The departments of education from both United States and Canada contacted the Educational Commission for Foreign Medical Graduates (ECFMG) and has required that all Caribbean Medical Schools be at the standard of United States and Canadian medical schools, this led the ECFMG to the Caribbean Accreditation Authority for Education in Medicine and other Health Professions (CAAM-HP) organization who will be assessing all Caribbean medical schools, and those schools that do not receive CAAM-HP certification will not be eligible for ECFMG certification, this means that the students will not be able to complete neither USMLE examinations nor MCCQE, and therefore will not be able to become United States or Canadian doctors, if their school is not certified by the year 2023.