St. George's slays image dragon

TRUE BLUE POINT, GRENADA — TRUE BLUE POINT, Grenada - It was a tiny, offshore medical school thrust into the middle of the Cold War when U.S. troops stormed this island nation in 1983 for what the Reagan administration billed as a rescue of American students from the threat of an unstable government.

Back then, St. George's Medical School was little more than a cluster of trailer-style buildings tucked into a lush tropical hillside, a haven for aspiring American doctors who couldn't get into a stateside program.


These days, St. George's is in the midst of a transformation that officials here hope will change its image as a sleepy refuge for second-tier American students into a truly Caribbean university that can rival its counterparts in the United States.

'We see an opportunity'


"This is a school that has withstood battles before, mostly with people who doubted us," says Charles Modica, St. George's founder and president. "But we see an opportunity now to become more pan-Caribbean while still being a top-notch medical school."

In a region that has too few college classrooms, St. George's ambitions are well-timed. The number of high school graduates produced every year by the Caribbean's two dozen countries has grown to about 125,000. Some students in the area attend college in Cuba, Puerto Rico or the Dominican Republic, but most traditionally go to the University of the West Indies, which has campuses in Jamaica, Trinidad and Barbados. Now, St. George's hopes to expand its mission and secure its future by moving to help address the need.

Over the last five years, the school has undergone an expansion that would be considered dramatic for any university. As part of a $42 million overhaul, financed mostly from tuition and loans from investors, it has added libraries, classrooms, laboratories, and beachside dormitories.

Enrollment exceeds 2,100

The result has been the birth of a small city of salmon-colored buildings on the southern end of the island. Student enrollment has surged to more than 2,100, compared with about 600 during the time of the 1983 military intervention, and 200 when it opened in 1977.

But the transition is proving tricky to pull off, especially for a private institution more accustomed to dealing with typical American students' anxieties - homesickness, financial aid and worries over hospital residencies - than with the concerns of Caribbean students and governments that sometimes want more of a say in how to run the college.

When trustees recently decided to shut down the English program - one of several new undergraduate programs targeted at Caribbean students - because only three students had signed up, St. George's ran into criticism from the normally supportive Grenadian government. Authorities have been pressing for more spaces for local students at the university.

The government agreed to amend the school's charter in 1996 and St. George's become a full-fledged university, adding new undergraduate and graduate programs. Although the medical school still draws the most students, St. George's now offers studies in veterinary medicine, business administration, public health and marine biology.


High exam pass rate

The average grade-point average for entering medical school students this year was 3.4 on a scale of 4.0, just below the 3.5 medical school average in the United States, school officials say. And of the graduates who take the standard medical licensing exam for the first time, 93 percent of St. George's graduates pass, slightly higher than the average of U.S. medical schools.

Faculty and administrators explain their students' success in two ways: Their students are talented enough to study medicine but often unfairly rejected by U.S. medical schools; and students flourish in St. George's "problem-based" approach to medical instruction, which combines American and European teaching styles.

But what about the beaches and year-round surfing? Students say the novelty of those amenities wears off quickly.

"My friends all think I'm kicking back, drinking pina coladas, and having a great time," says Baher Maximos, a 22-year-old student from Ontario, Calif. "But the truth is, there's not much to do here in Grenada except study, so that's what you end up doing the most. This isn't Cancun."

Despite the new buildings and improving statistics on student performance, Modica and other administrators are often reminded that it's hard for a Caribbean medical school and university to get taken seriously. Modica, a lawyer, has butted heads often with the U.S. medical school establishment, trying to get it to recognize St. George's abilities.


Invasion problems

The 1983 American invasion didn't help. Just as St. George's was settling into a new site near the Port Salines International Airport - built by Cuban allies of Grenada's then-revolutionary-minded government - it was forced to abandon the campus when 6,000 U.S. troops landed and airlifted students and professors back to the United States as part of the operation ordered by President Ronald Reagan. Officials scrambled to set up temporary campuses at Rutgers University in New Jersey and on Long Island, N.Y.

"We were near midterms and didn't have any cadavers for the students to work on because they were left back in Grenada," Robert Jordan, the school's anatomy department chairman, recalls. "We had to rush a shipment of about 60 fresh cadavers from our supplier in Chicago to New Jersey in time for exams."

Enrollment at St. George's dropped in the late 1980s, as they did at many U.S. medical schools, but rose again by the mid-1990s when trustees voted to expand. The university received an additional boost in 1996 when the U. S. Department of Education agreed to make the school eligible for federal student loan programs - the first in the Caribbean to qualify.

Robert Crone, dean of international programs at Harvard Medical School, says there was plenty of skepticism when programs like St. George's were first developed. "That's not necessarily the case now," says Crone, who works closely with foreign medical schools to develop curriculum. "There's no reason for the medical community to think negatively about institutions in general. It really depends more on the quality of the individual doctor."

Caribbean students make up about 13 percent of St. George's total undergraduate enrollment and 4 percent of the medical school, the annual tuition for which is about $25,000. Caribbean governments usually require that their students pay a reduced tuition, and they provide no money to St. George's.


'Cater to this region'

"There is a desperate need for more higher education in this region. So we can and should cater to this region," says C. V. Rao, St. George's dean of students. "We're not just a university for American students, but for the entire Caribbean, and we're prepared to provide this service."

Still, no matter how much the university expands or refurbishes its programs or image, Modica says the reality is that a U. S. medical degree will probably always be worth more than a foreign one.

"That's the political reality of the medical community," Modica says.

"But the educational reality is that our instruction and teaching are just as good, and we'll keep proving that with our students in the Caribbean and in the U.S."