Aside from that thing, I know that foreign students need to have a high Step 1 score As far as matching into a U.S residency is concerned. The only way for any foreign graduate to be seriously considered for a U.S or Canadian residency is if you have a High Step 1 score. In your case, your Step 1 score will need to be even higher than the Caribbean students since no U.S. doctor is familiar with you. Caribbean students have the benefit of completing their last 2 years of medical school at US-based hospitals, so they become familiar with U.S doctors. You can try to arrange clinical electives at U.S hospitals when you're in your last 2 years of medical school, but that process is expensive and will require a visa. If your Step 1 score is 250 or above, then you will be taken seriously by U.S and Canadian residency directors. Your class rank and having strong letters of recommendation will also help you a lot.
That is how foreign students get into residency. I am not saying this from my own. I asked a U.S. doctor by contacting him through his email address.
Apart from that, I need information about the other things, too. I read that it will affect our curriculum. And if it does then I imagine it will also make it easier to score in Step 1. And the letter of recommendation will also be credible.