Tuesday, 16 February 2016

Barbados The Best Source for Offshore Medical Education in the Caribbean

Why Barbados

Barbados is a coral paradise in the Caribbean. It is a delightful mix of culture, food, natural scenic beauty, a warm climate and the sea that merges with the blue skies in the distant horizon. It is a beautiful country with secure living conditions. There are eleven parishes and four towns, each with their own character, charm and history.

The beauty of the place has rubbed onto every Barbadian heart. There is a smile on every face and a twinkle in every eye.  It is the most pleasant place to pursue your dream of mastering the art and science of modern medicine.

Some Facts about Barbados:

The United Nations Human Development Index (2011) placed Barbados in the highest bracket, namely the "Very High Human Development" category, which is well above the regional average for the Caribbean and Latin America.
Visitors highlight the friendliness of Barbadians as the island's greatest and most pleasing asset. This is reflected in the highest repeat visitor factor in the region of 39%.
The people of Barbados have a history of long ingrained Christian principles and the nation’s free educational system has given rise to a literacy rate of 97%.
Barbados has the third oldest parliament in the world, with uninterrupted parliamentary governance since 1639.
Barbados was the only vacation destination in this hemisphere with a scheduled Concorde service. One retired British Airways Concorde now resides at our international airport.
The name 'Barbados' is derived from the Bearded Fig Trees once found in abundance on the island.
Barbados is completely surrounded by the Atlantic Ocean (see where is Barbados).
Barbados is 21 miles long and 14 miles wide!
Barbados Fertility Centre is the only full time fertility unit in the Caribbean region. Its success rates are higher than the UK and the USA and treatment costs are a third of the price.
We are the only coral island in the region with all white sand beaches.
Barbados has pure drinking water and was the first Caribbean island to have piped water.
The island has excellent telecommunications systems.
Barbados' cultural diversity helps make the island so distinctively charming.
Utilities are available all across the island.
Barbados is easily accessible from everywhere.
The maximum daily temperature is 75-90°F (23-32°C) year round. The island is consistently cooled by the north-east trade winds.

Offshore medical schools are medical institutions outside the United States that mainly cater to international medical students, most of them U.S. or Canadian citizens. These schools tend to attract students in large numbers who have failed to gain admission to accredited North American medical schools, whether because of low scores on the Medical College Admissions Test (MCAT), low undergraduate GPAs or a combination of both. Distinguishing offshore medical schools from other (public) academic institutions in the Caribbean is the fact that the former offer programs that are geared almost exclusively towards U.S. medical students while the latter mostly train domestic students.

The business of training North American medical students offshore began in the late 1970s with the establishment of campuses on the islands of Dominica, Grenada and St. Martin by American entrepreneurs and medical professionals who saw a demand for medical education that could not be met domestically. Entrepreneurs were able to begin meeting this demand by developing profit-generating institutions that were subject to much less stringent oversight from local authorities than was the case in the United States or Canada.  While in the past only a few Caribbean offshore medical schools existed, more recently they have mushroomed significantly both in number and location. Today, there at least 30 institutions catering almost exclusively to international students, and they are located on more than 15 islands and nations.

The reasons behind this explosive growth over the last decade are fairly straightforward. The primary factor is demand. Simply put, there are not enough places at North American medical schools to meet the demand of aspiring medical students; a demand that comes in part because of severe personnel shortages in the healthcare labor market in the United States. And of course, the basic laws of economic theory suggest that where there is demand for a product or service, supply will emerge to meet it. Also, from a Caribbean perspective, offshore medical schools bring in significant revenue to very small economies that are otherwise almost exclusively reliant on tourism dollars. A secondary, but not insignificant factor, is the lower tuition costs and laxer admission standards of offshore medical school programs.


With such tremendous growth in the number of offshore medical institutions in recent years, there is a considerable degree of concern surrounding the industry among stakeholders and lawmakers in the United States. Given that the primary motivation for the development of offshore medical schools appears to be related to profits (given that they are all for-profit enterprises), critics frequently point to the fact that the non-profit, public-service mission of the medical school as understood in the United States is lost.
Additionally, there are doubts about teaching methods and the availability of teaching materials. Anecdotally, it appears that much of the teaching at these schools is designed specifically to prepare students for the United States Medical Licensing Examination (USMLE) and the Educational Commission for Foreign Medical Graduates (ECFMG) certification process in order to become licensed in the Unites States. This ‘teaching to the test,’ it is argued, leaves students poorly prepared for the rigors of a professional career in medicine.
There is also significant concern that the teaching frequently occurs over the internet and through distance learning programs, which runs contrary to the American medical school model where strict attendance policies are enforced. With regards to clinical rotations and the integration of offshore medical school students into medical school programs and clinical study programs in the United States, it is very hard for students to transfer to U.S. medical schools. Furthermore, a number of offshore schools fail to meet the necessary standards set by the Liaison Committee on Medical Education (LCME) standards for U.S. residency, and broadly speaking residency directors in the United States do not favor international medical graduates. Many states also require longer periods of residency for international students in order to become licensed.

Another important consideration is that (typically) only a business license is needed to open a medical school in the Caribbean, which is in stark contrast to the rigorous series of standards covering academics, finances, and governance that U.S. medical schools have to comply with to meet the standards of accreditation set by the LCME or the American Osteopathic Association. In most Caribbean nations, licenses are issued with little to no concern over academic standards, and it is these licenses that allow institutions to be listed as a medical school on the International Medical Education Directory (IMED), which qualifies their students to undergo the ECFMG certification process.

Developing Standards
Caribbean Accreditation Authority for Education in Medicine and other Health Professions
These concerns notwithstanding, the establishment of the Caribbean Accreditation Authority for Education in Medicine and other Health Professions(CAAM-HP) has been noted as an important step with regards to improving some of the oversight concerns noted above. Prior to 2003, the Caribbean did not have an entity responsible for the regional assessment and quality assurance of offshore medical school programs. In 2003, CAAM-HP was established, replacing the General Medical Council (GMC) of the United Kingdom, which accredited the medical education programs at the University of the West Indies, at its campuses in Jamaica, Barbados and Trinidad and Tobago.
According to its website, the CAAM-HP is a “legally constituted entity … empowered to determine and prescribe standards and to accredit programs of medical, dental, veterinary and other health professions education on behalf of the contracting parties in CARICOM, … the political and economic affiliation of 15 member states that includes most of the English-speaking islands and some Central and South American nations.”

Certification from the CAAM-HP helps in improving the international acceptance of qualifications awarded by offshore medical schools. For example, the British government has accepted the CAAM-HP as “the official accrediting authority for new and developing schools in the British Overseas Territories located in the Caribbean.” It is also worth mentioning that the CAAM-HP developed its accreditation system based on that of the LCME and the GMC of Great Britain.

Abinash Dev
American University of Barbados
Contact :- +91- 8853426620


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