MORENO VALLEY, Calif. — It’s easy to dismiss the for-profit medical schools that dot many a Caribbean island as scams, set up to woo unqualified students who rack up huge debts, drop out in staggering numbers, and — if they make it to graduation — end up with an all but worthless degree.

But the schools are determined to change that image. Many are churning out doctors who are eager to work in poor, rural, and underserved communities. Their graduates embrace primary care and family practice, in part because they’re often shut out of training slots for more lucrative specialties.

And they just might help solve an urgent physician shortage in California and beyond.

The deans of two of the Caribbean’s medical schools, Ross University School of Medicine in Dominica and American University of the Caribbean in St. Maarten, are on an aggressive campaign to improve their image. They’ve published a series of editorials and letters with titles like “Why malign overseas medical students?’’ and have hired the public relations giant Edelman to make the case that their humble, hard-working, compassionate students may be precisely the kinds of physicians that America needs most.

“Our students have persevered. They haven’t had all the opportunities in life and they still want to help people,’’ said Dr. Heidi Chumley, dean of the American University of the Caribbean School of Medicine. “Absolutely, we want to get our story out.’’

That story is unfolding on the ground in places like Moreno Valley, a city of about 200,000 in California’s Inland Empire, a former agricultural region just east of Los Angeles. Here, the Riverside University Health System Medical Center rises from a stretch of largely undeveloped land once slated for luxury housing. It acts as the county’s public safety net for an ethnically diverse and mostly low-income population — including patients like retired carpenter José Luis Garcia.

On a recent clinic visit, Garcia, 69, was following up on a urinary tract infection and his high blood sugar. He saw Dr. Moazzum Bajwa, 30, a second-year resident and graduate of Ross.

Sitting eye to eye with Garcia, he spoke in a steady stream of Spanish. The visit lasted nearly an hour.

In an attempt to keep his patient off insulin, Bajwa had asked Garcia to improve his diet and to track blood-sugar levels after meals. “Números fantásticos!’’ Bajwa exclaimed, looking at the folded sheet of carefully written numbers Garcia had brought to show him.

Bajwa, a former middle school science teacher, then spent 10 minutes drawing a careful diagram to explain to a rapt Garcia exactly why certain foods raised his blood sugar. He then examined Garcia and checked his medical records.

As the visit was ending, Bajwa asked Garcia about stress. Garcia said his wife had recently had surgery for glioblastoma multiforme, one of the most malignant of brain tumors. “Wow,’’ Bajwa said quietly as he scanned the medical summary Garcia had handed him. “Wow.’’ He sat down again on his low stool.

“Lo siento mucho, señor,’’ Bajwa said, clearly moved.

Then he gave Garcia a hug.

“This is a very great doctor,’’ Garcia said later, through a translator. “Normally, I don’t feel important.’’

Bajwa, a US citizen raised in Michigan and North Carolina, is the grandson of Pakistani Nobel physics laureate Abdus Salam and holds two advanced degrees, in neuroanatomy and public health. But he couldn’t get into an American medical school. So he attended Ross.

“It was the only school that gave me an opportunity,’’ he said.

There are about 70 medical schools in the Caribbean, most of them established in recent decades and run by for-profit businesses that cater to Americans. These so-called second-chance schools accept students with lower grades and MCAT scores, or sometimes no MCAT score at all. Compared with US medical schools, tuition and dropout rates are higher and class sizes larger. Ross, for example, enrolls more than 900 students per year.

Graduates can practice medicine in the United States after passing their US licensing exams and completing a residency. But the schools have come under fire for generating a stream of students who don’t end up as physicians, but do end up with crushing debt because they flunk out or don’t win residencies.

One graduate of St. George’s University School of Medicine took a poorly paying job drawing blood to help pay off $400,000 in medical school loans. Another graduate of AUC entered nursing school after failing to get a residency.

“Are Caribbean medical schools promising something they cannot fulfill?’’ asked Dr. Glenn Tung, an associate dean at Brown University’s Warren Alpert Medical School who has studied the schools. “What I’m concerned about is the cost to the students who don’t make it and the cost to the American taxpayer when loans aren’t repaid.’’

Illinois Senator Richard Durbin has repeatedly introduced bipartisan legislation to strip the schools of Title IV federal funding for student loans. Three Caribbean medical schools — Ross, AUC, and St. George’s — took in $450 million in federal funding via student loans in 2012, Durbin said.

“These for-profit Caribbean medical schools need to be accountable to their students and to US taxpayers,’’ he said in a statement.

