Category: Caribbean Medical School

Most Caribbean medical schools don’t publish their attrition rates online.

So, we conducted a simple study in order to estimate the dropout rates at the Big Four (Saint George’s University, Saba, American University of the Caribbean, and Ross).

We reached out to at least 10 students and alumni from each school and asked them to estimate their school’s attrition rate. We then averaged their responses.

Here are the results.

AUC appears to have the lowest dropout rate at around 20%, while Ross has the highest.

Obviously, this is a small sample size. Because of this, these results don’t reflect the actual attrition rates at these schools by any means.

However, it does give us some insight into those rates.

Notes:

We reached out to students/alumni in ~2017.

SGU is the one school I could find that has an attrition rate on its website (7-12%). However, the statistic doesn’t appear to be a hard ‘average’, as the post says the dropout rate is ‘”usually” between 7-12 percent. So, I would take this stat with a grain of salt as well.

Many students plan to go to medical school in the Caribbean with the hopes of returning back to the United States to practice medicine. It’s actually a path many have taken. However, students considering applying to Caribbean medical schools should be well-informed about the potential drawbacks of going this route.

Below are some potential negatives of attending an offshore medical school in the Caribbean.

1) High attrition rates

Many medical schools in the Caribbean appear to have higher dropout rates than allopathic (M.D.) and osteopathic (D.O.) medical schools in the US. To make things worse, some Caribbean medical schools don’t publish their attrition rates, which lures many students into a false sense of security when applying and thereafter.

I’ve seen student-estimated attrition rates of Caribbean medical schools range from 10% to 75%.

However, please note that a decent percentage of this estimated dropout rate results from students choosing to leave medical school on their own (often within the first two weeks) due to a variety of factors (getting into a US medical school, realizing medicine is not for them, inability to adapt to island life, etc).

The rest of the attrition rate results from students failing to keep up academically. Many medical schools in the Caribbean set their own academic bar, and students below that bar are forced out.

2) Potentially lower residency match rates

Some Caribbean medical schools appear to have lower residency match rates than US allopathic medical schools. I also could not find match rates for certain Caribbean medical schools (which concerns me).

It’s certainly possible to graduate from a Caribbean medical school, but not match into a residency program back home upon graduation.

Some students I’ve talked to were forced to take a year off after graduation to improve their resume before applying to residency programs again.

However, residency match rate definitely varies by school, though, and I would encourage you to check your school’s website to get an accurate number. Some of these schools actually have high residency match rates.

3) Lower match list strength

In addition to having a more difficult time matching, Caribbean medical students might also have a harder time landing a residency position in a competitive specialty (dermatology, orthopedic surgery, radiology, general surgery, emergency medicine, etc).

They’ll be competing against students at allopathic and osteopathic US medical schools who are bright and might be coming from schools with better reputations.

Whatever the reason, Caribbean medical students often times end up in less-competitive primary care specialties like internal medicine, family medicine, pediatrics, etc.

Why are they less competitive? In my opinion, primary care specialties are not as desirable simply because they pay less than other specialties.

4) Expensive tuition

Certain Caribbean medical schools often cost more than the average medical school in the US.

Students at Saint George’s University, for example, can expect to pay over $250,000 for tuition in total. Students with in-state residency status at medical schools in the US will pay significantly less than this, although out-of-state students might end up paying around the same depending on the school.

Note: Certain Caribbean schools are cheaper than others, though, and again please check your school’s website to get an accurate number. Not all are expensive.

But doctors make a lot of money, and I’ll be able to pay off my tuition loans fast, right?

Yes, all doctors take home a decent amount. However, remember that doctors coming from the Caribbean oftentimes end up in lower-paying specialties and might have larger student loans. Caribbean medical students, therefore, might have a harder time paying off those loans off in the future.

5) Larger class sizes

Class size definitely depends on the school, but a couple of Caribbean medical schools have larger class sizes compared to US medical schools. For example, I talked to one Caribbean medical student who informed me there were 1000 people in his starting class.

I should mention that many of these schools offer smaller class sessions outside of these giant lectures to compensate. Nevertheless, I don’t think the material is going to be spoon-fed to you, and you’ll probably have to get good to a certain extent learning on your own (which isn’t necessarily a terrible thing, though).

