Med School Minutes- Ep. 43- 25 YEARS OF SJSM with Founder, Dr. Kallol Guha

Welcome to another episode of the Med School Minutes podcast, brought to you by Saint James School of Medicine. In this episode, we celebrate the 25th anniversary of our school with a special guest, Dr. Kallol Guha, the founder of Saint James School of Medicine. Join us as we delve into the history of Caribbean medical schools, the challenges faced, and the vision for the future of medical education.

0:00 - Introduction
0:36 - Guest Introduction: Dr. Kallol Guha
1:08 - Founding Saint James School of Medicine
3:00 - Early Career and Ross University
4:29 - Student Demographics and Quality
6:43 - Accreditation Challenges
10:10 - Improving Clinical Rotations
12:01 - Evolution of Caribbean Medical Schools
14:10 - Establishing SEBA School of Medicine
17:02 - Accreditation Efforts and Marketing Strategies
23:02 - Expanding Saint James to Anguilla and St. Vincent
30:30 - Milestones and Evolution of Saint James
38:00 - Financial Views and Sustainability
44:20 - Challenges and Lessons Learned
49:50 - Appreciation and Closing Remarks

#MedSchoolMinutes #SaintJamesSchoolOfMedicine #MedicalEducation #SJSM #CaribbeanMedicalSchool #DrKallolGuha #MedicalPodcast #25Years #InternationalStudents #MedicalJourney #FutureDoctors

Transcript

Speaker 1: 0:01

Hello and welcome to another episode of the Med School Minutes podcast, where we discuss what it takes to attend and successfully complete a medical program. This show is brought to you by St James School of Medicine. Here is your host, kaushik Guha.

Speaker 2: 0:19

Thank you for joining us on another episode of Med School Minutes, where we talk about everything MD related, with a focus on international schools, specifically students from the Caribbean. Today I have the honor of having a guest who is very, very special to not just the school but to also the 800, give or take practicing physicians in the United States and Canada, and that is the founder of our school, Dr Kaldur Guha. He founded the school about 25 years ago and today we are actually celebrating or this year we are celebrating the 25th anniversary. Dr Guha started his career at Ross University around 1980, 1981, and he's been in the field since that very day.

Speaker 2: 1:08

It is important to note that the Caribbean school as an industry started in 1976. So, in a field or in an industry that is about 45 to 47 years old, Dr Guha has been a part of that industry for over 40 years Now. With that comes an inner strength and a vision that is unparalleled, which is truly the driving force of our institution. So, without further ado, let's hear from Dr Guha. So welcome to our podcast, Dr Guha. We're going into the second season, you are the founder of St James School of Medicine and St James is celebrating 25 years, so why don't you take us back to the time that you started and give us some dates? When did you get involved with Caribbean Medical Schools?

Speaker 3: 2:11

That was in 1981. Actually March 1981. At that time I was in Tufts University as a postdoctoral fellow and from there I was introduced to this. I was looking for a job and then there was an advertisement from Ross University, dominica, and I applied for a job and I was called for an interview in New York Empire State Building and I went there for an interview and they decided to hire me right away without looking into any kind of documentation etc. And I didn't feel very comfortable. So it took a very long time for me to really decide that, whether or not it's a good idea to go to Caribbean.

Speaker 3: 3:12

What kind of place is Caribbean? Because I only knew about West Indies because of the cricket. So from there there was a lot of. In those days there was not much of a scope for doing research about what is West Indies or what is Caribbean, what kind of school it is, etc. Etc. So anyway, after talking to some people, I felt that maybe it's a good idea to try it out and then I was given the job and I joined Ross University around March 1981. And that was the beginning, okay.

Speaker 2: 4:01

And how long were you at Ross University?

Speaker 3: 4:06

From 1981 until, well, all the way to 1995. Okay, end of 95. In between there was a break, but it is. That was the time I spent at Ross University.

Speaker 2: 4:25

Okay. So when you were in Caribbean medical schools, what was the condition? What did you see? How the students were treated? Were these top quality students that were coming to Ross back in the day? Were they? Were you impressed by the students that you saw? Were you impressed by the way the school treated the students? It?

