New Medical School at University of Virgin Islands

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jhu99

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It looks like the Caribbean will be getting a new medical school soon. The article talks about how "UVI could be the only English-speaking Caribbean university that can be accredited by the Liaison Committee on Medical Education. Puerto Rico has accredited schools but of course the instruction is done in Spanish, so we would be the only one. And that intrigued me because it showed that we could have a market advantage over the other medical schools."

http://stcroixsource.com/content/ne...tees-approve-development-phase-medical-school

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Don't hold your breath....

-Skip
 
Why "don't hold your breath?" Seems feasible to me.
 
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Not to me. Many schools have tried to get an exception and get accredited. Hasn't happened to date. And, Puerto Rico is the exception because basically it's the "51st state" of the U.S.

Personally, I wouldn't enroll in this school unless and until this happens. We'll see.

-Skip
 
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Also...

There are many new U.S. MD-granting programs in recent years. Why would the LCME accredit a program in St. Croix? Couple that with the fact that this is a lengthy process, and again... I wouldn't hold my breath. Doesn't matter that it is a U.S. territory. There are no LCME-accredited schools in Guam (which already has a school of nursing and health sciences) or the Marianna islands, for example. And, they have already well-established colleges there for decades.

You can serve me a large plate of crow if I'm wrong. I promise I'll eat every morsel.

-Skip

P.S. At least one of the medical schools in Puerto Rico is currently not fully LCME accredited (San Juan Bautista on probation), and it is still open. Guess what? Who knows what's going to happen to those graduates? Plus many (if not most) stay in Puerto Rico for residency and practice. The school in St. Croix will have to prove they have enough clinical experience there and not merely adopt the current "Caribbean" model feeding people back to the mainland for clerkships and residency. Plus, there are already 10 new U.S. MD schools planned to open or in discussion over the next 5-10 years. Don't hold your breath... Discussion and action are two different things.
 
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According to their website "The University is partnering with both of the territory’s hospitals – Schneider Regional Medical Center and Juan Luis Hospital – as well as Boston University School of Medicine for this project. UVI plans to involve the clinics and medical centers on all three islands in this endeavor." I don't know I think it would be cool if one of the Caribbean island's got LCME accredited. They would have a competitive edge over the other schools.
 
St. Croix is a US Virgin Island... U. S.

UVI is an HBCU in the United States.

It would be a U.S. school that happens to be geographically located in the Caribbean, not a "Caribbean Medical School." There are no LCME schools in Guam because there are no Medical School's in Guam. If Guam decided to open one - it would fall under the jurisdiction of the LCME, just like UVI falls under the jurisdiction of the LCME. As long as they meet the standards, they qualify for accreditation.

And ALL Puerto Rican medical school's are fully accredited by the LCME. Probation doesn't mean they're not fully accredited... it means they're on probation. And yes, SJB is on probation... like Chicago Medical School at Rosalind Franklin University of Medicine and Science and the University of Louisville School of Medicine, all of whose graduates participated in the this year in the US match as graduating US Seniors.

The fact is that this thread doesn't even belong in the Caribbean forums - it belongs in the Allopathic forums because a UVI Medical School would be a new USMD program, not a Caribbean one. Puerto Rico isn't an exception, and neither would the USVI.
 
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St. Croix is a US Virgin Island... U. S.

UVI is an HBCU in the United States.

It would be a U.S. school that happens to be geographically located in the Caribbean, not a "Caribbean Medical School." There are no LCME schools in Guam because there are no Medical School's in Guam. If Guam decided to open one - it would fall under the jurisdiction of the LCME, just like UVI falls under the jurisdiction of the LCME. As long as they meet the standards, they qualify for accreditation.

And ALL Puerto Rican medical school's are fully accredited by the LCME. Probation doesn't mean they're not fully accredited... it means they're on probation. And yes, SJB is on probation... like Chicago Medical School at Rosalind Franklin University of Medicine and Science and the University of Louisville School of Medicine, all of whose graduates participated in the this year in the US match as graduating US Seniors.

The fact is that this thread doesn't even belong in the Caribbean forums - it belongs in the Allopathic forums because a UVI Medical School would be a new USMD program, not a Caribbean one. Puerto Rico isn't an exception, and neither would the USVI.


I agree. Would like this school to be successful. However, as Skip stated, the accreditation process is a lengthy and tough one.
 
You are absolutely right, but it would neither be a stretch nor an exception for them to gain LCME accreditation. It even sounds like they aren't interested in taking students until they gain this accreditation.

What's weird to me is them comparing themselves to Caribbean medical schools as if they would be competing for students... as if people go to the Caribbean for med school for the good weather and nice beaches.
 
You are absolutely right, but it would neither be a stretch nor an exception for them to gain LCME accreditation. It even sounds like they aren't interested in taking students until they gain this accreditation.

What's weird to me is them comparing themselves to Caribbean medical schools as if they would be competing for students... as if people go to the Caribbean for med school for the good weather and nice beaches.

Yeah, that is silly. If anything, they should use the Puerto Rican school/U.S. MD model -- but look to target English-speaking students.
 
St. Croix is a US Virgin Island... U. S.

UVI is an HBCU in the United States.

I know this. That's beside the point, as I already attempted to point out (re: Guam and Mariannas Islands).

Further to the point, Puerto Rico is a very large island with a population of 3.7 million people. The population of St. Croix? 50,601.

