Dr. Orien Tulp, the founder and president of the University of Science, Arts and Technology in Montserrat, has big plans for the Virgin Islands.
He and his team are in the midst of opening a new offshore medical school on Tortola, a hefty undertaking that Dr. Tulp says will involve outfitting a physical campus and dormitories in East End and eventually enrolling thousands of students worldwide.
But after those students at the nascent VI medical school graduate, there’s no guarantee they will be able to become licensed physicians in the United States.
In fact, although the newest branch of the university is opening its doors in this territory, Dr. Tulp described USAT as “effectively closed” in December court documents after the US-based Educational Commission for Foreign Medical Graduates took disciplinary action against the school last year.
ECFMG, which evaluates the qualifications of international medical graduates, alleged that Dr. Tulp had provided false information about unauthorised campuses that USAT was operating in the US.
The commission determined that USAT students with a graduation year of 2019 or later are no longer eligible to apply for ECFMG certification, which also means they will not be able to apply to ECFMG to take the US Medical Licensing Examinations. Without taking those exams and completing a residency training programme, graduates can’t obtain an unrestricted US medical licence.
The new VI school, which was recently named the University of Health and Humanities Virgin Islands, is not yet accredited or listed in the World Directory of Medical Schools.
Last year, ECFMG barred Dr. Tulp personally from submitting any documents on behalf of USAT, or any other medical school, to the commission for at least five years.
“This ban effectively precludes Dr. Tulp from operating, or being involved with, any medical school, in any capacity, for an indefinite period of time, subject to the unfettered discretion of ECFMG,” states a lawsuit filed by Dr. Tulp last December in response to ECFMG’s decision. “This ban effectively closes USAT, as an institution for medical students, for an indefinite period of time, if not permanently.”
In spite of the challenges facing USAT, Dr. Tulp said the VI medical school is on track to offer classes by September, and he strongly disputed ECFMG’s allegations. Though a judge sided with ECFMG and closed his first lawsuit last month, Dr. Tulp quickly filed another, which is pending.
The VI medical school
Since VI government officials announced last fall that a medical school would soon be opening here, the university’s name and branding have changed significantly.
At first, a September press release — which was deleted from government’s website a few hours after it was sent to the media — stated that the University of Science, Arts and Technology itself would be opening in the VI. Now, the VI school is being called the University of Health and Humanities Virgin Islands, and its website doesn’t mention USAT.
Dr. Tulp said in April that while “technically” UHHVI is a branch of USAT, it has its own licence, which is not linked to USAT’s licence in Montserrat.
Dr. Marcia Potter, the permanent secretary in the Ministry of Education and Culture, said in March that USAT had been issued a licence, but she did not refer to UHHVI. She later clarified that while originally USAT had been issued the licence, the university later asked to have the name changed to the “University of Health and Humanities (Virgin Islands).”
Neither USAT nor UHHVI is listed on a VI trade licence, according to an official at the Department of Trade, Investment Promotion and Consumer Affairs, and neither is registered at the Registry of Corporate Affairs.
Probe into USAT
Even as the groundwork was being laid for the VI medical school last year, the Educational Commission for Foreign Medical Graduates in the US was conducting a review of USAT.
“ECFMG suspected in mid-2017 (and confirmed in 2018) that USAT, a medical school with its primary campus and main operations supposedly in Montserrat, was in fact operating a campus and providing medical education in Miami, Florida without authorisation from the US Department of Education and/or the Florida Department of Education,” the commission wrote in court documents.
In August 2018, ECFMG alleged, it received more information indicating that USAT was operating satellite campuses not only in Miami, but also in Tampa, Florida and Dallas, Texas.
“USAT never provided documentation for those locations either,” the commission wrote.
During that time, ECFMG also discovered that the Caribbean Accreditation Authority for Education in Medicine and other Health Professions (or CAAM-HP) had declined to accredit USAT in 2012 because the university “had not provided sufficient evidence to indicate that teaching activities were actually taking place in Montserrat,” according to court records.
USAT is still listed as “not accredited” on CAAM-HP’s website.
ECFMG soon began reaching out directly to students and graduates of USAT, hoping to find out more about their attendance at the school.
“Ultimately, more than 300 students submitted affidavits to ECFMG indicating that they took classes in the United States, and not a single student indicated that he or she took all of his or her basic science courses in Montserrat,” the commission wrote.