Speaker 3: 4:49

was a very heterogeneous group of students. They came from many different parts of the world. In those days, I saw students coming from Pakistan, from China. Directly from Pakistan, yes, directly from Pakistan. Directly from South Africa. Directly from China. Directly from Pakistan, yes, directly from Pakistan. Directly from South Africa. Directly from Taiwan, Okay so, and most of them were, of course, from US, Very few from Canada. So I met those students from different. But this strange thing was, and very interesting thing was, that some of the for example, I still remember a student from Taiwan who couldn't speak or understand English, but he, that student, was admitted to Ross University.

Speaker 2: 5:41

Okay, and was the process more or less the same? They come here, takes USMLE and then become physicians. What was the hope for these?

Speaker 3: 5:48

Those days there was no USMLE. There was one examination. It was called ECFMG. It was called After that. Well, as time had gone by, then we were told that there will be no US assembly. There will be a VQE Visa Qualifying Examination. And those who took the test, they told us that it is a political examination, not an academic, because the failure rate was very high, deliberately made students to fail. But anyway, it's a visa qualifying examination and after that that test was scrapped and then they started what is called USMLE. Okay, and I think USMLE started sometimes around late 80s or mid 90s, early 80s, 90s, around that time. Okay, but the students' population it was a heterogeneous group. There were some very good students, very bright, what we call A grade students. Some were very poor good students, very bright, what we call A grade students. Some were very poor quality students. But admission was open. Anybody could come get in well, irrespective of their grades.

Speaker 2: 7:16

Okay, and as far as the prospects of the students once they come from, so was the majority of students from international geographies or were the majority from USA, majority from USA, and what were the career prospects of the students in the late 70s, early 80s when they finished from?

Speaker 3: 7:37

Ross bleak. I particularly remember one instance that you see, in those days Ross University was trying to get accreditation from New York, new Jersey. In those days New Jersey also needed their Department of Education, approval from the Department of Education to let these foreign medical students to get into hospitals in New Jersey. So New Jersey delegation came in. We encountered them. New York came in at least five times, and then California came in also, and then California came in also, these three. So we encountered those three panels.

Speaker 3: 8:27

New York I personally encountered at least five times, new Jersey at least three times, because each time they were rejected. But California, well, they just came, they saw whatever they saw and they approved With New York. I remember the students were sitting together with the faculty and the panel on the other side of the table. The panel was sitting and the panel asked the student that all the money that you are spending in this school, what happens if you don't get into residency or something? What happens? The student, without a blink, in front of the panel, in front of the faculty, he said I will have no other option but to commit suicide. The situation was so desperate those days.

Speaker 2: 9:27

So do you think that that situation has improved today, dramatically improved?

Speaker 3: 9:32

Okay, how so Dramatically improved, in the sense that in those days it was next to impossible for students to get into teaching hospitals for clinical rotation Out of the question. One instance is that we were told that in Florida, ross University has applied wrote to every single hospital in Florida. I don't remember exactly the number of hospitals they wrote to and that but every single. Well, they wrote to the hospital requesting them the possibility of accepting the Ross University student for clinical rotation, but of course, ross University promised to pay to the hospital, but every single one of them declined. All right, now, that was the situation.

Speaker 3: 10:34

Only one hospital agreed to take the students and we were told by one of the insiders of Ross University administration that the one who agreed that hospitals was threatened by the hospital association that if you accept any student from this institution, we will expel you from the UDL. That's the situation we will expel you from the UDL. That's the situation we have heard every now and then. The teachers used to tell us that they are getting frantic requests from students that if they could help the students to get into a decent hospital where they can learn something, because right now, wherever they are, they're either clinics working as an orderly of the physicians or in the hospital. Also, they're working as a menial task, so that was the situation there.

Speaker 2: 11:41

So was there no ability for them to? Or when did they start becoming licensed physicians? Because Ross has thousands and thousands of graduates, obviously. So when do you think that that paradigm changed and students started getting physician positions, so Ross started? I think you were in the first inaugural year of Ross University.

