Offshore Med School's Scholarship Deal Has City Colleges Steamed

The Grenada invasion

Offshore Med School's Scholarship Deal Has City Colleges Steamed

This fall, the New York City Health and Hospitals Corporation will select about a dozen young New Yorkers for a new $11 million medical scholarship program. Called CityDoctors, the program will groom participants for one of the toughest health care jobs in the city: working as a primary care physician at one of the city's 11 public hospitals, where a typical 10-hour day involves tending to as many as 40 patients with ailments ranging from diabetes to whooping cough.

To prepare for this assignment, students will begin their medical education in the most unlikely of places: the Caribbean island of Grenada, where they'll enroll as students at St. George's University Medical School, a for-profit institution founded in 1976 by Long Island native Charles Modica after he was rejected from U.S. medical schools. The scholarship program, which St. George's is funding entirely, aims to provide a pathway into city hospitals for young doctors who grew up in the city, Modica says. By requiring students to commit to working one year in a city hospital for every year of free tuition, Modica hopes to ease the city's growing shortage of primary care physicians.

But if CityDoctors, which far exceeds the size of any scholarship program offered by New York schools, is St. George's way to "give back to New York," as Modica says, it can also be viewed as the latest offensive in a protracted turf war between St. George's and New York City medical schools.

News of the program's launch has faculty and students at New York's own medical schools asking why the city has teamed up with an international medical school that few Americans have heard of (except for those who remember when U.S. forces invaded Grenada in 1983 on the pretext of evacuating St. George's students). "Why didn't the HHC speak with medical schools in the state with which it's had partnerships for more than 50 years?" asks Dr. Michael J. Reichgott, a professor at the Albert Einstein College of Medicine. "Why didn't the city come to any of us and say, 'Let's talk about some sort of a scholarship plan?'"

HHC president Alan Aviles declined multiple requests by the Voice to comment on why HHC chose to partner with St. George's, a decision HHC spokesperson Evelyn Hernandez curtly explained by saying, "We have a longtime relationship with them."

Since the 1970s, New York City's public hospitals have offered a solution to St. George's biggest problem: While the school is well equipped to bring students through the first two classroom-heavy years of medical school, Grenada lacks the large teaching hospital that every medical school needs for the third and fourth years, when students learn by shadowing practicing physicians. In 1978, St. George's sent its first cohort of students to do its clinical training in New York, at Coney Island Hospital. In the years since, St. George's has sent thousands of students to HHC hospitals and paid the perpetually cash-strapped HHC for the privilege.

The relationship was dramatically consummated five years ago when St. George's, whose enrollment had swollen to 1,000 students per year, making it five times larger than a large U.S. medical school, signed a 10-year contract to send about 600 students per year through the city hospitals for $100 million. The agreement allows St. George's to promise clinical training in the U.S., crucial for students who want to be more competitive as they pursue their postgraduate residencies. And it has allowed St. George's to justify its $226,000 tuition, which is higher than most U.S. schools'.

But the agreement has angered local medical-school leaders, who two years ago banded together to petition the New York State Board of Regents to restrict access to state hospitals by offshore schools. New York medical schools have themselves long used HHC hospitals as a venue for training their third- and fourth-year students, but they have never paid to do so.

With St. George's paying for its students to train in HHC hospitals, local students have been blocked from doing the same, according to Rob Viviano, a fourth-year student at Touro College of Osteopathic Medicine and a delegate of the American Medical Association. Dean Robert Goldberg confirms that before Touro opened in Harlem in 2007, it discussed a clinical-training arrangement with HHC hospitals in Manhattan. But HHC, he says, asked for the same payments it was getting from St. George's, something that Goldberg says would have required 50 percent tuition hikes, and Touro students were instead sent to do their clinical training in hospitals on Long Island and in New Jersey. (Some Touro students also do clinical training at hospitals on Staten Island and in Brooklyn.)

Viviano, who grew up in the state, says the CityDoctors scholarship is an "aggressive PR move" for St. George's, while HHC leaves "New York medical students who would love to have this same opportunity completely in the dust."