A copy of the 2018 USAT lecture conference schedule showed lectures taking place in Florida and Texas, but no lectures were scheduled for Montserrat, ECFMG reported. The commission wrote in court documents that videos on USAT’s YouTube channel “not only show USAT students dissecting human cadavers ‘in Miami,’ but also feature Dr. Tulp referring to USAT’s ‘Miami campus,’ USAT’s ‘other campuses,’ and USAT’s ‘satellite campuses.’”
Despite findings about the school from ECFMG and CAAM-HP, Dr. Tulp has long maintained that USAT has a fully functioning campus in Montserrat.
“And we’re only one of about seven schools in the Caribbean that has a campus, that owns a campus,” he claimed in an April interview with the Beacon.
Dr. Tulp said the Montserrat campus was purchased in 2003 and later renovated, and now features residence halls, an on-site generator and a satellite dish, among other amenities. In past years, typically about 50 students would live on campus at a time and complete a semester of classes there, he said.
“But when we first started, the volcano would continue to erupt about once a month,” Dr. Tulp said of the Soufrière Hills volcano, which remains active on Montserrat. “And that wasn’t good for business. That’s why we established an online element for those first three semesters of courses.”
Dr. Tulp claimed that “well over” 1,000 doctors have graduated from USAT since 2003 and that this year 90 percent of graduates were selected to do residency post-graduate training in the US.
In December 2018, ECFMG officially concluded that Dr. Tulp had provided false information about USAT, according to court documents.
“Specifically, you provided false information to ECFMG when you (1) notified ECFMG that USAT does not operate a branch campus in Miami, FL, and (2) certified to the attendance dates of several USAT students and graduates when ECFMG has information that these students were not attending USAT during some of these time periods to which you certified,” the commission alleged in a letter to Dr. Tulp.
In light of those findings, the commission warned, a sponsor note would be added for USAT on the World Directory of Medical Schools that reads, “In 2018, ECFMG determined that a certain official of the University of Science, Arts and Technology engaged in irregular behaviour in connection with providing false information to ECFMG.”
The commission said the note will remain in the World Directory for five years, regardless of whether USAT changes its name, ownership or location.
ECFMG also announced that USAT students with a graduation year of 2019 and later are not able to apply for ECFMG certification, which is required for students to obtain an unrestricted US medical licence, according to court documents.
A warning about that decision is now included in bright red text under USAT’s sponsor notes in the World Directory.
In December, Dr. Tulp sued ECFMG and Dr. William W. Pinsky, the president and CEO of the commission. Dr. Tulp requested that the court order ECFMG to immediately resume processing the medical exams of USAT students and remove the damaging advisory from the World Directory.
“We served them the suit on Christmas Eve and we blessed [Dr. Pinsky] with a federal subpoena on New Year’s Eve,” Dr. Tulp told the Beacon. “Not that I wanted to destroy his holiday or anything. It just happened to work out that way.”
Despite his attempt to fight back in court, the impact of ECFMG’s actions against USAT has been crippling, Dr. Tulp admitted.
“We were getting between 200 and 300 applications per month up until they put that [World Directory] warning up. Once they put that up, it shuts it off immediately,” he said in April.
Dr. Tulp also described ECFMG as an “unregulated monopoly.”
“If they get mad at someone, at a school, they can just shut them off overnight and that school is gone,” he said. “[ECFMG] cannot open a school, they cannot legally close a school, but once they put a warning on the [World Directory] website, that school cannot operate because no one will take the graduates.”
Asked what he believes prompted ECFMG’s initial review of USAT, Dr. Tulp said a disgruntled former faculty member had sent the commission an anonymous letter making “all kinds of allegations.”
That instructor, Dr. Tulp alleged, had been fired in December 2017 after falsifying USAT student grades and selling fake research credits from Harvard University. Dr. Tulp said the professor, whom he would not name, had falsified grades or credits for at least 30 USAT students.
“All I had to do was pull up the student roster and type in the word ‘Harvard,’” Dr. Tulp said. “And of those that I could find there were over 30 that he has sold fake credits to. And I contacted Harvard to try to verify them and Harvard said they were all bogus.”
The professor was therefore dismissed “with prejudice,” Dr. Tulp said.
“And he tried to extort money from the school. A large amount of money. And when I discovered that, we fired him on the spot,” he said.
In a June phone interview, Lisa Cover, ECFMG’s senior vice president for business development and operations, outlined the commission’s standard process for investigating certain medical schools.
Ms. Cover emphasised that ECFMG’s first priority is to serve the public.