Speaker 3: 12:06

No, ross started in 79 and I joined in 81, two years later, but the situation was really very, very desperate. But we have to accept the fact that it is one thing that one can criticize that it was all bad, et cetera, but they are the pioneers. Criticized that it was all bad, etc. But they are the pioneers. So before them they didn't know exactly that because the Ross University, like all other universities, at that time there were three universities One was St George's, another was AUC, american University of the Caribbean, and the third one was Ross University. These were the main universities that we knew of.

Speaker 3: 12:48

There may be some other schools also that we didn't know of, but these schools were being run by people who have no academic background whatsoever. So they didn't know how the administration of an educational institution should be structured, how they should function, how they should be administered. They had no idea at all. So they learned it through hit and run, kind of a trial and error, kind of a process. But they continued to stick to the project and they did everything possible to take it forward, with all the problems they had, but they didn't give up. So that credit must be given to them. They are the pioneers. All the other schools that are now doing whatever they are doing, like St James, for example, has found it relatively easy to take the institution forward. It is because we learned a lot of things from Ross University. That's the reason.

Speaker 2: 13:56

Wow, and after Ross you moved on to other Caribbean medical schools.

Speaker 3: 14:04

That was SEBA School of Medicine. Okay.

Speaker 2: 14:07

And when you were there, did you see any difference between SEBA and Ross?

Speaker 3: 14:11

Yes, well, seba had a much easier time. It is because the owner of SEBA was working in Ross University together with me, so consequently, he learned a lot of things from Ross, which Ross learned things the hard way, so Sabah administration learned a lot of things from Ross, and so consequently, it was relatively easy for Sabah University as a startup, because the experience required as a startup came from Ross. Okay, that's the point.

Speaker 2: 14:50

And in those days. But did you see any operational differences? Like was SEWA quote unquote a better school than Ross, or was it kind of the same thing?

Speaker 3: 15:03

Well, the difference was that when we first started with Ross we saw that they didn't have any idea as to what should be the job description of a dean. They didn't know, so they had to collect information, et cetera. It took them weeks to put together the job description. To form a curriculum committee, for example, it took them nearly three months. But those things were not a factor for Seva University because they acquired the experience and creating promotions committee, creating curriculum committee etc was a routine procedure. That was not a problem at all. With respect to clinical rotation, also, by then, in 1981, I started and then I joined SEWA in 1996. So by that time the students of Caribbean school were more or less accepted, so not as well accepted as it is now, but still they were accepted. They didn't have really the similar kind of difficulty. The students of SEWA did not have the same kind of difficulty in getting into clinical rotation as we saw the students of Ross University encountered.

Speaker 2: 16:29

Okay, so during this time with Ross in the 90s and 80s, was there any concept of accreditation in the Caribbean in?

Speaker 3: 16:42

the Caribbean. Well, yeah, the concept was there, yes, but there was no well-organized what do you call that? Independent accrediting body. There was none.

Speaker 2: 16:54

Okay.

Speaker 3: 16:57

So what came out is that Ross University, for example, they, after what information they could gather from St George's, they worked together with the government of Dominica at Ross University to put together an accrediting panel, accreditation panel by mobilizing the government officials with the best available resources. They mobilized them, put together an accreditation panel and I think the Ross University administration used their political and economic connection to get it recognized by the Department of Education of the US and this is what first initiated in St George's University in Grenada, first initiated in St George's University in Grenada. And after that Ross adopted the same technique and he succeeded in getting the same kind of accreditation by mobilizing the authorities of the government of Dominica. But these independent accrediting agencies that we are seeing now, that didn't exist at that time.

Speaker 2: 18:27

So during those days was so today. The competition of Caribbean medical schools is gutthroat. Every year, you see three to five students start. Every year, you see three to five students shut down. Was it like that back then as well?

Speaker 3: 18:45

I think in those days, I think the what do you call graduation rate was much, much less, far less, naturally, because they weren't accepting anybody. It was said that anybody who can sign a check they can get into the school. That was the way of thinking in those days.

Speaker 2: 19:04

So but what about the competition between the schools like Ross and St George's? Were they amicable? So it sounds like they competed against each other or never formed a consortium or worked together to lobby with the government to get DOE.