According to the LCME accreditation standards, there are several challenges they are going to have to meet:

3.1 Resident Participation in Medical Student Education: Each medical student in a medical education program participates in one or more required clinical experiences conducted in a health care setting in which he or she works with resident physicians currently enrolled in an accredited program of graduate medical education.

Are they going to have residency programs set-up in the same disciplines as the core clerkships?

5.5 Resources for Clinical Instruction: A medical school has, or is assured the use of, appropriate resources for the clinical instruction of its medical students in ambulatory and inpatient settings and has adequate numbers and types of patients (e.g., acuity, case mix, age, gender).

Will there be enough patients to see?

http://www.lcme.org/publications/2015-16-functions-and-structure-with-appendix.pdf

Again, I'm ready to eat crow. Talking/planning and doing are two different things. Trust me. There is a saying in the medical world that is very true when someone tells you about a patient or a case that might be coming in: "You can't treat a rumor."

I put the odds of this coming to fruition very, very low. And, even if they do put a medical school there and it does achieve LCME accreditation, it's not going to be as easy to get into than Ross, SGU, or AUC. In fact, it may be harder than a lot of already-established U.S. schools due to its location. As was pointed out, this should be a discussion in the allopathic forum. Not here.

But, I'm still not holding my breath...

-Skip
 
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And the title of this thread shouldn't "New Medical School at University of Virgin Islands".

It should be "Possible Medical School at UVI Being Discussed in Local Island Media". Far more accurate.

-Skip
 
According to their website "The University is partnering with both of the territory’s hospitals – Schneider Regional Medical Center and Juan Luis Hospital – as well as Boston University School of Medicine for this project. UVI plans to involve the clinics and medical centers on all three islands in this endeavor." I don't know I think it would be cool if one of the Caribbean island's got LCME accredited. They would have a competitive edge over the other schools.

Which means if you can't get into a mainland U.S. medical degree granting program you probably won't get into this one either.

Still breathing... in and out...

-Skip
 
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I agree that it would be tough and rough for them to get things together to start a medical school.

I thought your point with Guam and the Marianna islands was that those are US territories that couldn't (rather than just didn't) have LCME medical schools. Especially since you said "Many schools have tried to get an exception and get accredited. Hasn't happened to date. And, Puerto Rico is the exception because basically it's the "51st state" of the U.S." It struck me as strange because UVI wouldn't be an exception.
 
Yes and no.

Puerto Rico is a "special case" because it is huge and it is basically more a part of the U.S. than any other protectorate (e.g., closer, easier to get to, bigger, etc.). Puerto Rico essentially is the 51st U.S. state, but for reasons that do not need to be discussed here has decided not to become one. Nonetheless, they have special standing because of it (again, they have a resident commissioner to the congressional house who serves a four-year term, whereas the others (Mariana, Guam, etc.) just have delegates who serve two years, etc., all non-voting of course). Puerto Rico, in essence, has a bigger tax base, more muscle, and is extended this courtesy.

But...

What about Canada? Why do the Canadian schools have LCME accreditation? Canada is a sovereign nation with a huge economy completely capable of monitoring it's own medical education system. So why bother? Because of close proximity and cross-training of graduates it just facilitates things. Same principle. The nice people in the U.S. government didn't want to hassle with making all of those polite Canadians across the border who might want to come here to train or practice have to go through ECFMG certification. But, these same folks have no similar regard, I guess, for their own rebellious citizens who go to St. Maarten, Dominica, or Grenada for their educations. Politics, politics, politics.

For Canadian medical education programs, the LCME engages in accreditation in collaboration with the Committee on Accreditation of Canadian Medical Schools (CACMS).

http://www.lcme.org/overview.htm

So, in essence, they make an exception for Canada.

This is also why, decades ago, when the similar idea was tossed around for Mexico and the other Caribbean schools, there was already a precedent with Canadian schools being LCME certified. The LCME, for some reason, just decided not to extend their accreditation standards and work in collaboration with the bodies that accredit the other Caribbean schools, all of which are accredited by their own bodies and listed in the WHO director and FAIMER, for whatever reason. They just didn't want to take that on. Again... Politics, politics, politics.

So, just because a potential school is capable of being accredited by it's standing under the U.S. doesn't mean it will be accredited. And, even if accredited, it doesn't mean it will stay open and maintain that accreditation (search what happened to Touro recently in Hackensack, for one example). And this...

A fifth school, San Juan Bautista School of Medicine in San Juan, Puerto Rico, lost LCME accreditation in June, but it was reinstated at a Nov. 16 LCME appeals hearing ordered by the federal district court in Puerto Rico. The school is on probation pending a full survey visit scheduled for early 2012.

http://www.amednews.com/article/20111205/profession/312059943/4/

As with everything else in life, wanting something and getting something are two completely different concepts. "You can't treat a rumor." Personally, I'd love to see these guys get past the first step in the accreditation process and actually get a look because it would shake things up a lot in the Caribbean. But, as it now stands, they're not even on the list of pre-approved programs on the LCME website.

But, just know there is nothing actually preventing the LCME from accrediting Ross, SABA, St. George's, AUC, etc. Nothing at all.

Not. Holding. My. Breath.

-Skip
 
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We agree more than disagree. YES - it is difficult to open a medical school. It may be unlikely that UVI could do it. But it has NOTHING to do with where it's located on a map and everything to do with costs and the fact that the population of the islands may be too low to sustain a medical school and provide the resources necessary for accreditation.