“At the same time, we also want to be fair for students [graduating from international medical schools],” she said. “When we launch an investigation, again our primary focus is on the public interest and those individuals who are providing care to patients.”
ECFMG’s investigative process typically involves communicating with government officials in the country where the school is located, reviewing information obtained from school officials, or seeking information from US government officials, Ms. Cover said. If necessary, ECFMG might employ a private investigator.
One of the most critical components of an investigation, she said, is getting information directly from the medical school students themselves.
“And as I mentioned, we want to be fair to them, so seeking information from them is a very important part of ECFMG’s investigative process,” Ms. Cover said.
Because of the ongoing litigation, ECFMG general counsel Francine Katz added that the commission cannot comment on any specific facts relating to USAT.
In March, all of Dr. Tulp’s claims against the ECFMG were dismissed except one: common law due process.
“[Dr. Tulp’s] complaint contains sufficient factual allegations to support a claim that ECFMG violated a common law duty of due process owed to plaintiff,” District Judge Wendy Beetlestone wrote in a memorandum on March 26. “However, plaintiff ’s claims for common law fraud, negligent misrepresentation, abuse of process, and tortious interference with contract will be dismissed.”
Dr. Tulp had argued in his initial complaint that he wasn’t given a fair chance to refute the claims against him during an ECFMG hearing in Philadelphia, Pennsylvania on Nov. 28, 2018.
“The complaint alleges that ECFMG allotted 20 minutes to the disciplinary hearing, but that ‘[a]fter a few minutes,’ ECFMG’s counsel unilaterally terminated the hearing before plaintiff could present testimony or evidence,” the March memorandum states. “The complaint contains sufficient factual allegations to make out a viable claim that ECFMG did not provide plaintiff an opportunity to be heard before taking disciplinary action against him.”
Although most of his claims were dismissed, Dr. Tulp said in April that he would continue to rally against ECFMG’s actions from last year.
“We’ll spend a lot of money on [litigation],” he said. “I can’t predict how much it’s gonna cost. But I will take it all the way to the highest court if I have to.”
And while Dr. Tulp’s complaint mentions several times that USAT is “effectively closed” after ECFMG’s action, in April he told the Beacon the opposite. USAT has to remain open for a minimum of seven years in order to provide transcripts and other documents for past graduates, he said.
“We have to maintain operations at our cost, even,” he said, adding, “USAT is still operating and it will not close. That’s one thing you can put in the article.”
Late last month, Dr. Tulp’s lawsuit ground to a halt.
ECFMG filed a motion for summary judgment in May on Dr. Tulp’s last remaining claim. The court granted the motion on June 25 and the case was marked closed.
District Judge Beetlestone concluded, “The record demonstrates that ECFMG provided plaintiff all the process he was due.”
Asked for comment about the June court decision, Dr. Tulp reiterated his previous criticisms of ECFMG, including his claim that the commission lacks “proper internal oversight.”
While Dr. Tulp’s first lawsuit against ECFMG has come to a close, a second one is just beginning — this time with Dr. Tulp’s wife, Carla Konyk, as another plaintiff.
The additional lawsuit — which was filed on June 25, the same day that summary judgment was granted in the previous suit — includes many of Dr. Tulp’s original grievances. But now, Ms. Konyk, the vice president of USAT, also argues that she will suffer direct monetary damages “resulting from the closing of USAT.”
A June complaint alleges that Ms. Konyk was not included in ECFMG’s November hearing as a party or a witness, even though she was an equal owner of USAT alongside Dr. Tulp.
“The ECFMG violated the due process rights of Carla Konyk without giving her notice and opportunity to be heard,” the complaint states.
Elizabeth Ingraham, ECFMG’s assistant vice president of communications and external affairs, said the commission “intends to defend against this suit vigorously as well.”
Litigation aside, the future is unclear for prospective students at the University of Health and Humanities Virgin Islands.
Currently, UHHVI is not listed in the World Directory of Medical Schools and is not accredited.
The World Directory’s aim is to list all medical schools in the world and provide up-to-date information about each one. In order for international medical graduates to be eligible for ECFMG certification, their school must also meet requirements established by ECFMG — not merely be listed in the World Directory. The World Directory was developed through a partnership between the World Federation for Medical Education and the Foundation for Advancement of International Medical Education and Research, and ECFMG is one of the directory’s sponsors.
The World Directory and ECFMG do not, however, accredit medical schools. A university must go through a separate organisation, like the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions, to become accredited.