Speaker 3: 19:18

It seems like they all did this independently, absolutely yes, they were cutthroat competition in the sense that, for example, it so happened that there was a deliberate attempt from each school to how to say, to spread negative propaganda against the other. And even it so happened that one of the school would send agents at the airport and as soon as there are, let's say, students, new students coming from, coming to get admission in a given school, the other school would do everything possible to take those students and put them into their school. That is what was going on. That was poaching other students, poaching other faculty. That was going on freely, there was no barrier to that.

Speaker 2: 20:18

Not much has changed in that regard, though we still experience something. But the bigger schools, like us, for example, we don't necessarily get affected. But smaller, new schools, that's how they get students. Yes, what about marketing, like when it came to, you know, reaching out to students? How did these pioneer schools spread the word? I mean, there was no internet back then.

Speaker 3: 20:49

You see, unlike St James, those schools, like Ross University, SEWA, they were very secretive. They never involved faculty members in the process of preparation for accreditation, Not at all. Even when they are going to the accreditation panel, when the school is submitting application for accreditation. Those were kept strictly secret. I don't know why, but that was the way things are. Faculty like now, there are committees, et cetera, et cetera. Of course there were committees also in those days, but as far as preparation for accreditation is concerned, there was. Faculty had hardly any preparation before the panel actually physically appeared at the campus and decided to interview the faculty. Before that there was absolutely no interaction with the faculty. Okay, that's it.

Speaker 2: 22:01

So during that time obviously you worked at Ross and then you worked at Seva.

Speaker 3: 22:07

Now just a minute. You talk about marketing Again. As far as marketing is concerned, we didn't know much about how they're getting the students. They were mostly what is called tier of cards. There was a kind of a calendar and in the calendar the tier of cards, and in the cards all the information about the school was printed. And then there were agents who would distribute those tier of cards to different schools and colleges and so on. That was basically, and then advertisement in the newspaper, radio and TV also used to advertise, in that there was no computer.

Speaker 2: 22:53

So obviously you worked at Ross for about 15 years and Seba for about five.

Speaker 3: 23:02

From 1996 until 2001.

Speaker 2: 23:06

2001. But then you so about five, so you about 20 years. In those 20 years you conceived the idea of St James and you started St James. Officially, st James started in 1999. With you know, we got the charter and all of that and then classes started in 2001. But what compelled you to create St James? Because there was already enough like, as you said, st George's Ross, auc, saba enough schools. Why did you want to start St James?

Speaker 3: 23:44

Well, the owner of Seba School. Actually he how do you say he tricked me into this venture Because that school was in an island which is owned by the Dutch and the Dutch was very, how to say, not very cooperative. But the fact that in a small island like Ceiba that was the only school, that was the major economic support to the entire island. The whole economy of the entire island was supported by that school. So on one hand, the school knew the importance and how much the Ceiba's island is dependent. On the other hand, the government of Ceiba, even though they were helpless but they were very mean to the administration, they were never polite, hardly ever they really cooperated.

Speaker 3: 24:59

So this was a very difficult situation for SEWA and every now and then we used to hear, as a faculty member and the students, we used to hear that the school is closing. Why? Because the government is asking for complaining that the school is not paying tax, or school is not paying this, paying that, etc. So every time there is rumor that the school is closing, paying this, paying that, etc. So every time there is rumor that the school is closing Anyway. So I think because of that, the administration, mainly the owner of SEWA, who was. Once upon a time we were colleagues at Ross University. He encouraged me to go to go and find another island where we can start another medical school so that in case something happens to Seva, they will move to another island. So it is from there I started to, with the advice and support of Seva University administration. I first approached Anguilla. That was back in 1998.

Speaker 2: 26:13

Okay.

Speaker 3: 26:13

And I had a long discussion with them, all the cabinets came in, et cetera, et cetera. But then, even though they agreed that, yes, we would like to start a school, but we didn't get the charter from them, instead they gave it to some other school. They gave a charter it was called, I think I don't remember the name of the school but the school couldn't start because they didn't have the resources to start the school. So it was actually the administration of SEWA. They encouraged me to start. But when I actually started, well, at that time I proposed why not Bonaire?