What seems to make local medical-school faculty most irate is their perception that the HHC, lured by cash, has ushered into the city's public hospitals a school that they regard as second-rate. St. George's is "not following the regulations that were set up to make sure that people in the medical profession are well-trained," says Dr. Kristina Maletz, a 2010 graduate of Columbia University College of Physicians and Surgeons who helped draft a response to the $100 million contract from the Medical Student Section of the American Medical Association.

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22 comments
pestelence2k
pestelence2k

Sorta off topic, but:

 

http://www.sgu.edu/news-events/news-archives11-sgu-tops-us-performance-usmle-step1.html

 

This is one form of evidence showing that Caribbean medical school students (specifically, SGU) are given an education that is just as competitive (if not better) as US medical schools.  In SGU, the idea that the education is "sub-par" or that medical school students are not "well-trained enough" is a myth. 

 

While it is true that many SGU students (myself included) have picked the school out of second-choice (mostly because of continued rejection from US medical schools), it is not appropriate to assume that these are potentially inferior doctors that are being trained.  Long-standing EMTs, 4.0 College GPA/34 MCAT score students, Medical researchers, and even medical professionals that don't have an MD make up part of the student body.  We come from all over the world (US, Canada, India to name a few) from all sorts of backgrounds to come together and learn what we choose to be within medical healthcare, fulfilling our passions in the process.  Many students (including myself) did not want to stop there when we saw the rejection letters -- we wanted to keep going, no matter what may stop us, to have a chance at becoming one of the most fulfilling professions out there.

 

The idea of persistence we share, the backgrounds we have, and our Step 1 USMLE scores (one of the highest priority portions of our residency application, NOT GPA) are solid proof that SGU students deserve as much of a chance in the US as US medical school students -- academically, passionately, and most of all, with profound effect for not only the medical profession, but for the communities they will serve in the future.

honest
honest

Chief makes a good point standardized tests probably are the best predictor of knowledge almost any suck up can earn a high GPA.  I like the idea that you have to take a qualifier to proceed with your education. Being a teacher I also know to teach to a test and thus inflate a student’s grade. So I guess the only way to find out how good a school is the record of its graduates info none of us have.

I asked an American trained doctor that I know about your school and he basically said that it is ok.

The article seems to be trying to say New York medical schools are after your schools hospital slots, if that is the case our discussion is meaningless. I think that your school would lose for political and economic reasons even if its product (you) were equal or superior to Harvard Medical.

Your schools site and that of Touro Medical shows that it costs about 300 thousand dollars to get a degree.  That’s a lot of money and I think that the local medical schools will make the argument to our mayor that it should not be shared with Grenada. That’s twice as many NY jobs if they crowd out Grenada. Since NY is a Union town, and all of these medical schools are attached to larger universities your alma mater is in for trouble.

 

As for my Hip. I saw a guy from NY Orthopedic 8 years before I had it done. He argued for immediate surgery, even though I still had good mobility.  I showed my x-ray to a doctor friend (physiatrist) who explained that I could wait. When I was ready I saw the surgeon that eventually did the work. I liked the fact that he didn’t try to sell the job, infact he gave me a script for Naprosin which bought me another year.

I know the Nurse doesn’t know as much as a doctor, her job is to write scripts for my statins do or order blood other tests. If the numbers fall outside the parameters or if I don’t feel right it’s off to the specialist.

Next time maybe I’ll tell you how a doctor from a fancy Upper East Side hospital killed my brother in law.

Good Luck in your practice

honest
honest

Sorry Rokshana R O K S H A N A

honest
honest

Hi Roshanka You asked why I chose to go to a Nurse Practitioner the answer is simple. I got tired of waiting in overcrowded waiting rooms .

I'm a retired teacher that takes assignments from the Dept of Education to teach students who can not go to school because of illness. One of my clients was a teenager with leukemia whose RN mother credited  the nurse practitioner as a factor in her sons recovery.  She had known the nurse for twenty years of service at out local hospital (S.I University)

Since 95% of what a doctor does uses very little of his or her brain I decieded to take a chance.