I disagree with points you're making that are incorrect and irrelevant to UVI.

Puerto Rico being surveyed by the LCME is not a courtesy and it's not an exception and it's not a special case. Period.

Scope of LCME

Medical education programs leading to the MD degree in the United States and Canada are accredited by the Liaison Committee on Medical Education (LCME). The LCME's scope is limited to complete and independent medical education programs whose students are geographically located in the United States or Canada for their education and that are operated by universities or medical schools chartered in the United States or Canada. (https://www.lcme.org/about.htm)

It's simple geography. If you are a medical school that is geographically located in the United States or Canada the LCME is the national accrediting body (with collaboration from the CACMS for Canada). Canada isn't an exception. It's how it is. An exception would be saying this was the policy and then accrediting Ross. But, if the LCME changed their rules to include medical schools in the US, Canada, and St. Kitts and Nevis then accrediting Ross wouldn't be an exception anymore. It would be what the LCME does. Could they change the policy? Sure, but they don't. The LCME looks at schools in the US and Canada. Like you said - politics, politics, politics.

I'm not sure what the point of the SJB quote is. Yes, they lost accreditation in 2011, got it back later in 2011, were put on probation, and had a survey review this year. Since they got it back in 2011 they have been fully accredited, on probation. Yup, they might lose it come June. That doesn't make them not fully accredited. They're either accredited or not. And if they are accredited it can be provisional or on probation. But in either case - they're still accredited. There is nothing but full accreditation.

But we DO agree - this would be difficult for UVI to accomplishment, but it really has nothing to do with where they are.

Why do you think it would shake things up in the Caribbean? UVI would obviously fall under LCME jurisdiction.
 
I disagree with points you're making that are incorrect and irrelevant to UVI.

Puerto Rico being surveyed by the LCME is not a courtesy and it's not an exception and it's not a special case. Period.

Let me frame it differently then. My point is to demonstrate the completely arbitrary nature of the LCME's jurisdiction.

Forget the Caribbean for the moment. Why has the LCME not extended this courtesy to Mexico? It has a huge economy and many excellent medical schools. It has Mexico City, which is one of the most populated metropolitan areas in the world. It also shares a border with the U.S. Doesn't it seem logical that if they work with Canada to give approval that they wouldn't also work with Mexico?

I'm not now (nor have I yet) attempted to state that U.S. Virgin Islands aren't part of the U.S. They have a compelling (and perhaps what might necessarily prove to be legal) argument to insist that they are deserved a review. That's not my point and has never been my point (if you carefully re-read through this thread). The point that makes Puerto Rico an exception (or, if you prefer, allows them to be included) is that it is huge, and has a massive population and infrastructure. If they didn't, the LCME would adjust their rules to exclude Puerto Rico. This underscores the completely arbitrary nature of the LCME, the same arbitrariness that has excluded Mexico and the Caribbean to date.

The bottom line is, and at least we probably agree on this, that U.S. Virgin Islands probably will not be able to meet the criteria.

Still breathing. ;)

-Skip
 
Why do you think it would shake things up in the Caribbean? UVI would obviously fall under LCME jurisdiction.

Because, if they got approval based on what will likely prove to be inadequate infrastructure of the school based on the current rules, it would open them to legal challenges about why they haven't extended their review to other schools in the Caribbean (or elsewhere) based on the precedent that they already work with another foreign medical board (i.e., Canada's) to offer LCME accreditation to graduates outside of the U.S.

Arbitrary. Politics.

-Skip
 
Puerto Rico is not included because it is HUGE - it is included because they have schools that can meet standards of the LCME and it is part of the United Stated. That is why it is included. And if it didn't meet standards, then the LCME just wouldn't grant accreditation - it wouldn't completely exclude Puerto Rico. SJB is a perfect example - they don't have to grant accreditation.

We could talk all day about how the LCME could extend jurisdiction why they don't, blah blah, blah. But it really doesn't matter. For whatever reason - they only consider medical schools in the US and Canada. Maybe it's because it's enough work already to play watchdog over the over 130 medical schools already in their jurisdiction without expanding their jurisdiction to the thousands schools outside of it. And obviously - politics.

Now let's move to the unlikely world where there IS a UVI medical school and it has been given accreditation by the LCME because somehow it managed to meet the standards. (Yes yes, it's unlikely, but bear with me). How would that spur legal challenges? The USVI are under the jurisdiction of the USA, obviously they would be evaluated by the LCME. No other Caribbean island (excluding PR) is a part of the US. What legal argument could the possible make that they couldn't try to make already? The only legal argument I can come up with is UVI suing the LCME, but only if they refused to even look at the program.
 
Now let's move to the unlikely world where there IS a UVI medical school and it has been given accreditation by the LCME because somehow it managed to meet the standards. (Yes yes, it's unlikely, but bear with me).

:rolleyes: Okay... I normally don't entertain hypotheticals ("You can't treat a rumor..."), but since I brought it up...

How would that spur legal challenges? The USVI are under the jurisdiction of the USA, obviously they would be evaluated by the LCME. No other Caribbean island (excluding PR) is a part of the US. What legal argument could the possible make that they couldn't try to make already? The only legal argument I can come up with is UVI suing the LCME, but only if they refused to even look at the program.