Speaker 3: 26:54

Bonaire was very eager because no school wanted to go to Bonaire, because they used to speak not so much English but Dutch. So the administration of SEWA told me me it is not a good idea because if our students can't really communicate with the local people, then it will be very difficult to get students. But anyway, I reached out to Bonnier and Bon. Then after that they never left me. They wanted me further. In a way they forced me to start the school there, even though I didn't have the resources. But since I started in Bonnier, I wanted to start in Bonnier. I didn't get any support from SEVA except some verbal cues that would do this, do that, don't do this, don't do that.

Speaker 2: 27:45

In fact it was also important. Yes, so, as far as the actual reason for starting, what was the reason Like? Was it better student quality, was it? You know, this is a great way to make money. What was the reason to start St James?

Speaker 3: 28:07

When we saw how the students were treated in Ross University, I realized and then from there, when I came to SEWA, I had no intention or plan of starting a school. But from Ross, when I shifted to SEBA, then me and the owner of SEBA's university, we used to discuss that look, we have been working at Ross University, we know everything about medical education. So if and I also pointed out that because SEWA stood up on its feet so quickly, it is because of this experience. So, since we have been working with the medical school, it should be very easy for us to start something on our own and we can do it better. It is out of that conviction I started to proceed with Bonaire, even though Seba told me that they. I realized that Seba will not be interested in working with me, but so I continued that since I have experience in working at the medical school, I should be able to do it faster and better. But that turned out to be a wrong assumption.

Speaker 2: 29:36

So do you think St James isn't better?

Speaker 3: 29:39

than Ross and St George's and all these. It's not a question of whether it is better or not, but when I started the school, I realized that teaching is maybe only 5% to 10%. The remaining of it is law, is finance, is management, of which we knew very little. But then, when we are already in there, we had to do everything, whatever it takes, to learn the techniques, learn the tricks and go forward. It was not easy, but we did it.

Speaker 2: 30:13

So, since you started in 1999 and where we are today, how do you think the school has evolved in your view? How do you think the school has evolved in your view? What do you think have been the most the biggest steps that the school has taken for improvement?

Speaker 3: 30:30

You see, we started with 18 students back in 2002. Well, actually the school started with students of clinical rotation Okay, with students of clinical rotation. And at that time, I think in the year 2000 and 2001,. I was still working in SEWA and I was still a member of the SEWA faculty. I was working there and as an employee of SEWA, I started the school, and how, by the owner of SEWA. I didn't do it behind his back, I continuously kept him informed as to how, what we are doing. So so he proposed, or he suggested, the best way to start is this that you take transfer student. So we put an advertisement in a website. The name of the website was ValueMD. Ah, they're still around. They're still around? Yeah, I think so.

Speaker 2: 31:40

They are still around.

Speaker 3: 31:41

Yeah, I think so In ValueMD we advertised that we were starting a school and we welcome transfer students. Relatively easily we got a couple of students, transfer students, and they paid and they transferred from different places. They transferred from different countries. I particularly remember one student. He is now a graduate of St James and he's now practicing family medicine somewhere in Atlanta. He was originally from Ethiopia Not in Ethiopia, but Eritrea.

Speaker 3: 32:22

Okay, there was a war going on, so as a medical student he couldn't complete his program, so on the halfway he just left. So he came to the US and so he enrolled and we gave him credit for everything that he has done in Eritrea. So he straightaway started with clinical rotation. That was our first student. So like that we got about maybe half a dozen students who paid and this is how we started St James Until we reached a point where I discussed with the owner of SEWA and he said yes, now you can go and start your basic science. So there was no, really I was not operating behind his back and it was he who actually gave me a copy of the agreement that they had with SEWA and that copy of the MOA, of the agreement between SEBA University and the government of SEBA. That was the basis based on which we concluded the agreement between St James and Bonaire.

Speaker 2: 33:41

Okay, and have you seen any changes since the school started in 1990? A lot of changes.