It worked out the NP works out of the same office as a good foreign trained ( EGYPT)  MD .

If something serious pops up she has the TIME to explain and if needed refer me to one of the doctors that she has worked with at the hospital. As you know the nurses know which doctors are good and which are jerks.

So far this arrangement has worked well . When I needed a hip replacement she sent me to a great surgeon whose work has stood up to 5 mile walks 6 months after the surgery.

 

As for your medical school my only reservation is the article says they are forcing out local medical training programs out of our local hospitals. Since the local medical schools pick their students on merit and charge them lower tuition I have to lend my meager support to them.

 

If your school wanted to do some good why don't they take their hundred million and set up a training program in a third world country. I'm sure Haiti would love to get your assistance. 

rokshana
rokshana

 @honest that's a misinterpretation...sgu has had students in many of these underserved hospitals for over 30 years, including many of the HHC hospitals that are under the 100 million dollar agreement...WHERE were these "local" hospitals then...and now? Trust me, NO American MD program's students have been ever displaced by a foreign student. If you are interested, look back at the history of these hospitals...they get very few students doing clerkships from say, Columbia, or Cornell, or MSSM, etc...and ever more rare is the medical student that decides to actually do their training and then practice as an attending at these hospitals. Just as any place wants to train people, hoping that they will then stay on and give back to the community that trained them...many of these programs know that the Cornell, Columbia, Einstein, etc students are simply not going to stay. 

A Tuoro rep told the reporter that sgu "pushed" their students out of Harlem Hospital because of the HHC agreement....which is totally untrue...1st because the HHC agreement only mandates that sgu be the only FOREIGN school to be able to rotate if the hospital takes foreign students, it in no way, shape, or form keeps any US MD student from rotating and 2nd...currently, NO sgu clinical rotation are currently done at Harlem Hopsital, so its not because there are sooooo many students vying for the attending's attention. 

 

And as I posted in my 1st reply, the tuition that these schools charge, really aren't that far off from the tuition charged but sgu (and our tuition includes room and board while on the island, so its probably about the same once you account for paying rent in NYC). 

 

I appreciate that you want to give support to the home team so to speak, and the local students, but realize that many of the students that go to sgu ARE those local boys and girls, who want to be doctors and for whatever reason fell short....whether it be because they were foolish 18 year olds, or made a 31 instead of a 32 on their MCAT...or come from a state so populous that there are just so many more intelligent, capable students than there are spots in medical schools.

 

Sure there is a lot of publicity value in citydoctors, but realize that each and every one of the local med schools could do the exact same thing....they do not need HHC to "invite" them to offer up such a scholarship program , but where are they? And from what I know of our chancellor, HE did not wait to have the hospitals ask him to offer up such a scholarship....

 

And you are absolutely right, the NP usually does have more time to spend with their patients....maybe if there were more doctors, we would be able to do the same (one of the things I like about hospital medicine, I do get to spend time with my patients)...after all one of the reasons we went into medicine is because we are people persons and we like to be able to help.

honest
honest

Roshanka I have to agree with you that we have and probably will have a shortage of doctors for the at least in the near future. It is also true that an inferior doctor can give superior service if he or she is motivated ( at least as a gatekeeper and adviser ). My problem is that your people are taking the place of people that have demonstrated superior intellectual capacity by a combination of Grade Point Average and Standardized tests. They are replacing hard work and preparation with the use of money as an unfair short cut.

The test that is given at the end of med schools 2nd year is a not a competitive exam it is a qualifing  exam , which means students have reached a minimum level of competency.

My main concern is that their presence could block the development of more talented doctors.

 

As for my self the nurse  that I go to has put in 25 years of floor time at my areas largest hospital and thus knows which of the specialists are good and bad based on her observation of their work. Its like a soldier knowing which officer is worthy of respect.. So far she is batting 1000.

 

rokshana
rokshana

 @honest first, my name is spelled R-o-k-s-h-a-n-a, the 1st time I figured it was just a slip of your typing, but...