6) A certain percentage of students take longer to graduate

From the students I have talked to, it appears that some students will take more than four years to graduate. If a student fails a class, some schools will allow them to take the class over again (which causes some extra time to be tacked on to their medical school education).

I’m honestly not sure how this compares to US medical schools, but my guess is that this is more common in the Caribbean.

Going to medical school in the Caribbean also has its perks. You’ll most likely be able to spend at least two years on an island with amazing weather and experience a culture different from your own. You will also still receive an M.D. (unlike if you went to osteopathic (D.O.) medical school in the US).

Graduating from a Caribbean medical school and matching into a residency thereafter is definitely possible, but it is important that you understand the potential risks associated with the path. If you are still interested, please check out what some Carribean medical students have to say about their medical schools (SGU and Ross).

What are the best Caribbean medical schools? Which schools will give you the greatest chance of landing a residency position in the United States following graduation? We’ll answer these questions below.

This post ranks the top Caribbean medical schools on the following criteria: attrition (dropout) rates, USMLE Step 1 pass rate, class size, residency match rate, match list strength, incoming student statistics, housing costs, and location.

These schools are then ranked overall following the analysis. To see the final rankings and skip the analysis, click here

The Top Caribbean Medical Schools

There are many medical schools in the Caribbean, but only a handful will allow you to practice medicine in all 50 states in the US. Those schools include St. George’s University School of Medicine (SGU), Saba University School of Medicine, American University of the Caribbean (AUC), Ross University School of Medicine, and The American University of Antigua (AUA). 

SGU, Saba, AUC, and Ross (commonly known as the “Big Four”) have been around for a while, unlike AUA (which was founded in 2004).  Because AUA is newer and less established than the others, it will not be discussed in this post. However, I believe AUA is a viable option as well, so feel free to look into this school also.

Therefore, I will only be ranking SGU, Saba, AUC, and Ross.

Attrition Rates

Not all Caribbean medical students end up graduating. Some leave for personal reasons, and some also can’t keep up academically. 

Since I was unable to find most of the Caribbean medical schools’ published attrition rates online, I instead conducted a simple study to make a guestimation for each school. I reached out to at least ten students and alumni from each school and asked them what they thought their school’s attrition rate was. I then averaged their responses. 

Here are the estimated attrition rates for each school:

Note: SGU was the only school I could find that publishes an attrition rate for their school (7-12%). However, this number doesn’t appear to be a hard average.

AUC’s estimated attrition rate is the lowest of all four.  However, SGU is not far behind, and the attrition rate on their website is very low. AUC and SGU both seem like good options to me.

Just to put things in perspective, the dropout rate at an allopathic (M.D.) medical school in the US is only 4%.

Why do the best Caribbean medical schools appear to have such high attrition rates? In my opinion, a decent number of students who gain admission to Caribbean medical schools have failed to get into US medical schools, and oftentimes aren’t the cream of the crop or don’t have the strongest academic backgrounds.

These students oftentimes just can’t make it through the rigors of medical school. Larger average class sizes at Caribbean medical schools probably also play a role.

Whatever the reason, the attrition rates at the Big 4 are higher than those on average at US allopathic medical schools.

USMLE Step 1 Pass Rate

The USMLE (The United States Medical Licensing Examination) is an exam taken by medical students interested in practicing in the United States. Step 1 of the USMLE is the first part of the three-part exam and is usually taken after the second year of medical school. A high pass rate on this exam is indicative of a medical school preparing its students well for a career in medicine.

First-time USMLE Step 1 Pass Rate:

The average pass rate for students at US/Canadian (M.D.) schools for Step 1 in 2017 was actually 94%. SGU, AUC, and Saba surprisingly actually all had higher pass rates than this. Saba’s score was especially impressive (although no year was given for Saba’s).

Note: I talked to some Caribbean medical students about the USMLE. Some schools might not let you sit for the USMLE until they think you are prepared (which might explain the high step 1 pass rates).

Tuition

Caribbean medical schools are expensive, although allopathic and osteopathic medical schools are pricey as well (especially for out-of-state students). Here are some ballpark estimates of how much you’ll end up paying over four years at each school. 

Note: These numbers were calculated in 2018.

SGU and Ross appear to be the most expensive, while Saba seems to be the cheapest. To put things in perspective, Harvard medical school tuition and fees for first-year students is $44,522. Therefore, students will end up paying around $178,000 over four years at Harvard.