Presuming they got approval based even with their current deficiencies (e.g., don't own their own hospital, don't have residency programs, can't ensure diversified patient exposure to students, etc.), I don't see how DeVry with all their money and muscle couldn't make an argument that the LCME should change their rules and also review their schools considering them for approval, especially since the vast majority of students at St. George's, AUC, and Ross are U.S. and Canadian citizens.

They would simply sue the LCME.

"It doesn't matter. It's not the U.S. Those are the rules," you say.

But, Canada is the precedent. And, if they will bend their criteria for a school to allow a similar type program that just happens to be in a U.S. territory to functionally operate the same as all other Caribbean medical schools without the co-requisite curricular changes, then they open themselves up to a legal challenge - not saying DeVry would win such a lawsuit - just that it could (and might likely be) a maneuver they try. For that matter, Mexico could get on-board, but they were already granted a "fifth-pathway" option that is somewhat in between (and has been required by the Mexican government's civil service obligations).

But, this is moot. Either the St. Croix school will figure out a way to meet the requirements, or they will never get accredited. Again, the LCME could expand their accreditation. They just don't want to...

Dan Hunt, the senior director of accreditation services for the Association of American Medical Colleges and co-secretary of the Liaison Committee on Medical Education, which accredits medical programs in the U.S. and Canada, says that the LCME has been active in working with the World Federation for Medical Education in promoting the development of accreditation systems in other countries, but that it has no plans to expand its own scope of authority.

“It is our strongly held position that the variations in cultural resources and disease patterns and the ways in which students are prepared for medical school mean that accreditation should be local,” says Hunt. He adds that the LCME doesn’t want to do anything to facilitate the “brain drain” of doctors from the developing world to the U.S.: there already is a process for graduates of foreign medical schools to qualify for licensure (as is also the case in pharmacy), “but we don’t want to make that access automatic.”

http://www.insidehighered.com/news/...xpand-their-activities-overseas#ixzz2zqOVSP54

The "brain drain" argument doesn't apply to the well-established Caribbean schools. It's high time someone challenges this cartel, IMHO.

-Skip Intro
Armchair Attorney (haha)
 
Let me frame it one last way...

This is the most important concept here: (1) The rules were written to fit the situation, and not the other way around; (2) they can change the rules, if they want to.

Those are critical points in this. Take the Philippines, for example. If the LCME had come into existence, with the U.S. territory rule in effect like it is now, prior to the time we removed our control as a territory restoring them fully to an independent sovereign nation, there would be no inclusion for U.S. territories in the LCME rules. Why? Because this country would be flooded with Filipino physicians. And, it would contribute to the exact "brain drain" they are worried about.

-Skip
 
And, if they will bend their criteria for a school to allow a similar type program that just happens to be in a U.S. territory to functionally operate the same as all other Caribbean medical schools without the co-requisite curricular changes, then they open themselves up to a legal challenge - not saying DeVry would win such a lawsuit - just that it could (and might likely be) a maneuver they try. For that matter, Mexico could get on-board, but they were already granted a "fifth-pathway" option that is somewhat in between (and has been required by the Mexican government's civil service obligations).

But, this is moot. Either the St. Croix school will figure out a way to meet the requirements, or they will never get accredited. Again, the LCME could expand their accreditation. They just don't want to...
Yes - this! I don't think the LCME would consider a school that didn't meet the criteria for accreditation. And if they let UVI slip in without something I think it would be USMD schools suing before the Caribbean. And if DeVry wants to, they can try to open a school on US soil. The LCME removed the requirement to be a non-profit, so if they could meet the standards, they could qualify for accreditation. It comes down to this - it is unlikely that UVI can muster this, but in the unlikely event that they DO, there is no argument against LCME accreditation.

But I'm going to disagree with your hypothetical about the Philippines. I disagree because I think that if PR became independent that they should lose LCME status because they are outside of the jurisdiction of the LCME. Therefore, physicians out of these schools after independence would be considered IMGs. Those who graduated while it was still LCME would be fine. Same as if SJB loses their accreditation this year - those who already graduated would be fine.
 
But I'm going to disagree with your hypothetical about the Philippines. I disagree because I think that if PR became independent that they should lose LCME status because they are outside of the jurisdiction of the LCME.

You're right, but I think you might have slightly missed my point. I was trying to illustrate that, if the Philippines was still a territory, the rules would have been written differently to begin with so that LCME accreditation would never have been giving to any schools physically located outside the actual United States or Canada borders. In other words, had that occurred there would be no LCME accreditation in Puerto Rico right now either. Again, the rules were written for the situation; the rules didn't create the situation. Do you understand the subtle distinction?

But, now that those rules are written, they have to honor them and at least consider this school. It's kind of like letting the skinny, short, wimpy kid try out for the basketball team knowing that he's never going to make it.

-Skip
 
If UVI opens up a med school, it would be just as competitive as the US mainland schools. PR schools are not crazily competitive because they cater mostly to Puerto Ricans and the education is bilingual...
 
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Well, well, well... They just secured a $30M donation to help them start this school. The plot thickens.

http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=11244733&ref=rss

But, I'm still not holding my breath. There are a lot of obstacles to overcome, and they are not even on the LCME's radar screen (at least by their website).

Personally, I'd hate to be at the LCME and have to deal with this. I'd be willing to bet that they don't want to have anything to do with trying to navigate this potential political hot potato.

