No Medical School For St. Croix, Committee Recommends

St. Croix should get the simulation center, but the medical school should be built on St. Thomas. Those are the recommendations of an independent committee employed by the University of the Virgin Islands to vet the building of what would be the first accredited medical school in the English-speaking Caribbean.

The recommendation was revealed today at UVI’s Board of Trustees meeting, which was closed to the public. However, St. Croix senators Diane Capehart, Nereida “Nellie” Rivera-O’Reilly and Judi Buckley, who attended the three-hour session, emerged eager to share details.

For starters, a simulation center provides third-year medical school students with hands-on training that mimics real-life medical procedures using mannequins and other instrumentation. The simulation center would also provide doctors and other licensed medical professionals with on-going required professional training.

According to what the senators say was discussed in the meeting, students would complete their first two years of studies at the medical school on St. Thomas. They would then travel to St. Croix for hands-on training at the simulation center during their third year. Their fourth, and final, year of medical school would be completed in an off-island residency.

While UVI’s Board of Trustees did not take a final vote today on where the medical school would actually end up being built, the independent committee’s recommendation was enough to anger the St. Croix senators, who openly voiced their displeasure after the meeting.

“They have not made a decision and I encouraged them not to make any decision until we have more dialogue,” said Sen. Rivera-O’Reilly, who, just on Tuesday, submitted a letter to UVI’s Board of Trustees detailing why the medical school should be built on St. Croix. “They haven’t shared the feasibility study and the feasibility study was funded with tax payer’s monies. I think it should be made public and I think they should have more discussion, even with the community, and get the community’s input.”

Rivera-O’Reilly continued, “They tried to make an argument that the medical school isn’t going to generate as much economic activity as the simulation center, but without the numbers, I don’t believe it.”

And with raw emotion in her voice, Rivera-O’Reilly offered an opinion with which many gathered around her and her colleagues agreed.

“I’m not surprised that the recommendation is for the [medical] school to be in St. Thomas,” Rivera-O’Reilly said, “because everything gets placed in St. Thomas.”

The idea for a medical school for the university took shape when, in his first year as university president, David Hall, was approached by a local physician with the notion. And just this year, a generous $30 million gift was awarded to the university on behalf of New Generation Power and its Chairman, Dr. Chirinjeev Kathuria, to serve as a major part of the seed money for the school.

However, the donor’s funding is contingent upon very specific requirements being met.

“They will not fund this medical school unless it can get accredited, and in order to be accredited, it has to be partnered with an accredited hospital,” Buckley explained. “And our understanding is that right now Schneider [Regional Medical Center in St. Thomas] is the only one [that is accredited]; Juan Luis is not. [The donor] said that was their number one priority and criteria for determining where the medical school would be placed.”

The VI Consortium visited Juan Luis Hospital immediately following the UVI meeting and requested an interview with Dr. Kendall Griffith, CEO, to gain insight into the hospital’s current accreditation status. He was unavailable for comment before press time.

In addition to citing accreditation as a deterrent to the medical school coming to St. Croix, the three senators highlighted other road blocks the committee say existed, including the island’s inability to attract students, Juan Luis’ ongoing financial woes, and low numbers of currently licensed doctors.

Of the number of licensed physicians, “they say there is 235 total in the territory, roughly, and only about 67 of them are on St. Croix,” Buckley said.

To that, Rivera-O’Reilly suggested, “So, recruit. Recruit. They didn’t mention any challenge or obstacle that we cannot overcome.”

When asked her opinion on the information discussed in the meeting, Sen. Capehart pointed out that the Territory’s first move should have been to ensure that all of its hospitals are accredited. To that, she referenced the adage ‘don’t put the cart before the horse.’

“I think this is exactly what we’re doing because we need to make sure that our hospitals are accredited before we can even think about the medical school,” she said.

Without receiving any hard facts, Capehart also dismissed the notion of the millions of dollars in revenue that was said would be generated in St. Croix as a result of having the simulation center on the island.

“When we started out in the beginning we were saying that we want the medical school physically here on the island of St. Croix,” she said. “But today, again, they’re telling us that the simulator (sic) will bring thirty-million dollars in revenue. That’s the estimate. But we want to see the numbers. We want to see this on paper.”

However, Buckley believed St. Croix will see the benefits of having the simulation center, but in time.

“There will be benefits of getting a simulation center, we just don’t know that we have the full picture,” she said. “There’s a lot of studies out there that show what the economic impact is of having a medical school and not so much about simulation centers because that’s something that will be used in their third year and not the first and second year. A medical school will have an immediate impact and a simulation school, the impact will be a bit delayed.”

As far as when the medical school and simulation center will begin construction, Buckley said the first 25 students are expected to be enrolled in August 2016, so ground would break before then.

“There are still many more phases they have to go through; this is all still just on the paper phase,” she said. “There’s a lot of [phases to go through] to include site visits from the accreditation team, finalizing land, there’s so much more to do.”

She pointed out that Dr. Hall plans to have both facilities being constructed on both islands at the same time.

“Dr. Hall did say his recommendation was going to be that they are built simultaneously, so that there would be immediate construction impact,” Buckley explained. “But I get the sense from this meeting and from previous meetings we’ve had with him, that the long-term impact of the simulation center could be really great, but not immediately.”

Power of the People

There were a number of people who attended today’s meeting to lend their support to the idea of the Territory’s medial school being constructed on St. Croix. One such person was local orthopedic surgeon, Dr. Deborah Appleyard.

“I think there’s a lot of very immediate and a lot more peripheral benefits that would come from having a medical school here,” she said. “We’re definitely at a point in time where we need to grow our healthcare industry. It would provide better care for people locally and help to train our local people for really excellent careers.”

She also honed in on an area many residents on St. Croix identify as a sticking point for constructing the medical school on the island: space.

“St. Croix has the space, the land, the opportunity and the people who are ready to embrace it and support it, and we’ve shown that by embracing Barry University and the PA program,” Dr. Appleyard said.

Barry University’s physician’s assistant program has been in existence for the last three years on the island.

“I’ve worked a lot with the PA students at the hospital and they always add value; they keep doctors on their toes and they make everybody a little bit better at their jobs because we’re teaching them how to be good PAs, so you want to show them your best,” Dr. Appleyard said. “So, I think having a medical school here and the students around, it’s going to do the same thing. It’s going to improve the quality of care for Crucians and St. Thomians and St. Johnians.”

One of several senatorial candidates in attendance, Miguel Quinones, offered his thoughts on the hot-button topic. He, too, expressed the economic boost the school would bring to the island.

“Needless to say, every body understands the dire economic stress we all face, in the territory at large, but specifically St. Croix. We’re just about 15 percent employment.

He continued, “This medical school on the island of St. Croix is critical for us, economically, as well as leading the edge in what we offer, maybe to the Caribbean, but to the world at large because who knows where these students will go.”

Quinones concluded by saying the presence of the medical school would also be beneficial in filling any staff shortages and deficits at Juan Luis Hospital with locally trained professionals.

While Puerto Rico has accredited medical schools, instruction is being taught in Spanish. UVI’s medical school would then be the only English-speaking Caribbean university to be accredited by the Liaison Committee on Medical Education. The other English-speaking Caribbean medical schools are not accredited.

The senators who attended today’s meeting say they expect a final vote on the medical school’s location to come within the next week. Today’s vote was stalled because not all senators were in attendance, having received an invitation to the meeting on short notice.