Speaker 3: 33:48

The first thing that happened was we acquired the building of an old school the school that was existing. It shifted to a new building. The old building was abandoned existing. It shifted to a new building. The old building was abandoned and the government gave us that building almost free, free of cost. So it was the whole facility was available. But anyway we had to spend some money to retrofit and make it suitable for classrooms. But that took time. But by the time the first group of 18 students came in they started their classes in a motel called dv flamingo. In their hall the classroom started. The first md1 started there with two faculty members. That's how things started. And then we gradually built. This, improved the quality of the classrooms and this is how things improved. But it took quite some time before we could really make it, brought it to a standard which is acceptable and presentable.

Speaker 2: 35:06

So, along the journey, this 25-year journey, what are the biggest highlights for you in the development of St James?

Speaker 3: 35:13

Number one was that we could get students, place them in clinical rotation. It was very difficult to get in touch with the hospital authorities and persuade them to take our student. That was one that gradually changed and improved and that was one Then. Second was, in those days there was not much of a restriction with respect to whom we can accept, enroll as a student, and then it was relatively easy to get faculty to teach the course. Relatively easy it was. It was, and we also had the possibility in those days we had the possibility of accepting students who are in their, who are PhDs. For example, they could enroll as a medical student and at the same time teach. So the student teacher. So that was a cost-cutting device that we could use was a cost-cutting device that we could use. So those were some of the steps that we made use of and that helped the school to move forward.

Speaker 2: 36:36

Okay, any other milestones along the way?

Speaker 3: 36:43

Well, it was not easy to get more and more students. But our cost was also quite less because the faculty salary, because of the student faculty, student cum faculty, we used quite a few of them, quite a few of them, some of the faculty member was employed to teach multiple course like anatomy and embryology, pathology and histology, like that, that kind of combination that was allowed in those days. There was no restrictions in that, so that way we could cut down the cost. And it was usually. The classes were small, anywhere between 12 to 15 students in a class. So administration was not very complicated either and we didn't need a large office, many staff because limited number of students. Everybody could be accounted for, everybody could be accounted for. So that way it was more easier and simpler to manage the entire thing. But then as time went on we could see that there are more and more students are applying. So when we saw and our marketing was not because, there was no online marketing, etc.

Speaker 3: 38:26

etc. It was again the tier of cards, distribute them through agents, etc. The marketing has changed dramatically. Now. Teaching has changed dramatically also, and we are getting better quality of student also. We are getting better quality of students.

Speaker 2: 38:42

Okay, and as far as hospital relationships are concerned, do you think that that's improved over time?

Speaker 3: 38:50

Yes, it has improved, but it was in those days. Nobody knew how to really improve the relationship with the hospital, improve the relationship with the hospital. Our first how to say encounter was when the Dutch accreditation team visited our campus in Bonaire. It was called NVAO, and when NVAO came in after the first encounter with the panel, we realized that we are way, way behind the point where we can get accreditation. So it is through their criticism we learned a lot about how to close the gap and with meticulous care we used their recommendations and that is how we made relatively rapid progress in closing the gap and that helped us to reach the point where we are now.

Speaker 2: 39:56

Okay, if you were to look back and do things differently, what would you do different while starting St Leo's?

Speaker 3: 40:08

Yeah, that's a very difficult question but given the existing circumstances, difficult question. But given the existing circumstances that now everything is computerized, everything is high-tech, well, it is not a question of what I would do differently, but we are forced to adopt a different marketing strategy, a different teaching technique, different counseling system. So everything has to be different. So, whether we like it or not, but well, because of the change in the environment, social and social, economic and political environment we have to do things so that in order to adapt to this change situation. But in terms of relationship between the student and the faculty, I think this relationship is. Now we know we have a much better experience in how to really help the student to go forward in reaching their goal. We know that. So I wouldn't say that I would do differently, but in those days these things were simply not known to us.

Speaker 2: 41:29

Okay, and would you say that it's not known to us, as in St James, because we didn't have the resources? Or was it just across the board, not an application to pedagogy?

Speaker 3: 41:47

Both.

Speaker 2: 41:48

Okay.

Speaker 3: 41:48

Yeah, I think both. I think both because, you see, it is well, whatever experience I inherited, it is I was a teacher, I was teaching a subject. It is one thing that you teach a institution where you are responsible for not only teaching but finance, but administration, relationship with the government, relationship with marketing agencies, vendors, etc. It's a very different experience altogether. So the experience that we had, we inherited, is by no means adequate in order to start an institution and bring it to a point where it can be competitive.