-Skip
 
Well, well, well... They just secured a $30M donation to help them start this school. The plot thickens.

http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=11244733&ref=rss

But, I'm still not holding my breath. There are a lot of obstacles to overcome, and they are not even on the LCME's radar screen (at least by their website).

Personally, I'd hate to be at the LCME and have to deal with this. I'd be willing to bet that they don't want to have anything to do with trying to navigate this potential political hot potato.

-Skip
I think it might be easier for them to start with a small class size (40-50 students) and have affiliation with hospital(s) in the mainland so students can spend the last 2-year doing their rotations in the mainland (just like SGU, ROSS etc).
 
I think it might be easier for them to start with a small class size (40-50 students) and have affiliation with hospital(s) in the mainland so students can spend the last 2-year doing their rotations in the mainland (just like SGU, ROSS etc).

They will not be able to get LCME accreditation if that is their proposed model.

-Skip
 
You're right, but I think you might have slightly missed my point. I was trying to illustrate that, if the Philippines was still a territory, the rules would have been written differently to begin with so that LCME accreditation would never have been giving to any schools physically located outside the actual United States or Canada borders. In other words, had that occurred there would be no LCME accreditation in Puerto Rico right now either. Again, the rules were written for the situation; the rules didn't create the situation. Do you understand the subtle distinction?

But, now that those rules are written, they have to honor them and at least consider this school. It's kind of like letting the skinny, short, wimpy kid try out for the basketball team knowing that he's never going to make it.

-Skip

I disagree, but there's really no way to know one way or the other what would've or could've happened. All we know is how the rules exist now.

Well, well, well... They just secured a $30M donation to help them start this school. The plot thickens.

http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=11244733&ref=rss

But, I'm still not holding my breath. There are a lot of obstacles to overcome, and they are not even on the LCME's radar screen (at least by their website).

Personally, I'd hate to be at the LCME and have to deal with this. I'd be willing to bet that they don't want to have anything to do with trying to navigate this potential political hot potato.

-Skip

And again with the political hot potato. There is literally no political juggling that the LCME has to do with UVI. Like you said, it's like letting the scrawny kid try out for the basketball team. They meet standards, or they don't. Period.
 
And again with the political hot potato. There is literally no political juggling that the LCME has to do with UVI. Like you said, it's like letting the scrawny kid try out for the basketball team. They meet standards, or they don't. Period.

My bet is the LCME will do whatever they can to ensure that this school does not get accredited. If that means simply failing them on their credentialing, they will. If it means changing the rules, they will.

I'm sorry that you can't understand the distinction between Puerto Rico, a highly populated, developed, and industrialized island (thanks to Harry Truman), and the U.S. Virgin Islands, a lush, tropical, tiny, resort island that caters to rich tourists. I'm also sorry you can't understand, as well, why this is a potential political nightmare for the LCME. I think the LCME take themselves quite seriously, and the idea that is tantamount to a resort island being able to set-up a medical school like the other Caribbean schools that they have turned-up their noses at for the past 30+ years, and that they will be forced to accredit, has got all manner of closed-door meetings going on there. Right now.

As it now stands, you can check they LCME website. It's not (officially) even on their radar screen. No wonder why...

-Skip
 
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My bet is the LCME will do whatever they can to ensure that this school does not get accredited. If that means simply failing them on their credentialing, they will. If it means changing the rules, they will.

-Skip
They will fail the school before changing the rules. The fact is the ONLY way they would be looking at a lawsuit is if they changed the rules to exclude the USVI. It obviously falls under the LCME's jurisdiction and there is literally no reason not to consider it.
 
They can change the rules to suit whatever purposes they want to suit. That's what you're not getting.

-Skip
 
They can change the rules to suit whatever purposes they want to suit. That's what you're not getting.

-Skip

Of course I understand that they can change the rules however they like.

But such speculation is pointless.

What you're not getting is that you're making these speculations with no foundation. Why would they change the rules - there is literally no reason to. They have standards and the school makes it or it doesn't. Yes, they could change the rules to say only commonwealth status or higher... they could also change the rules to say that a medical education program must partner with a Clown School. So what?

The only thing I'm not getting is this: WHY would they change the rules? There's no need or reason to.
 
"Discussion and planning for the medical school began in 2010 with the Boston University School of Medicine (BUSM), which has been very instrumental in helping UVI move in this direction. Some BUSM students have been taking their fourth year electives at Schneider Regional Medical Center for the last two spring semesters." Who wouldn't want to go do an elective in the Caribbean for a few months? Sign me up.

Read more: http://www.digitaljournal.com/pr/1880684#ixzz30JmKzGrk
 
“The Virgin Islands is truly fortunate to be eligible for accreditation of its planned medical school. America's Liaison Committee on Medical Education is the accreditation body for medical schools in the United States and Canada, and it would also extend its authority to the Virgin Islands, as the only English-speaking United States territory in the Caribbean,” he continued. “This advantage over every other medical school in the Caribbean will put UVI's Medical School on the map and ensure its success.”

http://www.uvi.edu/news/articles/2014/12_126_medscho.aspx
 
@ReeseC . I agree with @Skip Intro in that LCME can change their rules so they can stop UVI from opening that med school... Opening a med school in an island with a population of 50k makes little sense... But I don't understand why Skip said that they cant not set it up in a way that students can spend their last 2-year doing rotations in the US mainland.. I also disagree with Skip when he/she keeps mentioning that LCME accredits schools in the US 'and Puerto Rico' because when you say that, it makes seem like PR is an exception (not the rule).
 