Using Harvard as a reference point, you’ll probably end up paying more for medical school than you would in the US if you attend SGU or Ross.

Class Size

Smaller classes generally allow students to get more attention from professors, and therefore learn more and perform better. Here are the estimated class sizes at the schools in the Big Four:

Note: Again, I had a tough time finding class sizes for these schools. I reached out to three students at each school and asked them to make a class size estimation. These numbers do not represent actual class sizes at the Caribbean medical schools but are a rough approximation.

It seems like you might receive more individualized attention from professors if you go to AUC or Saba. Ross and SGU appear to have huge class sizes.

However, from the students I have talked to, there often seem to be resources outside of lectures (like discussion sections) which allow students to learn in a smaller class size setting.

Residency Match Rate

During their final year of medical school, medical students apply for residency programs. To become a doctor, you must do some sort of residency following medical school (at least in the US, as far as I know). The residency match rates for each Big Four school are listed below:

The only statistic on Ross’ match rate I could find was from a flyer posted on Reddit, which stated that their match rate was 99%. However, this rate included students over two years and only applied to students who had passed the USMLE exam on their first attempt. Because of this, it’s really hard to directly compare this match rate with the others. 

SGU appears to have one of the stronger residency match rates and is almost on par with that of allopathic medical schools. AUC isn’t too far behind, though, and Ross might be close as well (but we don’t know for sure).

Match List Strength

Some residency positions are harder to get than others. Specialties like dermatology and orthopedic surgery are notoriously difficult to match into and are generally reserved for students who graduate at the top of their class and have excellent USMLE scores. Generally, competitive specialties are competitive because of the higher pay, better work-life balance, or more desirable work.

Some Caribbean medical schools seem to give their students a better chance than others at matching into competitive and slightly competitive specialties.

The match lists of the various Caribbean medical schools for 2017 were analyzed, and the results are listed below.

Criteria:

Very Competitive Specialties: Plastic Surgery, Neurological Surgery, Dermatology, Orthopedic Surgery, Vascular Surgery, Otolaryngology, Radiation Oncology, Urology

Slightly Competitive Specialties: General Surgery, Diagnostic Radiology, Anesthesiology, Emergency Medicine, Obstetrics and Gynecology

Not Competitive: Internal Medicine, Pediatrics, Family Medicine, Pathology, Physical Medicine and Rehabilitation, Psychiatry, Neurology

Note: The division between very competitive, slightly competitive, and not competitive was mainly made based off of online research from blog posts and personal opinion. 

Looking at the results, SGU and Ross seem to have the strongest match lists, with AUC trailing close behind them. Not many students at any school matched into very competitive specialties. 

Incoming Students Statistics

Some Caribbean medical schools are able to recruit students with higher MCATs and GPAs. You could make an argument that this implies something about the prestige of the school.

No school seems like it’s a clear winner, although SGU and AUC look like the best options for this category.  Saba strangely has the lowest GPA, but the highest MCAT.

Cost of Living (Housing)

Although probably the least important ranking factor, housing costs should still be considered. These additional costs add to the expense of going to the Caribbean for medical school.

I decided to compare the on-campus housing rates at each school to determine which was the most expensive.

Unfortunately, I wasn’t able to compare the same housing type for every school. But, I figured I could make a rough approximation using the data above.

After looking at the data, SGU appeared to be the most expensive. Students with their own bedroom and a shared bath can expect to pay around $1800 over the course of a year. Compared to a similar apartment at AUC, SGU is almost twice the cost.

Because Saba only offers single dormitories, it’s tough to directly compare it with the other schools. Nevertheless, Saba appears to be very inexpensive.

Here’s my final housing price ranking:

1. Saba (cheapest)
2. AUC
3. Ross
4. SGU (most expensive)

Location

All four Caribbean medical schools are located on different islands within the Caribbean, and therefore have different things to offer their students outside of medical school.

AUC:

AUC is located on an island, Saint Martin, in St Maarten (population: 33,609). St Maarten is a part of the Netherlands and is one of the most developed and touristy islands of the Big Four. It’s known for its shopping, casino resorts, bars, beaches, and ‘good island life’.

Saint George’s University:

SGU is located in Grenada (population: 107,317). It’s considered to be less touristy and more undeveloped than St Maarten, but more than Saba. Grenada is known for its beautiful beaches, food, and hiking.

