When considering medical school, a Caribbean island where sand runs away from beneath coconut trees to a turquoise sea is not likely what first comes to mind. That is, unless one consider St. Martinus University Faculty of Medicine in Curaçao.
A former seminary set atop a hill, the university is a quiet, well-equipped refuge away from the colorful distractions of the rest of the island, which is a magnet for divers, golfers, vacationers, history buffs and more.
Stephanie Peters, a Canadian student in her second year at the university, said the weather was a big factor in her deciding to move to more balmy climes.
With magnificent understatement, she said, “It’s a significant improvement from what I see in northern Ontario.” Her parents were also comforted by the fact that even the US state department puts Curaçao in its safest category. Which is why she decided not to opt for the residential facilities available on campus.
“I wanted to be where people actually live – and have a life,” she said, adding a little possessively, “Our island is different. The main economy is not tourism. Aruba, a lot of people know about [but not Curaçao].”
Peters, who plans to specialize in obstetrics and gynecology, said she could not opt for a better school.
Though living costs are low enough, comparable to her native Ontario, she points out the significant savings she made by moving to Curaçao.
“In Canada, it takes three years before you get into med school. In the Caribbean, I’d be done by the time I would have started school in Canada,” she said, describing her move as a good one.
“The class sizes and faculty are perfect – 30 students is the average. It gives us an opportunity to know professors on a one-to-one basis,” she said, adding that while she relished all her classes, the pharmacology class of Dr. Danna Soria was particularly fascinating.
Dr. Nikhil Hemady, Dean of Clinical Science at St. Martinus University, said he was skeptical of what to expect when he first went to Curaçao.
“The island is fairly well-developed, like a mini first-world country. I was expecting something completely different. I was very impressed.” he said, describing, like others, the warm and friendly locals and, more importantly, a well-structured medical school with a staff clearly good at taking care of students.
Jenilee Misko who, like Peters, is from Canada, described the island as being “super nice,” waxing lyrical about the beaches and the mountains and the safety when walking to the corner store or the school. She particularly liked the fact that unlike other Caribbean islands, Curaçao lies outside the hurricane zone and that she did not have to pack a variety of clothes.
Misko concedes that swotting away at med school could naturally get frustrating. But then there was always the beach to go down to and unwind.
Swapna Bobbity described Curaçao, with its beaches, mountains and lovely weather as being rather distracting.
“The point is to stay focused. It can be hard at times,” said Bobbity, who said her anxious family had come over to the island after she got admissions and were reassured by how safe it was.
Rondoo Mbaidjol had higher reasons than beaches and mountains to pick the university. With a family from Chad, experience living in France and the US, he said he was drwan to Curaçao’s variegated culture – a blend of Dutch, English, Spanish, Portuguese, African and local influences. He aims to study in Europe, and is working on getting accreditation from a Dutch university.
The hard road up
Today, the school may be flourishing. But things were a little different when the founders of St. Martinus – Sanjay and Priyam Sharma – took over the ailing university, which at the time was risking losing its license if it also lost its one and only student, Ariel Yeshurul.
“The school was shutting down. At that time a lot of the students were very skeptical [and] left,” Yeshurul said, describing the problems as being essentially of a financial nature.
“Bills were not paid. The anatomy lab had no electricity,” he said. “It was just a shell. Everybody abandoned ship. Here I was, the only student.”
“I struggled between family – being a rabbi – and going to school,” Yeshurul said. “I kept on on going. I managed with a high GPA: 3.9. I believed in the school. I believed there was a lot of potential.”
Despite the problems and the fact that people had not been paid for a year, there was a still a strong sense of community, even before the Sharmas – Sanjay and Priyam – stepped in, Yeshurul said.
“There was a good vibe before, too, incredible atmosphere,” he said. “The professors were incredibly highly trained, and beyond the classroom, there was a cohesiveness, a camaraderie.”
Yeshurul’s faith was not misplaced. The Sharmas built upon the university’s sense of community, infusing money to recharge the coffers to fix the infrastructure, and to bring in new staff with strong credentials and students who could burnish the university’s credentials.
An orange a day
Today, the university has less worrisome problems, such as how to deal with the downside of living in healthy climes. Medical students cannot heal already healthy people.
Priyam Sharma, the Vice Chancellor, points out that Curaçao means island of healing in Portuguese.
Legend has it that back in the fourteenth century some sick European sailors, possibly down with scurvy, the result of a lack of vitamin C, were offloaded on the island. When the ships returned to the island, the crews were astounded to find the people they had left behind were in robust health, in fact healthier than they were (the island is famed for its bitter Laraha orange, rich with vitamin C). Whatever the reason, according to that narrative, the visitors bestowed the name that alludes to its restorative powers, a title that could discourage budding doctors.
St Martinus students do go over to the one big hospital on the island, St. Elizabeth Hospital, an advanced facility built with help from the Netherlands. But they need to know Dutch to get proper experience with patients there.
According to Dr. Ravi Kishor Reddy Vintha, who teaches at the university, the school has come up with the novel strategy of getting local people to act as patients, exhibiting symptoms that students have to identify. But while this helps address textbook cases of a disease, the world of diagnostics is often way more complicated.
The Sharmas’ solution was to have a teaching hospital of their own where students could be
ensured clinical rotations. In fact, the Pontiac Hospital is the only hospital linked to a Caribbean medical school that is accredited by the Accreditation Council for Graduate Medical Education, which is responsible for accrediting most graduate medical training programs for physicians in the US. Thanks to this, students do not have to keep looking out for rotations in a variety of hospitals but can get back-to-back rotations, saving time and money while completing their curriculum.