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All due respect to Skip, but I don't think he's giving this school a fair look. Skip is a graduate of Ross University, which is a Caribbean school but unable to ever receive LCME accreditation. Now, here comes along UVI, a school also on an island, that seems to have a legit shot of being accredited. If things move forward with this school, it will be better than any Caribbean medical school. It will simply be an American medical school on an island. This, in a way, may make Caribbean medical students/alumni a bit.... upset.
 
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@ReeseC . I agree with @Skip Intro in that LCME can change their rules so they can stop UVI from opening that med school... Opening a med school in an island with a population of 50k makes little sense... But I don't understand why Skip said that they cant not set it up in a way that students can spend their last 2-year doing rotations in the US mainland.. I also disagree with Skip when he/she keeps mentioning that LCME accredits schools in the US 'and Puerto Rico' because when you say that, it makes seem like PR is an exception (not the rule).

I also agree with that. The LCME could absolutely change the rules - the question is would they and why?

I think you actually thought of the best rule change they could make. I would be shocked if they just arbitrarily changed the rule to exclude the Virgin Islands, Guam, etc, but I could see them making some rule that required a certain US population to be living within a certain radius of the school. This could effectively block UVI from opening a school, but could have an actual reasonable argument beyond, "Oh well.... we just don't want to accredit you, so we changed what 'US' means..."

But I think that this is also doubtful. It comes down to a simple question, "Why would they?" There's just no reason to change the rule.
 
All due respect to Skip, but I don't think he's giving this school a fair look. Skip is a graduate of Ross University, which is a Caribbean school but unable to ever receive LCME accreditation. Now, here comes along UVI, a school also on an island, that seems to have a legit shot of being accredited. If things move forward with this school, it will be better than any Caribbean medical school. It will simply be an American medical school on an island. This, in a way, may make Caribbean medical students/alumni a bit.... upset.

Haha, no.

I have no dog in this fight. Really, I don't. It's not personal. I'm done with my formal education, I completed residency at the university level, am board-certified, and living the good life. My medical school/education is behind me and, although I'm grateful of the opportunity Ross provided me, I think if you search my posts you'll find I'm equally honest and critical of the challenges going that route.

What I do like to do is carefully analyze a situation, consider all the variables, and ponder the most logical conclusion based on the best available evidence. That leads me to believe that the LCME can go either one of two ways: (1) they can allow this school to become accredited (and, BestDoctorEver, they would have to provide clerkships/residency per the current established rules which will be a significant challenge) with the understanding that they will potentially open a huge can of worms (e.g., possible legal challenges from other schools, opening of other schools in other U.S. territories, etc.), or (2) not accredit the school based on deficiencies that they are likely not going to be able to rectify. The 2nd scenario seems most likely. However, just know that the LCME can change the rules at any time they want.

Other than that, I really don't care. It honestly doesn't matter to me if the school opens and gets accredited, if that's what is meant to happen. But, as I've said repeatedly, I'm not holding my breath. Beyond that, it has no affect on my life.

-Skip
 
I also agree with that. The LCME could absolutely change the rules - the question is would they and why?

I characterized Puerto Rico as an "exception", and I know you took a little umbrage with that. Naturally, I don't work at the LCME and I have no idea what is going through their collective minds, past or present. But, the reason why I would characterize Puerto Rico (and Canada, for that matter) as being included (maybe that's a better word) has to do with pragmatism more than anything else.

When the rules were established, as I mentioned before, the goal was to likely limit burdening the regulatory component of the ECFMG for those graduates/doctors who would be more prone to crossing the borders/getting in a plane for training or otherwise to establish a practice. It makes sense for Canada, which has numerous well-established schools, to be included because it would significantly cut down registration with the ECFMG, giving consideration to the excellent training at those schools and the high bar for admission... and that we share a border. That's very neighborly.

Again, why Mexico - who also shares a border - wasn't included and instead given a "fifth pathway" is beyond me, but probably had to do with concerns about purportedly "sub par" matriculants (and possibly what-was-considered sub par training) at some of those institutions. It was too much work for potential oversight of the 38 Mexican medical schools for the LCME. So, they just wrote the rules to exclude them. There are only 4 in Puerto Rico (one of which has had problems maintaining LCME accreditation), which is much easier manage. Plus, as you astutely point out, it is a part of the U.S. However, they could've very easily made a "fifth pathway" type of arrangement for Puerto Rico, but that might have been a political lightning rod at the time. Just easier to include them and provide proper oversight. Again, remember the rules, and who's excepted, included, or not included, are arbitrarily set by the LCME.

Now, consider St. Croix opening a medical school that would likely going to be run in what is tantamount to a similar model for the other already well-established Caribbean medical schools. What would be the real difference, then, between St. Croix's school and Ross, AUC, or St. George's? The biggest part of why the LCME has never considered including these schools, in my estimation, has to do with the fact that they are perceived as not really being institutions of higher learning that support research, residency, ongoing training, etc. and instead more as clinical instruction sites that circumvent requirements of what the LCME considers necessary for the "mission", if you will, of medical education (namely research, clinical stewardship, etc.). If this is the case as it plays out, I don't see how they could approve the U.S. Virgin Islands school if this is the model. The rules wouldn't have to change.