Ross Medical School:

Ross is located in Barbados (population:  285,719). Ross recently relocated here from Dominica due to Hurricane Maria. Like Saint Martin, this island attracts tourists and is developed. 

Saba:

Saba University School of Medicine is located in Saba (population: 1,824), an island only five square miles in size. This is by far the smallest island in the Big Four. The island has no beaches and is instead known for its hiking, diving, and snorkeling. Saba is the most undeveloped island of the Big Four.

Conclusion:

Here is my final ranking of the best Caribbean medical schools:

1. SGU
2. AUC
3. Saba
4. Ross

In my opinion, SGU is the front-runner. The school appears to have one of the lower attrition rates, a strong match list, decent residency placement rate, and decent incoming student profiles. The only real negative of SGU is its tuition. However, the school seems to give its students the best chance of becoming a physician in the US out of the Big Four. 

AUC appears to be the next best option. Its attrition rate seems to be lower than Ross’ and Saba’s, and the school also appears to have relatively small class sizes and cheap tuition. AUC’s surroundings are nice as well, although some may view St Maarten’s beautiful beaches and good island life as a distraction during medical school.

I put Saba third. Due to the school’s low tuition, high USMLE pass rate, and small class sizes, I placed it above Ross. 

Though I put Ross last, the school did boast a strong match list in 2017. Although, the school is also relatively expensive and appears to have decently large class sizes.

I would encourage you to also take a look into allopathic (M.D.) or osteopathic medical schools (D.O.). Some believe that M.D. and D.O. schools provide their students with an easier path to becoming a physician. Regardless, please do your own research (on the schools’ attrition rates, class sizes, etc) for whatever Caribbean medical school you end up choosing if you do end up going this route.

Want to read more about Caribbean medical schools? Check out this SGU student interview and Ross student interview.

Below is an interview with a Saint George’s University School of Medicine (SGU) 3rd year student. Questions encompassing academics, drop out rates, daily life in the Caribbean, and more at SGU were explored below.

Question: How are the professors/lectures at SGU?

SGU Student: Most are excellent. One of the world’s top anatomists teaches at SGU. He wrote the book Grey’s Review. I also had guest lecturers from top US medical schools like Harvard, UCSF, Stanford, UCLA, Duke, Cincinnati, etc.

Are lectures required?

When I was taking classes at SGU, an 80% lecture attendance was mandatory. My strategy was to go to as many lectures as possible at the start, so if I slept in a day, got sick, or needed to cram more for finals I was not risking dropping below that 80% attendance mark. Most of the lectures were recorded, so if you missed a day, you could watch the lectures via an online program called Sonic. 

There were 4-8 hours of class and lectures a day depending upon the term and day.

Can you give a general overview of the first four years at SGU?

The first two years when I was there were as follows:

Term 1:

Medical Human Anatomy + Lab

Medical Histology and Cell Biology

Medical Biochemistry

OSCE 1

Term 2:

Medical Bioethics

Community and Preventive Medicine

Medical Physiology

Medical Neuroscience

Medical Immunology and Medical Genetics

OSCE 2

BSCE1

Term 3:

Cognitive and Behavioral Science

Medical Law

Medical Bioethics

Health Insurance

Child and Developmental Psychology

OSCE3

Term 4

Pathology

Medical Microbiology

Communication and Physical Diagnosis

OSCE 4

Term 5

Pharmacology

Pathophysiology

Introduction to Clinical Medicine

Basic Science Foundation and Clinical Reasoning

However, from my understanding, SGU is changing to a single class system. The info above will still be covered, but will focus on a body systems based style of teaching (instead of having many individual classes).

Summer between year two and three:

USMLE Step one (the most important test for a medical student trying to practice in the US)

Year Three:

Core rotations: (I’m here now).

Year Four:

Optional Rotations

What is the attrition rate (i.e. what percent of students drop out?

I don’t know the exact numbers. My class started off with about 1100 students, and by the end of two years dropped to 671. Some students don’t show up to the first day of class. Some students — from the moment they arrive in Grenada — don’t like the island/have never been away from home and leave within the first month (getting almost a full refund).

By the end of the first month, the class was down to about 980.

By the start of the second term, that number dropped to about 800.

By the start of the third term, there were about 700.

