For Jesse Cottrell, a fourth-year medical student, the decision to attend the American University of the Caribbean was simple: "I couldn't get into a U.S. school."

Cottrell, who is wrapping up his student rotations at Kern Medical Center, had applied to medical school once before and gotten a few interviews. But he also wanted to attend theology graduate school and opted to finish that degree first. When he reapplied to medical school afterward, he didn't get any interviews.

"And that's how I ended up in the Caribbean," he said.

Cottrell extensively researched foreign schools, only looking at the handful that are approved by all states' medical boards. It wasn't difficult to get into American University of the Caribbean (AUC), he said. He said most students there couldn't get into U.S. schools for a variety of reasons.

But the ones that make it through AUC are the best and the brightest, Cottrell said. And the licensing exam pass rate is high since "they won't let you take it unless you're going to pass."

After doing his medical school rotations at KMC -- which Cottrell describes as one of the few places friendly to international medical graduates -- he got into an OB-GYN residency program in West Virginia.

"You have to face the facts: You're not going to get a residency at Harvard or Princeton," he said. "If I were the program director at Harvard, would I take a Caribbean grad? Probably not."

While that lingering discrimination could hurt him if he chooses an academic route, it will make little difference in private practice, where the playing field levels out, he predicts.

Cottrell might be leaving Kern, but several of the Caribbean students currently rotating through KMC have Bakersfield roots, and say they're eager to practice here one day.

Take David Aguirre, who was born at Kern Medical Center, attended Garces Memorial High School and Cal State Bakersfield. At CSUB he heard about the connection between Ross University and KMC, and thought it'd be a good pathway home.

Now he's doing his medical school rotations at KMC, and hoping to secure a residency spot there next year. Since there aren't enough places in California that welcome Ross students, KMC's "IMG-friendly" approach has made it a school-wide name.

"We want KMC because it wants us," he said. "Everyone at our school knows KMC and would love to come to KMC."

Similarly, Andrew Michael -- who also attended Garces and CSUB -- knew about the KMC connection and plans to stay in the county after residency.

Michael's mom worked at Kern Medical Center and his father, a surgeon who attended medical school in Egypt, did his residency there.

Unlike other international medical graduates, they share the advantage of already having language and cultural understanding of Kern County patients, the two pointed out.

If all works out for the Caribbean students, the winding path home was well worth it -- especially since it involved spending time in an idyllic island paradise, they added.

Maryam Yazdanshenas, who graduated from AUC and is now a KMC family medicine resident, said the slow, happy pace of island life balanced the frenzy of her tough studies.

Her goal: "I'll go to med school, have the benefit of a beautiful island, work hard, do my best and finish my last two years in California."

Yazdanshenas, who spent her childhood in Iran and attended college in Alabama, knew her chances of getting into a California program were slim, but she worked hard and achieved top scores. Yazdanshenas moved to Bakersfield for her student clinical rotations, stayed on for residency and now is considering settling in Kern after her training is over.

The Caribbean connection absolutely feeds doctors into the Kern County community, she said, adding: "That's exactly what happened to me."