Medical Schools

Compared to the rest of the OECS, SVG came late to the Offshore Medical School business. While some islands had two or more schools, SVG had merely a part of the Grenada school. Today, we have four such schools. The primary reason for the rapid expansion in the industry in the OECS is the shortage of medical school places in the US and Canada.The OECS was quick to fill the breach because of its proximity to the US and the similarity of our cultures. There is hardly a Vincentian who does not have a relative in North America and we are all heavily influenced by American television.{{more}} It is also true that our country is relatively secure. Students, many female, wander all over the place with locals protecting rather than molesting them. The overriding factor, however, favouring the OECS is language. We are English speaking, which we take for granted, but which, of course, is far from universal.

The economics of offshore medical schools is not all that complicated. In traditional medical schools, a student spends six years to become a doctor. Two or three of those years are spent doing the relevant science subjects: biochemistry, anatomy, pharmacology and the like. When the students have passed these subjects, they then go into hospitals attached to these traditional schools to do clinicals. After a further three years and more exams, they then become doctors going on to their internships. The offshore medical schools handle mainly the two-year period doing the science subjects. The students then have to find places in hospitals primarily in the US and Canada. In order to do this, the school must be accredited and the student pass the United States Medical Licensing Examination (USMLE) step 1 exam.

Offshore schools are usually set up by doctors or other entrepreneurs. Their main cost is the salaries of the US professors needed to staff them. Their main source of revenue is the tuition fees paid by the students. Other significant costs are those of the building to house the school and the expense incurred in unending promotion to attract students. Key to the success of these offshore schools is the availability of clinical places and job opportunities for doctors in North America. Since students are usually financed by loans, the provision of this form of finance, normally in the US, is critical. Its availability often depends on the age, track record and accreditation of the school, not to mention the state of the US economy. The island can benefit from the schools in at least seven ways: taxation, rents, employment, general expenditure, assistance to local hospitals, training of Vincentian doctors and tourist development. Direct taxation will often not be much, since foreign staff will often be on reduced rates of income tax and the schools themselves will have been granted tax holidays. Some islands have been smart enough to tie the tax holiday to the number of scholarships granted to local students. The school’s impact on the training of locals to become doctors merits a study by itself. Indirect taxes will come chiefly from general expenditure, since building materials, furnishings and vehicles for the school are usually duty free. Assistance to the local hospitals often depends on the relationship between the island’s medical hierarchy and that of the school. Employment will be mainly for administrative staff, security personnel, drivers, maids and part-time for local doctors. Rents will be one of the major, if not the major, ways in which the schools can benefit the local economy. The school, the staff and the students all need lodgings and by and large, this is provided by the private sector. In some cases, entrepreneurs have built dormitories for students. Of course, there are also the house owners with the odd room or two. There should be no need for governments to make concessions on accommodation. As for tourism, the staff and students are themselves tourists of a kind. The perennial sunshine, the beaches and the entertainment all help to attract not only the students, but also their friends and their families.

Above all, we are dealing here with people, not commodities. Our guests will inevitably form attachments of various kinds and these can have far reaching implications. By way of illustration, between 1966 and 1990 the British Voluntary Service Overseas (VSO) sent some 100 volunteers to St Vincent. At least four of them got married to local partners, including myself. Many did not go that far, but still they keep coming back. The picture in the insert is that of Mary Gatehouse, who came here as a VSO in 1966. Fully half a century later, in January 2016, she was back yet again, with her brother, his wife and a friend. Talk about repeat business!!