However, let's say they somehow meet the requirements. I don't still believe that the LCME would want to accredit this type of program, notwithstanding the fact that I believe it would be hard for them (in my opinion) to maintain that accreditation. Again, it has to do with resources and opening the door for other such programs in Guam, Marianas Islands... heck, even Samoa. That's why I think they would consider changing the rules, were this to become the case.

I will say this, though. With the infusion of promised cash, I think that there is a real challenge there. I would hate to be at the LCME trying to figure out what to do about this "problem". It is my strong opinion that the AAMC and LCME (and other regulatory bodies) would like nothing more than to see the Caribbean medical schools completely disappear. Discussion of this school in St. Croix just adds a different, and slightly bizarre, challenge to the mix. That's why I'm not holding my breath. The rules have created the current situation, no doubt. But, I don't believe that anything is off the table, including (again) changing the rules to fit the situation.

-Skip
 
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I characterized Puerto Rico as an "exception", and I know you took a little umbrage with that. Naturally, I don't work at the LCME and I have no idea what is going through their collective minds, past or present. But, the reason why I would characterize Puerto Rico (and Canada, for that matter) as being included (maybe that's a better word) has to do with pragmatism more than anything else.
Or maybe it's as simple as the fact that Puerto Rico is a part of the United States - so it is included. Canada really has nothing to do with it.

There are only 4 in Puerto Rico (one of which has had problems maintaining LCME accreditation), which is much easier manage. Plus, as you astutely point out, it is a part of the U.S. However, they could've very easily made a "fifth pathway" type of arrangement for Puerto Rico, but that might have been a political lightning rod at the time. Just easier to include them and provide proper oversight. Again, remember the rules, and who's excepted, included, or not included, are arbitrarily set by the LCME.
You are oabsoletely correct - they could have made a fifth pathway for Puerto Rico. They didn't. They arbitrarily made the rules to limit it to US and Canadian Schools... perhaps that's why Puerto Rican schools were included.


Now, consider St. Croix opening a medical school that would likely going to be run in what is tantamount to a similar model for the other already well-established Caribbean medical schools. What would be the real difference, then, between St. Croix's school and Ross, AUC, or St. George's? The biggest part of why the LCME has never considered including these schools, in my estimation, has to do with the fact that they are perceived as not really being institutions of higher learning that support research, residency, ongoing training, etc. and instead more as clinical instruction sites that circumvent requirements of what the LCME considers necessary for the "mission", if you will, of medical education (namely research, clinical stewardship, etc.). If this is the case as it plays out, I don't see how they could approve the U.S. Virgin Islands school if this is the model. The rules wouldn't have to change.
Or maybe, call me crazy, Ross, AUC, and St. George's aren't considered because the LCME has arbitrarily decided that only schools in the US and Canada can be considered, and none of those schools are located in the USA or Canada. "But they could change the rules to include them!" Sure, but they haven't and they likely won't. Now whether or not they could meet LCME standard is another question.

You are absolutely right in saying that the challenge UVI will have to overcome is meeting the LCME standards.

However, let's say they somehow meet the requirements. I don't still believe that the LCME would want to accredit this type of program, notwithstanding the fact that I believe it would be hard for them (in my opinion) to maintain that accreditation. Again, it has to do with resources and opening the door for other such programs in Guam, Marianas Islands... heck, even Samoa. That's why I think they would consider changing the rules, were this to become the case.
Let me understand if I'm hearing you right... You think that even if UVI met LCME standards... the LCME still wouldn't want to give it because then other medical schools in the US might want to open? They better just stop accrediting ALL medical schools then. If a new school in Texas opens up... maybe California will want a new school too! The horror!

This literally makes no sense. Who cares if more schools want to open up if they can meet the standards of the LCME? (Other than students fearing a saturated market like with Law schools)

I will say this, though. With the infusion of promised cash, I think that there is a real challenge there. I would hate to be at the LCME trying to figure out what to do about this "problem".
Oh my goodness, an American University wants to try to open a Medical School. This is a problem.

Oh... wait... how is this a problem?

It is my strong opinion that the AAMC and LCME (and other regulatory bodies) would like nothing more than to see the Caribbean medical schools completely disappear.
I honestly don't think that the AAMC or LCME care one way or another about the Caribbean schools. Why should they? Even if you want to see them as competition, it's like competing in totally different weight classes where the LCME and AAMC obviously have the upper hand.

Discussion of this school in St. Croix just adds a different, and slightly bizarre, challenge to the mix.
Except it doesn't. It is a US school considering opening a medical school. How is this even in the same mix as Ross, AUG, etc?

That's why I'm not holding my breath. The rules have created the current situation, no doubt. But, I don't believe that anything is off the table, including (again) changing the rules to fit the situation.
As I said previously, if the rules were changed it would be indirect, like a rule requiring a certain US population to live within a certain radius of the school. I don't think they would ever change the rules to say, "We accredit most of the US and Canada."

Basically our differences lie in the fact that you see this as some big problem, and I don't. You like to extrapolate, "Oh, Puerto Rico maybe is only included because they had to at the time." "UVI could open a can of worms with this." "What a 'problem.'" Whereas I prefer the more logical, "Maybe it was included because it's part of the US." "UVI can't open a can of worms... it's part of the US." "This is not a problem... unless the LCME sees every new med school that wants to open as a problem."