Dean Chumley and Dr. Joseph Flaherty, the dean of Ross, take exception to such criticism.

They acknowledge many for-profit medical schools aren’t doing a good job training and developing students. But they argue that AUC and Ross, two of the oldest Caribbean schools — both owned by the for-profit educational juggernaut DeVry Inc. — are creating successful doctors.

“Obviously, brains help, but judgment, empathy, intuition, that’s all part of it,’’ Flaherty said. “Our students are gung-ho.’’

Just 54 percent of US medical graduates who trained overseas are matched with a residency program in their first year of eligibility. That’s an abysmal record, compared with the 94 percent for graduates of US schools. But Ross and AUC say they have match rates higher than 86 percent. And they say a vast majority of students pass their step 1 licensing exams on the first try.

The schools are also controversial because they buy their way into hospitals to train students. In 2012, Ross inked a contract — beating out rival St. George’s University School of Medicine of Grenada — to pay $35 million over a decade to the cash-strapped Kern Medical Center in Bakersfield in exchange for the lion’s share of the hospital’s roughly 100 rotation spots for third-year medical students.

Some critics fear such deals will squeeze American-trained students out of rotations; disputes have flared in New York, where St. George paid $100 million for rotation spots, and in Texas, where lawmakers attempted to ban Caribbean students from training in the state.

But Flaherty, Ross’s dean, said such deals are a win-win. A struggling hospital gets funds. His school, which has no teaching hospital, gets a place to train students.

“The doctors get to know our students and say, ‘These guys are good,’ ’’ he said.

While their numbers are up, it’s still harder for international medical grads — known as IMGs — to get residency positions. They’ve heard all the jokes about studying anatomy on the beach with mai tais in hand. But when it comes to residency positions, they are deadly serious.

“You have to apply very widely. There’s always a stigma that IMGs don’t get as good an education.’’ said Rina Seerke-Teper, 31, a second-year resident who has wanted to be a doctor since she was 6. She graduated from the University of California Berkeley and worked in stem cell research before attending AUC.

Many Caribbean graduates don’t even apply to residency programs that are filled only with American trained students. Instead, they look for “IMG friendly’’ programs like the family practice residency here, run in a busy clinic housed within the county hospital. The program is highly competitive — about 800 applications for 12 positions each year — and of the three dozen current residents, 29 studied in a medical school outside the United States.

Competition for the coveted slots is likely to grow even more as California, which just got one new medical school and is slated to soon add another, starts spitting out more locally trained graduates.

California will need an estimated 8,000 additional primary care doctors by 2030. The United States as a whole is projected to need some 30,000 additional primary care physicians in the coming decades.

Dr. Michelle Quiogue works in one of the areas hit hardest by the shortage, rural Kern County. A graduate of a prestigious medical school — Brown University’s — Quiogue has worked alongside many foreign-trained doctors and “would never know what college they graduated from.’’

In her mind, the problem is not a lack of medical students but a lack of residency programs to train them. The governor has proposed cutting $100 million for primary care residency training, and her organization, the California Academy of Family Physicians, is scrambling to get it replaced.

“I have never heard a patient ask where a physician is trained,’’ said Carly Barruga, a third-year medical student at nearby Loma Linda University who said she is getting excellent training in her rotation here from Caribbean-trained doctors like Dr. Tavinder Singh.

Singh, 30, is chief resident here and a Ross graduate. Singh didn’t apply to US medical schools because his MCATs weren’t as strong as they should have been. He didn’t want to wait a year to retake them.

While Singh was once the one begging for a chance, the tables have turned. In a state hungry for family practice physicians, he’s now fielding numerous job offers.

For now, though, he’s just happy to be practicing medicine. He loves helping patients like Wendy Ocampo, a 19-year-old with limb girdle muscular dystrophy. During an appointment this month, Ocampo came in to see Bajwa with respiratory symptoms.

It was supposed to be a quick visit, but he ended up spending a half-hour with her once he discovered bureaucratic hurdles had left her waiting seven months for the wheelchair she needs for her job and college.

“It burns me up that these things are falling through the cracks,’’ said Bajwa, after taking a few minutes to compliment Ocampo’s “impressive new shoes’’ and ask if she was growing out her hair.

Though sick, Ocampo beamed. “Honestly, he’s great,’’ she said. “He calls me to check on me. I have, like, 30 doctors and none of them have ever done that.’’

STAT

Usha Lee McFarling can be reached at usha.mcfarling@gmail.com Follow Usha Lee on Twitter @ushamcfarling