u/Queasy-Cry-7334

I’m very interested in applying and hopefully enrolling in a Caribbean medical school. I have lived my entire life in Europe, including my graduate studies (‘I’m a mature applicant’). However, due to family ties I’m a USA passport holder (dual citizen). I’m very confused on the application process. Does having a USA citizenship trigger a USA application rather than an international application? The pre-reqs of the two different applications streams vary quite a bit, which makes sense since education is different. I’m struggling to understand why the passport itself would trigger a USA application stream – surely it is based on country/education system you apply from.

 A bit about me: I wasn't very focused in school and didn't really mature until my early 20s. Healthcare was always the goal, but my school grades weren't good enough for medicine. I did a conversion year, completed a 4-year osteopathy degree, graduated with distinction, and was ready to sit the UCAT. Then COVID hit alongside some major family uncertainty about staying in the UK, and I had to pull out.

I stayed, discovered ACP, and six years later I'm solidifying a role as MSK ACP embedded in ortho, midway through  the MSc. I'm well-respected in my team and trusted clinically. I must say I agree with a lot of the things on the doctorsuk reddit page, and I guess I compensate by learning and hitting the books as much as possible.

I’m in my early 30 now thinking about a family but the itch for med school never left. My conundrum:

1. Apply to GEM.  But early 30, thinking about starting a family, and the finances are genuinely uncertain. We immigrated to the UK; I have some support but not sure how we would do it with kids

2. Train as a paramedic (MSc, 2 years) and work my way towards EM ACP - dual registration as MSK ACP and EM ACP. Stay within the ACP pathway and continue to push as far as it will go. I have really enjoyed all my placements in acute care, and it is genuinely an area that I feel I would enjoy.

I want to be a competent clinician, respected by my peers. I don’t need to be the top consultant - I would be happy operating at a senior trainee level with consultant oversight. I think what drives this uncertainty the most is I always want to push myself and do more.

From those who went GEM at a similar stage how did you manage? And from those who stayed in the ACP/paramedic route do you feel the ceiling?

No wrong answers - just trying to make a decision I won't regret.