribbean or not but you won't be spoon fed. I taught myself clinical medicine. I skipped probably half of my clinical rotations but I scored well on CK. I know many people who did well and are in good residencies - Mayo, Dartmouth, John Hopkins, etc... Just look at the avg board scores of the different caribbean schools and it'll give you a good picture. I know several who scored 260+ on the steps. You can forget about plastic, rad, derm although I know someone who matched into an Ophthalmology residency (her dad was an ophthalmologist). I'm not going to list the pros and cons because it's too complicated. If you know you want to do it and you can succeed in it then go for it but 20% quit/fail in the first few semesters of most caribbean schools because they weren't cut out for the rigors of medical school.