Your concern is unfounded in that, frankly, the "more" talented doctors that you think would be in their place...they don't exist...those "more" talented doctors are looking at greener pastures...they think that they can do better...prestige and money are a big driving force and those Columbia, and MSSM, and Cornell and NYU grads? most of them rarely go into primary care (as a recent AMA study demonstrated that only 2% of US graduates remain in primary care) and if they DO go into primary care, it will be at places like Columbia, Cornell, MSSM, etc...not the Elmhirst, Queens, Harlem Hospitals...

 

sure, it would be great if everyone had focus when they are 18 and know to keep the nose to the grindstone and make those good grades and do well on standardized exams, but just because they weren't good students when they were 18 doesn't mean they won't make good doctors when they are 30....and conversely, there are plenty of people who make the 4.0 and the 45 MCAT and they make horrible doctors, because they don't know how to deal with people and being a good doctor is not just being book smart and its also not just about being a good people person...its a combination of the both and the ability to combine the two...

 

and frankly, IMHO the harder working student IS that caribbean student...they sacrificed a lot more than the US student and know that they have to prove themselves even more than the US student...don't get me wrong, having worked with US students as a resident, I know they are smart and hard working...they wouldn't have gotten to where they are if they were not so, but they have nothing to prove so they are not as hungry.

 

I do find it interesting that you seem to think an NP is inferior, yet you go to one...why? 

honest
honest

Roshanka my point is that Doctors have a very important responsibility they should not be chosen from the ranks of B students. Being right 8 out of 10 times is not enough.

Financial assistance should be made available for those that make a habit of perfection. When 8 out of 10 is good enough go to a nurse practitioner. which some of your people should be.

As for a parent's opinion  what would they know , pay attention to them and frown or smile when appropriate and your a hero. Which by the way is a indicator of a good nurse practitioner.

By the way I consider a nurse practitioner my primary care giver.

Shinny
Shinny

@honest This is dumb statement.  Nothing in life is perfect and that includes you. 
I prefer to take a b student over an A student most times because they know that will make mistakes but get over it plus they will work harder given they are not always on top of the class. An A student on the  other hand when he or she makes a mistake will go beserk! Who are you to judge anyways. Contrary to popular beliefs, some of the best doctors are not from the those prestigious universities. 

rokshana
rokshana

 @honest well, see the thing is, like you said, you are not a doctor, so you really don't know how everything works. I'm sure your nurse practitioner is a very good primary care person too. MY point, is that its not necessarily the school that makes a good doctor...and i don't really fault the doctors at NYU's ED for how that case was handled...we don't know what was gong on at that time and its easy to be a Monday quarterback and say how you would have done it (well not YOU since you are not a doctor and all...)...there are many examples of US med students/graduates that didn't turn out to be a good choice (the craiglist killer...michael jackson's doctor, dr. kovorkian, so forth and so on)...and until the US recognizes that there IS a physician shortage and increases the number of med school AND residency spots to train more doctors, there will be qualified people who don't get into a US school but still have the drive and desire to be in medicine.

 

And, frankly, I rarely have had a patient ask me where I went to medical school or where I trained...they feel bad, they are sick and they just want someone to help them feel better...if I can do that...they are happy and feel cared for...and that is what counts.

honest
honest

Hey Frank how does it feel to work with nurses that had a higher grade point average than you. Tough to feel superior

Chief
Chief

 @honest GPA is one of the lesser important criteria when it comes to matching in residency.  

 

Let me clear this up for you:

1) A four year degree (BA/BS) indicates you can finish something you start.

 

Competitive MCAT= Good test taker

High GPA= super nerd (possibly annoying to be around as a 18-22 year old)

 

2) Finishing medical school shows you're wiling and determined to make a career in medicine regardless of the institution's name on your diploma.

 

US hospital rotations & USMLE scores + interviews decide how appealing you look to programs. (for your edification) http://www.usmle.org/pdfs/bulletin/2012bulletin.pdf

 

*The qualifying exams create an equal playing field for all examinees (students, foreign students, and foreign doctors alike).  It may shock you as an educator to find out that favoritism plays a large part in undergraduate studies.  