Speaker 2: 42:50

So what would you have done different? I think we would competitive.

Speaker 3: 42:55

So what would you have done different? I think we would deal with the government in a different way, not the way we did before. Then we would probably do marketing in a different way. Well, it is a wishful thinking, but I don't see how, even though we knew that. Well, in those days we didn't know how to market. What do you call that online marketing? How to do that didn't exist at that time, but so we did whatever we could in order to promote our services. In order to promote our services, and well it was. The result was not really as good as we expected, but in those days, we thought that we are doing the best we can, okay.

Speaker 2: 43:49

That's it. So, just generally speaking, if somebody came and told you that you need to start another Caribbean school tomorrow, would you do it Tomorrow? Tomorrow, given the current circumstances and climate, would you want to do this all over again?

Speaker 3: 44:10

Yes.

Speaker 2: 44:11

I would do that, okay, yes, yes, we do that, okay, yes.

Speaker 3: 44:13

And well, you can see that it is very clear that when we first started Bonair it took a long preparation and that too we had the support of a very experienced individual who actually started Sabre. He was actually behind us giving different kinds of suggestions etc. So that resource was available. But for us when we started that, it took a very long time really to stabilize and the most difficult part was this poaching of students, poaching of faculty by some other competitors, etc. That was a very difficult situation. So by the time Bonnier Bonnier started in, let's say 2002, around that time by the time we more or less stabilized, it was say 2010.

Speaker 2: 45:16

Okay.

Speaker 3: 45:16

And in 2010, we started Anguilla. So actually it took about nearly six to eight years to start Bonair, to stabilize Bonair.

Speaker 2: 45:29

Okay.

Speaker 3: 45:30

But then when we started Anguilla the moment we started in 2010, it was already on its feet and it hardly took about maybe less than a year to give it a start and have a relatively strong base Then from Anguilla. When we then relocated, we closed down Bonaire and then relocated to St Vincent. St Vincent was a few weeks only. So, as you see, bonaire took so many years, anguilla took less than a year and St Vincent took a few weeks. So, as you can see, the evolution, experience and resources definitely has its value.

Speaker 2: 46:17

Let's talk a little bit about the money. I know St James is one of the most cost-effective programs in North America. What are your views on that?

Speaker 3: 46:40

well. Well, first of all, I always felt well I saw that when I was at ross university that the whole administration was mobilized in order to squeeze money from the students. The way they used to threaten the students, treat the student to make sure that the students pay their fees on time, I felt it was very unprofessional. But looking back, I can see that there was no support from any quarters. Students' fees were the only source of income, so they probably had no other alternative. However well, I was thinking that an institution, when it has its expenses and this expense includes all the salaries and fees, etc I never understood why it is necessary to make profit out of this institution and take that profit somewhere and invest it somewhere else and make more money. This I never understood.

Speaker 3: 47:50

So that's, that is one and the second, when I came to Scandinavia, in Scandinavia education is free. It's at the expense of the state, so there is no tuition fee there. That's the reason why I could get into the Scandinavian Danish University and Finnish University without paying a cent, and I could get into the Scandinavian Danish university and Finnish university without paying a cent and I could get an education which has helped me to go forward and even to make the school so. Right from the beginning I never thought that the institution should be built to make profit no, ever thought that the institution should be built to make profit no. So we will build the institution and train boys and girls to become a physician, and whatever it costs, as long as that cost is recovered, we should be satisfied. It is out of that consideration I started. It is out of that consideration I started.

Speaker 3: 48:53

But then, when I started St James, then I realized that it is necessary to generate some surplus, not because we want to make more profit, but with that surplus you never can tell there are bad times that may come and that surplus can be used. And this is exactly what has happened in the case of St James and that fortunately, we generated surplus and that is why, at the time of need, we could use that surplus. But I still think that it is not a good idea to use an institution like this to make profit by cutting corners and maximizing profit. I don't think that's a good idea.