By the end of the fifth term, there were about 671.

Note: These students may not necessarily have dropped out. They could have also been held back, or taken a term off to attend to personal matters. 

How do students drop out?

There are a variety of ways. Cheating is an automatic fail. I know of a student who was kicked out for “unprofessionalism”, which covers a variety of unprofessional behaviors. Some drop out because they fail two semesters. Although, I know of one student who was given a third chance due to extenuating circumstances. However, this person had to go through an appeals process. Others fail to maintain a cumulative GPA of 75%.

Some people also choose to leave, which accounts for a portion of the attrition rate. I knew someone who became paralyzed in a car accident and ended up leaving SGU. I also had another friend who passed away from cancer. Some people cannot pay the tuition.

Is there a test you have to sit for before taking USMLE Step 1?

After completion of your second year of medical school, SGU requires you to take the British equivalent of the USMLE.

If so, what was the pass rate of that?

I don’t know the exact number, but ~7/671 did not pass on their first try. Each of those 7 got another chance, and I would guess that at least 5-6 of those passed on their second try.

Is there anything important you can add about the USMLE Step 1?

It’s the most important test of your life as a medical student, so do the best you can. It is the most grueling test I have ever taken. It is about 8 hours and 280 questions long. The pass rate now in 2018 is a 194. The average score is somewhere between a 220-230 depending upon the year. For more info, check out First Aid 2018 which will give you the most up to date results.

How difficult is it to get the rotations/clerkships/electives you want?

I’m not there yet, so I can’t answer that one. I do know that SGU sets up each student’s core rotations for their third year. From my understanding, fourth year rotations are the duty of the student to set up. I believe resident hiring managers look most closely at applicants’ USMLE scores (hence its importance).

What percent of graduates from SGU successfully match in a residency position in the US?

I don’t know, but I can say that the match results SGU publishes (edit: 2017 SGU match rate is 93%) only consider those they allow to submit an application to the “match”.

What is life like outside of SGU?

I arrived a week early before school started, so I could enjoy what Grenada had to offer and go grocery shopping (which I ended up doing once every two weeks thereafter), get my books, buy other items, etc. While at SGU, I got certified as a Rescue scuba diver, and was able to go on 30 dives total during my first two years on the island. I was also able to go bowling three times, see three movies at the cinema, and go to the beach occasionally to swim (for exercise). I went on an island tour of Grenada, where I visited places like the chocolate factory, rainforest, and various waterfalls. During my last semester, I played on an intramural basketball team.

SGU offers a variety of Extracurricular activities. I was personally apart of Internal Medicine Group, International Federation of Medical Students Association, and the Christian Student Association, but there are many others.
Because of the monthly meetings after school, though, I was hard pressed for time due to my studies. There was also a weight room that I used.

There are many other intramural sports, medical groups, and tourist activities. Many of my friends enjoyed going on runs through the surrounding community after class or in the mornings.

How are the living conditions near SGU?

I can’t really speak too much about this, since I lived on campus for two years. I lived in both a double and an apartment split between me and two other roommates — I preferred the apartment. There are a wide range of accommodations near SGU, like a free bus system. Students who choose not to utilize the bus system typically buy used “island cars” or mopeds, which can range from reasonably priced to expensive.

Is there anything else you can add or advice you can give to future students at SGU?

Work harder than you ever thought possible. Be nice to everybody you meet. Scores matter. Sleep well. Eat right. Try to get exercise. Reduce needless distractions. Friends are important, but the closest friends I made were my study partners. Get into a good study group. My faith and my family were always there for me when times got tough.

Sincerely,

An anonymous 3rd year medical student at SGU

Below is an interview with a Ross University School of Medicine (Ross) student. Questions concerning academics, drop out rates, daily life in the Caribbean, and more at Ross were explored below.

Question: How are the professors/lectures at Ross?

Ross Student: The professors and lectures were great in my opinion, although some were obviously better than others. I personally feel like it might depend on the student’s learning style, though.

Most lectures were PowerPoint presentations, and they were all recorded. Attending lecture was encouraged but wasn’t mandatory. Some students went to lectures, while others chose to stay at home and watch them on the computer later.

Can you give a general overview of the first four years at Ross?

