Despite delays and concerns about the status of the territory’s hospitals, University of the Virgin Islands President David Hall said Thursday that he remains committed to making the long-planned School of Medicine a reality.
Hall told The Daily News in an interview in his office that when the university is able to reapply for accreditation for the medical school from the Liaison Committee on Medical Education, he hopes to be able to show the accreditors the university’s endowment, additional gifts and support from the government so that they “will feel more comfortable this time that we have the resources to make this a financially viable medical school.”
Plans for the medical school were previously put on hold after hurricanes Irma and Maria hit the territory in 2017, with a chief issue being an absence of funding. The university had also struggled to obtain accreditation.
Hall said in a written statement recently that the university has a goal to secure $10 million in funding to resume the accreditation process. As of January 2017, Hall said, UVI had raised $3 million in gifts and pledges.
Plans for the School of Medicine were put in motion when Dr. Chirinjeev Kathuria, chairman of New Generation Power, pledged $30 million in 2014 to help establish the school. Hall said on Thursday that the university used that pledge from Kathuria to secure a loan from First Bank.
While the university was entitled to borrow $30 million from the bank, Hall said only $23 million was borrowed in order to create an endowment to show accreditors “that there was a permanent source of funds that can kick off revenue to the medical school.”
UVI spokeswoman Tamika Thomas Williams said via email that the interest rate on the loan is variable with a minimum of 3.95%. Kathuria’s gift agreement and the “broader university endowment” were used to serve as collateral for the loan, Hall said during the interview.
“First Bank is in a wonderful position, because our combined endowment, which is the medical school endowment and the university’s endowment, is somewhere around $62-63 million for a debt of $23 million, so it’s in a very strong position,” Hall said. “The other good news is that the endowment has been earning enough revenue for us to be able to pay the debt service on the loan and also have had some funds to take care of some of the expenses related to the medical school.”
The UVI president said that not having medical school faculty on the university payroll has allowed for some relief from paying those expenses. Hall said the last report he saw showed that the endowment was up to approximately $25 million.
Construction is in progress on both a classroom building on the St. Thomas campus and a simulation center on St. Croix. Hall said previously in a written statement that both buildings should be complete by early next year, and the simulation center will be made operational right away.
Williams said that to date, approximately $5 million of the allotted $8 million has been spent on the simulation center. For the St. Thomas classroom building, $8 million of the allotted $11 million has been spent. The university also received approximately $2.9 million in insurance funds for hurricane damages to the building, Williams said.
Hall said Thursday that he did not want the public to “conflate” the endowment with the School of Medicine buildings.
“The debt service for the buildings comes from the local government,” Hall said. “That has been its commitment to help us get this project moving forward.”
The university has also received $1 million to allow it to borrow from the U.S. Education Department’s Historically Black College and University Capital Financing Program, which has an interest rate of approximately 3%, Hall said.
“That has allowed us to be able to move forward on the buildings even though we still need to raise more money for the operation of the medical school,” Hall added. “So, I’ve just seen people conflate those things, and I just want to make sure factually that there is a good understanding of the difference.”
Hall also clarified that operation of the St. Croix simulation center is not dependent on medical school accreditation.
“We are conducting a search right now for the director of that center, and we will be able to start offering classes, providing training to local physicians, nurses, so there is no doubt that the simulation center is going to be fully used,” Hall added.
The classroom building, on the other hand, is a “little trickier,” Hall said. Without accreditation, the university cannot admit students to the School of Medicine and operate the classroom building for its intended purpose.
The UVI president said that, in the time between the building’s completion and the university ultimately securing accreditation, science and math faculty will use “some” of the classrooms and equipment. The university will also offer “some of the simulation classes that we would normally offer on St. Croix” for St. Thomas physicians in the classroom building.
The university will eventually reapply for accreditation for the School of Medicine, and Hall said he is prepared for possible concerns. While he noted that the accreditors said previously that the split campus between St. Thomas and St. Croix is “not a problem,” Hall anticipates that the status of the territory’s hospitals “is going to be a concern.”
The committee “raised no concerns about the quality of the hospitals” in their previous report to UVI before the hurricanes, but that could change with there still being damage at both Schneider Hospital and Luis Hospital, Hall said.
“We know that ahead of time,” Hall added. “I think what they will be looking for is whether the territory has a plan for rebuilding Juan Luis and that’s why I’ve said to both governors [former Gov. Kenneth Mapp and current Gov. Albert Bryan Jr.] … we have to make sure the university is at the table when those plans are being developed because we need to be able to say that to our accreditors when we get to the point of reapplying.”
Hall said he thinks that Schneider Hospital is “going to have an easier job getting back to full functioning,” whereas with Luis Hospital, the territory might “have to build a completely new hospital.”
“If we can’t use [Luis Hospital], then that means we will have to send students to one of our partner institutions, the University of South Florida, so they can do some of their rotations there,” Hall said. “We do not want to do that. That option has always been there. That’s the strategy that the un-accredited Caribbean, at least the non-LCME accredited schools in the Caribbean, that’s what they follow.”
Those Caribbean schools send their students to the states after two years for their rotations, the UVI president noted.
“We wanted the medical school to have a positive impact on the local hospitals and clinics, and you can’t do that unless the students are there,” Hall added. “So that would be a deviation from the plan.”
But Hall also noted that because medical students are not able to go into the hospitals until their third year and the university is likely a year away from admitting students anyway, there might still be some time, especially since he said the plan is to use the clinics on St. Croix, St. John and St. Thomas as well.
“So, if we can demonstrate that we have two-thirds of our facilities that are fine, and the territory has a plan for rebuilding Juan Luis, our hope would be that that would be satisfactory for them,” Hall said, referring to the accreditors.
Despite the bumps in the road, Hall said he is still excited about the School of Medicine and what the future might hold.
Hall said that he and the UVI Board of Trustees remain committed to the project “because of our belief that it could really make a difference and have a positive impact.”
The School of Medicine would help increase the number of physicians in the territory and help turn the local hospitals from just “service” hospitals to “teaching” hospitals, which operate at a “higher level,” the UVI president said.
“Our hope is that the medical school will bring about a quality enhancement to the territory,” Hall added. “A segment of Virgin Islanders leave the territory to get their medical care on the mainland in part because they either can’t get what they want here or there is a perception that it’s going to be better someplace else, and we have to reverse that.”
Hall said many states and cities improve their quality of care by having a medical school associated with their hospitals.
“So, the thing that has always motivated us is, what can this university do that will touch the lives of all Virgin Islanders?” he added. “I mean, we all need some level of healthcare, even the healthiest person around needs to go to the doctor sometime, and if we can improve the quality of healthcare, then we really would have made a contribution.”
The UVI president also discussed the potential economic impact of the School of Medicine, noting studies that show for every dollar invested in a medical school, there is a $6 return “because of the jobs, the people it attracts.”
“So, when I look at the healthcare benefits, the possible economic benefits, then it really becomes a transformative project,” Hall said. “And even though, and that’s why I personally have stayed committed to it and I believe our board have stayed committed to it despite the delays, because of our belief that it could really make a difference and have a positive impact.”
Above all, Hall said he wants people to get more “excited” about the UVI School of Medicine because there is much fundraising left to be done.
“I know this has been a controversial project because some people believe we shouldn’t be trying to do something like this,” Hall said. “But when you think about the benefits, I do believe it’s one of those things where we need to get people excited again about what it can do for this community.”