Speaker 2: 49:42

Okay, well, thank you so much, dr Guha, for the insight. It is fascinating to hear that you have been working in Caribbean medical schools for about 42, 43 years. Now the entire industry is about 47 years old. Yes, Sort of, but again, I think it is that guidance that has gotten us to where we are as one of the best and one of the biggest Caribbean schools, and we've always taken a path that is very different from big businesses and big schools that are run by private equity, and here's a firsthand look at what that is. So thank you so much for your time. One parting question is in the years to come, where would you like to see St James? Whether it's five years, 10 years, 20 years, what would you like to see of St James? How would you want St James to stand out from the rest of the possibly 75 plus Caribbean medical schools?

Speaker 3: 50:56

Well, I think that we already are doing certain things, which is significantly that in a way, segregates a school like St James from others, and that is our research is very strong. Some other school, most of the other schools, they have no research whatsoever, but we have deliberately established a research wing and it is working very well. So that is one part of it. It's an academic institution, so consequently it should be. I think administration should realize that. I mean, the students should not be seen as a source of profit. That's one of the things that you, administration, should pay attention to. That's one. And the second is that educational institution is, and it should be designed to not select student but condition student to do well. Why am I saying this? Is because it's because during my days in Finland and also in Denmark, I saw that students come from different backgrounds and the administration of the university, they know, they realize that students coming from a cosmopolitan city they react and they handle the existing education system in one way. But students who come from rural background, in the deep interior, in the village circumstances, they cannot be put together with these urban students from the urban environment and expect them to do same kind of result, so they have a different. The institution has taken it for granted that these students from deep interior villages, their instruction should be different and they should be treated, treated differently. So right from the beginning, from school onwards, they have established a system of education, an inverned system of education, where the students from deep interior villages are segregated and treated differently, but they do pass the same examination and ultimately get into the professional life and they do well. That concept is very difficult to implement in a place like this because the mindset is completely different. So I believe that an educational institution should be conditioning students. They should institution should push the student up and not select the student as oh, your grade is very poor, you cannot come in, so you are dismissed. That's very unfortunate. I am totally against. But once I express this kind of opinion to an accreditation panel and they were very upset to hear that kind of opinion from me. So I realized that you cannot really express ideas which doesn't fit into the right environment. So I have learned to use expressions that fits into the environment. That's it. That is one.

Speaker 3: 54:44

And the second is that I think that an institution, when it is imparting education to the people, and this institution, I have not designed this institution to make profit. So, on the other hand, it is very clear that one person, or two person or a family cannot possibly create an institution like this. It's a contribution, it's a teamwork. The many people have worked together. So, going forward, it would be most appropriate and most logical to consider that this institution should be an employee-owned institution and not an individual or a family-owned institution.

Speaker 3: 55:35

But again, I tried to implement that kind of system in here and in fact I also talked to the University of Wisconsin. They have an employee-owned enterprise, a big department. We had a long discussion, enterprise big department. We had a long discussion. They came to our office and we had a long discussion and they told me that, look, this idea that you're trying to implement is very advanced for the environment where you are. What you need to do first thing, first step, is to introduce a cooperative culture among your employees. Unless you do that, you cannot implement this. And well, it is like how to say if and when that situation comes. Then you people can think in that light. But it's very time-consuming and it cannot be achieved in one generation.

Speaker 2: 56:39

Thank you so much, dr Guha, and we hope that this particular school lives up to your expectations. I genuinely think that our school is very, very different and, as you pointed out, that students are not we are not a profit-driven school. We are a people-driven school, and that's largely the vision that you have instilled in the entire upper management that runs the school. So thank you so much for everything that you do and thank you to all our supporters and students. We really appreciate all the support. We just also want to point out that you know a lot of hard work goes into developing these podcasts, and give us a like, give us a follow, please. If you like the content, download the content at Spotify, google or wherever, whichever platform you choose. Again, please remember there's no shortcut to becoming an MD.

Speaker 1: 57:39

Thank you so much for tuning into our show. We hope you enjoyed another episode of Med School Minutes. If you like our content, please follow us and receive notification when a new show is posted. This podcast is brought to you by St James School of Medicine. For a video version of this podcast, please check us out on sjsmorg slash video.