You’ll be taking basic science courses your first two years at Ross. Ross uses a system based curriculum, which I believe has been revamped even more since my time on island. It’s modeled after the US system in many ways (if not pretty much the same). When I was there, you could go to lecture, or you could watch lectures online. All lectures were recorded, and you could access them at any time.

My first semester was basic sciences on steroids (biochemistry, cell biology, pharmacology, anatomy, etc), while my second semester was more systems based and focused on physiology and pharmacology. My third and fourth semesters revolved more around pathology and disease pathophysiology.

After fourth semester, we had to sit for a comprehensive test, which tested our readiness for Step 1. We then came back to the mainland to take Step 1.

We then started IMF (Intro to Medicine Foundations), a six-week boot camp, which got us ready for the core electives in hospitals.

After this, we completed two years of electives/rotations at sites of our choosing (or sites assigned to us by Ross).

What is the attrition rate (i.e. what percent of students drop out?)

That is a difficult questions to answer accurately.

Ross has two tracks: the fast track and the slow track. On the fast track, you complete the (first) two-year curriculum in four semesters, while on the slow track you complete the two-year curriculum in five semesters.The slow track spaces out the material and gives students more time to study.

All students start on the fast track, but they can decide to move to the slow track if they wish.

Also, if you do not score above the MPS (minimum passing score) in a semester, you are forced to repeat a semester. However, I have heard that the MPS might have changed a bit since I was at Ross.

It’s therefore hard to tell who actually drops out due to the two tracks.

How do students flunk out?

Students flunk out if they don’t do the work or can’t figure out an effective study method. Everyone is given access to tutoring free of cost, and you can attend group tutoring classes or request a personal tutor. The faculty was also approachable and helpful if you had questions regarding specific material.

Flunking out happens when you don’t take full advantage of the resources the school provides you with. I personally used all the resources available to me and more! Every student on island is also really helpful, and if you have questions anyone will be happy to help you. Make a strong group of friends and develop good study habits and you’ll be set!

Is there a test you have to sit for before taking USMLE Step 1?

Yes, it is called COMP, and it is mandatory to pass in order to sit for Step 1. I believe the pass rate for COMP was 70% when I was there, but don’t quote me on that as I’m not too sure about that number.

If you failed, you were given an extra month (or more) to go back to the mainland, prepare for the test again, and retake it free of cost. I believe you’re given three tries (four if you appeal to retake it). Don’t feel scared or intimidated; if you’ve done the work you’ll pass it.

How difficult is it to get the rotations/clerkships/electives you want?

It’s not difficult at all; Ross has connections to many places. You can do your full core track at any of Ross’ given sites. For an accurate list of affiliate hospitals, visit Ross’ website. States include California, New York, Georgia, Florida, Illinois, Michigan, New Jersey, Connecticut, and more.

What percent of graduates from Ross successfully match in a residency position in the US?

I’m not sure, although we do have a high rate of people matching into all specialties (including some competitive ones). You can visit Ross’ website to see their match list, which will tell you where our graduates have gone for residency. I am actually currently applying for the match, and I feel pretty good about the number of interviews I’ve had thus far.

What is life like outside of Ross?

There are many activities and opportunities students are able to take part of on the island. I spent most of my time at the beach with friends when I wasn’t studying. I also really enjoyed exploring the island.

If you’re an outdoorsy person you will NOT run out of places to see and things to do (like hiking, kayaking, trails, sulfur spas, etc). Plus, there’s a lot of food options both near Ross and in nearby towns. A farmers market occurs every weekend as well, where locals sell fresh produce (which I took advantage of).

The school also has a fully equipped gym, tennis courts, and basketball courts that many students use.

How are the living conditions near Ross?

I can’t comment much on the current situation/standard of living post-hurricane, but while I was there housing was readily accessible. Housing ranges from studios (which was my first place) to nice apartments with beautiful views of the beach (with some right on the water).

Apartment prices definitely vary, but you will probably be able to find something for very cheap if that is what you are looking for. I rented a two bedroom apartment (which I split with my partner), and ended up paying around $400 (US dollars). This included cleaning and laundry services (where they basically picked up my laundry at home and folded/ironed everything for me). It was awesome!

Is there anything else you can add or advice you can give to future students at Ross?

If you want to be a doctor and you’re hesitant about investing your time, stop doubting yourself! You already have the most important thing you need to make it: desire. Let that drive you in everything to do moving forward and good luck!