U.s. Med School Rejects Find Their Place in the Sun, and a Second Chance, in Grenada

UPDATED 07/06/1981 at 01:00 AM EDT Originally published 07/06/1981 at 01:00 AM EDT

Parading through the lush tropical gardens of the Holiday Inn on the Caribbean island of Grenada recently, the members of the first graduating class of the St. George's University School of Medicine whistled a tune of perseverance in the face of adversity: the Colonel Bogey march from The Bridge on the River Kwai. From the moment they had arrived on Grenada four and a half years ago, refugees from the rigorously selective admissions practices of U.S. medical schools, they had proved their mettle as dogged survivors. First they found that the school consisted primarily of a single open-air classroom, a cafeteria and a cluster of prefab motel units for dormitories. Often there was no running water or electricity. Seventeen students left during the first three weeks and received refunds. Two years later, those who stayed on had ringside seats for a coup d'état by a Castroite revolutionary who charged the school with harboring CIA spies. Meanwhile, medical authorities back in the States were challenging St. George's credentials and the right of its graduates to call themselves doctors. Yet when the time came for the students to collect their diplomas, 94 of 99 graduates had been accepted as residents in U.S. hospitals. "Some people in the medical establishment saw this school as an unwanted child," observed Sir Gordon Wolstenholme, once president of the Royal Society of Medicine of Great Britain and now the chairman of St. George's trustees. "But this group had the most impressive motivation I've seen in medical students anywhere."

In terms of sheer dedication, however, none could compete with Charles Modica, who founded the school after being turned down by some 30 American medical schools himself, spending a year studying medicine in Spain, and becoming a jaundiced authority on med school admissions. "I didn't do this for dollars," says Modica, 34, a non-practicing lawyer who works full-time as St. George's chancellor. "I wanted to show that it could be done. It was an act of pure vengeance." A native New Yorker and son of a wealthy real estate developer, he first felt the sting of rejection after graduating from Bethany College in West Virginia. "At first I blamed myself," says Modica. "Later I realized that maybe it wasn't me but the system. At the same time I was being denied the opportunity to go to medical school, I could look into the emergency room of any U.S. hospital and see a foreign-born, foreign-trained doctor taking my place."

Unwilling to accept defeat, Modica enrolled at the University of Oviedo. "I did all right academically," he says of his Spanish sojourn, "but I didn't like the sight of blood." Nor did he like the fact that many of his American classmates, ignorant of European admissions policies, had been suckered into paying hundreds of dollars to unscrupulous middlemen. After leaving Oviedo, Modica visited 44 European medical schools where Americans were enrolled and published a catalog for prospective overseas students. By the time he graduated from the Delaware Law School of Widener University in Wilmington, he was so involved in medical education that he never bothered taking a bar exam. Instead, he worked as the admissions officer for a medical school in the Dominican Republic. He quit after a year when he became aware that even students he rejected were being admitted if they put up the cash. Disgusted, Modica rounded up a group of wealthy backers, including his father and several American doctors anxious to guarantee their own children a medical education, and persuaded them to pledge $10 million to launch his school on Grenada.

In several respects, the school has already proved a worthwhile investment. With European medical schools cutting back on American admissions, there are now some 1,100 students enrolled at St. George's, 90 percent of them from the U.S. Though the government of Prime Minister Maurice Bishop is stridently anti-American, its relations with St. George's remain cordial, both because the school is now a major industry on the island, adding $5 million to the economy, and because it provides Grenadians with cost-free inoculations and medical service. In a spirit of amiable coexistence, Bishop, a British-educated lawyer, even shoots an occasional game of pool with the students.

Still dissatisfied, however, is the Association of American Medical Colleges, which challenges the training offered at so-called castaway colleges, of which there are about a dozen in the Caribbean. "They shouldn't even be called medical schools," maintains Dr. Steven Beering, dean of the Indiana University School of Medicine. Modica and St. George's Vice Chancellor Dr. Geoffrey Bourne (father of Dr. Peter Bourne, former health adviser to President Carter) disagree, pointing out that their students are exposed to two years of basic sciences in modern labs on Grenada, plus two and a half years of clinical training, much of it in British, Canadian or U.S. hospitals. "If students don't measure up, they get thrown out," says Bourne. Modica, who spends much of his time away from the island placing his students in U.S. hospitals, charges that organized medicine has a vested interest in keeping the number of physicians low. Half the more than 36,000 Americans who applied to U.S. med schools were turned down last year, he points out, "and you don't get many C students applying to medical school in this day and age. Just about everyone who is applying is qualified." Modica, who accepted no salary for two years, now receives nearly $85,000 per, plus the gratitude of hundreds of students. "He took a dream and made it into a reality for all of us," says Frances McGill, a former nurse who will graduate next month and go on to a residency at a Harvard teaching hospital. Says Modica: "In a few years I hope to be the highest-paid chancellor in the world. I won't feel greedy. I think I'm worth it."

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