I cannot begin to comprehend why you think that this is a problem, except that you seem to have decided that the LCME never wanted to include anything but the fifty states (oh... and federal districts?) in it's jurisdiction and it accidentally overlooked PR, Guam, Somoa, USVI, etc now creating this "problem." I see absolutely no basis for that thought process.
 
Or maybe it's as simple as the fact that Puerto Rico is a part of the United States - so it is included. Canada really has nothing to do with it.

Canada has everything to do with it, for the reasons I elucidated. The same that Mexico not being included also has everything to do with it.

They arbitrarily made the rules to limit it to US and Canadian Schools... perhaps that's why Puerto Rican schools were included.

You could've stopped right here. Everything else is conjecture, speculation, and armchair musing. :)

-Skip
 
Canada only has to do with questions asking why Mexican or the Caribbean schools are not included.

It has nothing to do with why/why not include the Puerto Rican or USVI schools.
 
@Skip Intro ... I still don't get why you keep saying PR schools are 'included'... It is not a matter of special circumstances. These schools are accredited because they are US schools and they also meet LCME accreditation standards just like schools in FL, NY, CA, VA etc... Canada is another story.

I know wiki is not the best source in the world, but they don't make that distinction that you insist in making.
http://en.wikipedia.org/wiki/LCME
 
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I think you guys are hung-up on some notion that the LCME is obliged to act a certain way or another simply because these territories are covered under U.S. sovereignty. That, because PR is part of the U.S. , this proposed school in the U.S. Virgin Islands will necessarily get the same treatment.

For the record, I'm not making a distinction about what is and is not a U.S. territory. I am making a distinction about the LCME accreditation rules, similarly to how this distinction is extended to Canada and their schools are "included" in their accreditation process. Just the same as Mexico is not included.

-Skip
 
I think you guys are hung-up on some notion that the LCME is obliged to act a certain way or another simply because these territories are covered under U.S. sovereignty. That, because PR is part of the U.S. , this proposed school in the U.S. Virgin Islands will necessarily get the same treatment.

For the record, I'm not making a distinction about what is and is not a U.S. territory. I am making a distinction about the LCME accreditation rules, similarly to how this distinction is extended to Canada and their schools are "included" in their accreditation process. Just the same as Mexico is not included.

-Skip
Yeah... I guess you could say we assume that the LCME will follow the rules they placed. I guess you could say we're "hung-up" on that. We're hung up on the idea that the LCME will continue the same rules that they seem to have been using. You seem to be hung-up on the idea that the LCME has some reason to change them because of UVI. You're making speculation with literally no examples with which to base your assumptions. We have reasons to think that UVI will absolutely be considered - you only have conspiracy theories.

Is the point of your second paragraph to illustrate how the LCME arbitrarily decides who is and isn't accredited? If so - yes you are correct. Currently they consider Canadian and US schools.

If you're trying to say that Canadian schools being accredited/considered are similar to PR or a UVI schools getting accreditation/consideration, then no. That is not similar because Canada is international.

And yes - the US and Canada school set is ARBITRARY. So lets try to figure what will happen based reasonably on what we know rather than on absolutely nothing.

Seriously... so have any reasons why UVI should be blocked by the LCME? I don't think I've seen anything even remotely reasonable from you, but you continue to insist on using rhetoric painting this school as a "problem" for the LCME.
 
The LCME accredits medical schools in the United States and Canada. UVI is located in the Virgin Islands, which is part of the United States. Therefore, as long as it meets appropriate standards, it should be accredited. Is it not as fundamental as this? Why is Mexico, or any other random country being mentioned?
 
And yes - the US and Canada school set is ARBITRARY. So lets try to figure what will happen based reasonably on what we know rather than on absolutely nothing.

As I said at the very beginning of this thread, don't hold your breath...

Seriously... so have any reasons why UVI should be blocked by the LCME? I don't think I've seen anything even remotely reasonable from you, but you continue to insist on using rhetoric painting this school as a "problem" for the LCME.

The reason is that it would make a mockery of the LCME's "high standards" they purportedly hold themselves to, namely putting an accredited medical school on primarily a resort island in the Caribbean. It serves no greater purpose.

-Skip
 
The reason is that it would make a mockery of the LCME's "high standards" they purportedly hold themselves to, namely putting an accredited medical school on primarily a resort island in the Caribbean. It serves no greater purpose.

-Skip
If they meet they "high standards" of the LCME, it doesn't make a mockery of those high standards. Furthermore, it's not as if they are just putting a medical school on an island like with Ross or AUG. UVI is a University that already has existing programs, and they're looking to add medicine to the list.

How does it make a mockery of the high standards of the LCME? Again - you're making assertions with absolutely no basis or argument or support.
 
Again - you're making assertions with absolutely no basis or argument or support.

ReeseC,

I've made my arguments and supported them. You are free to re-read them. You may not agree with them. But, to claim that I haven't is disingenuous.

I think, after this circular exchange and (at this point) fruitless discussion, it's clear we can at least agree to the arbitrary nature of the LCME rules. That doesn't mean they have no basis. It just means that they are arbitrary. They can change them at any time and for any reason. Not that the will. Just that they can.

I've also said I'll be the first one to eat a large plate of crow if this school gets LCME accreditation. What's your wager? I don't care whether or not they even get a look by the LCME. That part is irrelevant. They will not get accredited. That's my bet. I'm sticking to it.

And, at this point, I think I've said all that needs to be said. I'm not going to hold my breath. The dead horse is beaten.

-Skip
 
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