After two years of basic science preparation on the Curaçao campus, during which they study everything from anatomy to parasitic zoology, the students do two years of clinical work at the hospital, in Pontiac, Michigan.
While not as much fun as soaking in the Caribbean sun, the students do not have to scrounge around for clerkships in any available hospital in the US, but can do their 48 weeks of compulsory rotation requirements and 24 weeks of elective ones all in one place. They do all have to clear the US Medical Licensing Examinations to practice in the US.
According to Dr. Hemady, the Program Director of Family Medicine Residency Program at Pontiac General Hospital, while a majority of the students plan to study for it, those seeking in other countries, including Canada, the United Kingdom or their home countries, have to meet other requirements.
Hemady said that the two years at the hospital builds on the students’ experience, supplementing the education they got in Curaçao.
“My job is to be an educator,” he said. “They come in with basic medical knowledge. My responsibility is to train them in clinical medicine.”
While Mbaidjol, Misko and Bobbity are getting their clinical requirements behind them, Peters is working on her Step 1, the first of three USMLE exams.
“Some do this after clinical rotations or during them. I just want to get it out of the way,” Peters said with some determination.
Yeshurul, the student who saved the school, also plans to get back to his clinical rotations.
Clearly, besides encouraging healing Curaçao also has a salubrious influence on the healers.
Vice Chancellor Priyam Sharma: The Turnaround Artist
A potential geologist, a software mogul, and a vice chancellor of a university would raise the standards at any gathering. You could have them all if you invite Priyam Sharma, who also wears the hat of dean of administrative affairs at the St Martinus Faculty of Medicine.
Sharma, the only woman vice chancellor of a Caribbean university, had once dreamed of becoming a geologist, after earning a degree in the subject at Kumaun University in Nainital. But since the field had little future in the India of the 1980s, she opted for another master’s degree, in computer science, at the Florida State University in Tallahassee.
Among other jobs, she did benchmarking for a supercomputer, worked on software for the US army and then at the University of Illinois. Her husband Sanjay, who was earning a PhD in computer science in the interim, got a job at IBM. So she went off to Austin, Texas, where she set up a small company, Winaix Software.
She worked on healthcare software, and opened a back office center in India. And then a vacation changed everything. “We had gone for a trip to one of the Caribbean islands,” she said.
“We saw that a lot of schools were not been run very well. Some were in ruins. My family decided we could run one properly.” In 2011, they purchased a school that seemed promising – St Martinus in Curaçao.
“The people were welcoming. We were bringing business [after all],” Sharma said. But once she entered the campus, reality descended on her, dark and ominous. The campus lay in about a foot of water, the saving grace being a pink laptop sitting in just eight inches of water. The only equipment still available in the medical school were microscopes.
The Sharmas could fix the infrastructure, buy equipment, but potential employees shunned the institution and news students were hard to find. “The previous owner had not paid people for a year. Nobody wanted to come,” Sharma said.
According to Sharma, “[there was] one student in the school – Ariel Yeshurul.” Just because he had stuck on, the university had not lost its accreditation. An official from another medical university who remembers hearing the details, said, “If I were in her place, I’d just walk away.” Not the Sharmas.
“We had money from other businesses. We have never take money from anybody else,” she said before remembering that at least once they had taken a loan from Enhance Capital, a partner of Berkshire Hathaway, in 2008, but that was for their software business. Because of the work on the university, their attention was divided.
“The stress is two-fold. Capital is taken out of the [successful] business. When involved in other businesses, we lose focus. The other businesses were run by employees but it’s not the same,” Sharma said.
“We have highly qualified faculty who constantly updates the curriculum with new advancements in the field of medicine,” she said. There are 30 professors on the island teaching the basic and clinical sciences, about 30 in Michigan managing clinical rotations and a staff of Curacao locals to take care of administration and other school work.
Sharma said the biggest challenge was that students had never heard about Curaçao, even though Tiger Woods popped over often enough to play golf. Her children were in school but she had to travel to many countries to set things up. If in 2011, she was hiring staff in Curaçao, by early 2012 she was in Canada, pushing to get federal loans for her students there.
From May to September, she was in India, trying to get new students there. She went in with one solid advantage, though – her husband Sanjay. They have been married now for 35 years, and known each other for 51. That is the benefit of having first met your spouse in the second grade. With that backing, she could go on her travels, secure that things at home would go fine. Sharma soon realized that while the Curaçao end was stabilizing, the students still had an uphill task organizing internships.
“Students kept moving to different hospitals – a few weeks at a time [to do the required clinical clerkships],” she said. “There was no stable places to do their third and fourth year. That was a huge challenge. Some students sat for months in hotel rooms waiting for their next rotation. They get one for six weeks and then wait again. How fair is that??” So, the team bought an ailing teaching hospital in Pontiac, Michigan, in 2016.
“There people could now do their third and fourth year of medical school in the US if they wished,” she said. But the hospital had its own problems: It was bankrupt and yet, debts apart, became profitable within a year. “When we took over, there were 18 spots for [clinical rotations in] family medicine,” Sharma said. “We got it raised to 24 in 2016. Last year, we applied for psychiatry residency and got 16 spots this year. We are now increasing psychiatry wards, and medical psychiatry wards.”
There are about 72 students doing rotations in Pontiac, more than in 500 when the students back in Curaçao were included. A few are doing rotations in other hospitals. Yeshurul, the student who saw the darkest days of St Martinus, said Sharma has been creating the right environment for students, keeping a strong sense of continuity.
“A lot if it has to do with Priyam’s leadership and vision. She believed in St Martinus. The university was on its way to closure. She saw what other people did not see.” That is indeed what is called a visionary.