 

For the most part carib. student's are trained to go into primary care.  That's their specialty.  They fit all of the personality and educational criteria to involve themselves in their patients' daily lives.  It may seem like a round-about way of getting there but everybody has their own obstacles and different way of living life.

 

Note: The most experienced nurse will NEVER have equal training to a new doctor.

 

It's entirely possible your hip fracture was altogether preventible with a good internist of family medicine doctor.

And to be clear- financials are none of anybody's business. 

 

3) As a doctor you're held to the highest standard set by societal norms.  Everything is balanced and the world continues to spin. 

honest
honest

Sure Frank you be my witness. If your mom needed a hip or a heart valve to which SGU graduate rwould you take her ..

frank
frank

honest do you have any evidence that SGU trains inferior doctors, or are you just trolling?  SGU has outdone US schools on USMLE step 1 for two years in a row.  That's the test all doctors take after the first two years of medical school.  The last two years are spent literally side by side with American students in US hospitals.  So please keep your ignorant BS to yourself, or give us evidence of your own.

I am biased in my opinion, but not in my facts.  I'm an SGU student, paying my own tuition at that.

honest
honest

I'm not a doctor but the situation seems simple to me.  These people can't get into US medical schools because they are not good enough.  They have rich parents who pay for their little darlings second chance and now they want to practice on poor New Yorkers.

These guys are the reason you should always check on where your doctor went to school.

I often wonder how many lives Regan took by saving the Grenada medical students.

rokshana
rokshana

 @honest so, maybe you will take your child to the doctors at NYU's emergency room? Those involved were all educated and trained at US medical schools...and the one that the parents felt that did the most for him in the ICU was...a foreign educated (though US trained) doctor. The point isn't to ding those doctors, but to point out that the better doctor isn't only guaged by where they went to school.

NJReader
NJReader

To further the point made by Rokshana above, while SGU is investing a part of the tuition it collects into NY hospitals and is now using an additional part of it to fund these scholarships, the NY medical schools keep all the tuition they collect while focusing their energies on vilifying a school and its students who are contributing both their talents and their money to the health care of NYC.

 

Intentionally or unintentionally, this is a reflection of the values of these vocal NYC schools and the character of their administrators, which casts a dark shadow on their students. The air of entitlement, the unabashed bullying, the unfounded generalizations and frequently vitriolic rhetoric are anathema to the principles which should be instilled in every future physician - tolerance, humility, compassion, fairness, open-mindedness, kindness, respect, benevolence, and the spirit of service to others.

sohdad
sohdad

Rob Viviano is a long time hater of Caribbean medical students who will go to any lengths and use whatever dirty tactics and lies to make their lives hell because he feels that DOs should get priority in residency selection over IMGs. I'm sorry that this guy has such a large inferiority complex about his education at Touro that he feels the need to continually attack Caribbean medical schools and students' credentials. 

 

SGU graduates have long contributed to the health of the NY/NJ residents by filling up residency spots that domestic graduates flee from to other states. SGU's role in filling the state and the country's physician shortage is undeniable and more state hospitals should take HHC's lead and recognize SGU and its graduates for their role in bridging the healthcare gap in the country. 

 

rokshana
rokshana

Realize too that there is a distinct difference between medical education and medical training...my medical training was at a 3 year ACGME accredited residency, which I matched into after passing the same USMLE exams that my counterparts educated at US medical school had to pass. The medical education I received at SGU allowed me to succeed in my residency.

rokshana
rokshana

I find it interesting our " high tuition" is pointed out as being higher than most US med schools, but (as with most things in NYC), the tuition of the NYC med schools are pretty close...mssm is the cheapest at 39,652 per year, while Columbia's yearly tuition is a whopping 52,659 per year...at least sgu's tuition includes housing while we are on the island!

rona
rona

 @rokshana Correction:  Rokshana, the least expensive (and most affordable) medical school in New York City (NYC) is SUNY Downstate Medical Center, a public institution. 

rokshana
rokshana

 @rona you are right, for an NYS resident the tuition is 29,530 per yr with about 500 in additional fees...but they make up for it with the tuition for an out-of-state student...54,650! + the ~500 in fees...yikes!!

 

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