Dr. Tulp said last week that he plans to submit an application for accreditation to CAAM-HP this month.
Asked if UHHVI graduates would be able to take the US medical exams despite the inability of USAT graduates to do so, Dr. Tulp outlined one potential option.
“What we will likely do, and this probably shouldn’t be in your article necessarily, but we have agreements with other schools that [UHHVI students] can take their exams under cooperative agreements with other schools that have that listing until this is settled,” he said.
After this reporter asked if he was requesting to keep that statement off the record, Dr. Tulp did not say he was.
“Well, I don’t want to give the ECFMG information, because everything that’s being recorded on the internet they’ll pick up and try and use against us right now,” he said.
Dr. Tulp added that the VI government submitted documents to the World Directory on behalf of UHHVI last year, but the organisation responded several months later and said the school must prove it is operational before being listed. Once the World Directory posting is completed, he claimed, students will be able to take the US medical exams and complete a residency programme. “The government has already started that process,” he added.
Information from ECFMG’s website, however, contradicts Dr. Tulp’s account.
The site states that medical schools must go through a separate process to demonstrate they meet eligibility requirements for their students and graduates to apply for ECFMG certification.
“Not all schools in the World Directory are acceptable for certification,” Ms. Cover explained.
Dr. Tulp, though, remains confident about career prospects for UHHVI graduates.
“So the students that are enrolled now, if things go according to history, they will be able to take the exams on time,” Dr. Tulp said. “We know from our reputation that once they’re graduated, they have a very strong case of getting a residency.”
Dr. Tulp estimated this week that about 30 or 40 students are already enrolled at the new school. Accreditation, he also argued, is an “institutional privilege” rather than a legal requirement.
“Medical schools do not have to be accredited. They have to be licensed. That’s a mistake that many people make,” he said.
But starting in 2023, all individuals applying for ECFMG certification must be a student or graduate of a school that is accredited by an accrediting agency officially recognised by the World Federation for Medical Education, a non-governmental organisation based in Europe. That means that if UHHVI is not properly accredited by that time, its graduates will not be eligible for ECFMG certification or medical licensure in the US.
ECFMG’s decision to prohibit Dr. Tulp specifically from submitting any documents on behalf of USAT, or any other medical school, also poses challenges for his involvement with UHHVI. Dr. Tulp said that he was “present” for the VI school’s organising committee, but he doesn’t yet know if he will have an active position at the new university.
“I have to earn my ranks there,” he said. “Until the ECFMG gets their head straight, until they settle this issue, I will not become president of anything because if I do they will earmark me and try to further destroy my career.”
In his stead, Dr. George Einstein will serve as the dean of the UHHVI College of Graduate Studies, Dr. Tulp said.
According to UHHVI’s website, Dr. Einstein holds doctor of science and doctor of philosophy degrees. Dr. Einstein’s LinkedIn profile states that he received his PhD from the University of Warsaw in 1979, and has worked as a professor and director of the Einstein Institute at USAT for the past eight years.
In April, Dr. Tulp promised that UHHVI will be much more than a medical school. The university, he said, will also offer programmes including veterinary medicine, veterinary assistance and nursing.
“BVI has a race track,” Dr.Tulp said, referring to the Ellis Thomas Downs Horse Racing Arena in Sea Cows Bay. “They don’t have very many veterinarians here, but what an ideal place to have a veterinary school because of the local uniqueness of BVI.”
The university’s new website lists a wide range of possible degrees for students, including: Master of Science, Master of Public Health, “Masters in Education,” Master of Arts, Doctor of Philosophy, Doctor of Science, PhD in Medicine, Doctor of Education, Doctor of Pharmacy, Doctor of Physical or Occupational Therapy, Doctor of Public Health, Doctor of Nursing Practice and Doctor of Psychology.
Dr. Tulp said in May that a lease was being prepared for the university’s campus to be located in the James Young Harbour View Marina in East End. In June, he said that renovations for the space — “a large open area used for receptions” — were under way, adding that the space would be ready for occupancy within two weeks.
Last Thursday, however, no visible work was ongoing in the large room that an employee at the marina said the school plans to use. The room was mostly empty except for a long table covered with a jumble of serving trays. The employee said that work is expected to begin soon and to be complete around the end of this month.
Dr. Tulp said that classes will be held there by September at the latest.
“There are multiple dorm rooms in the upstairs of the complex that will become available as well,” Dr. Tulp wrote in an email. “Space in BVI is scarce at the moment, due to the hurricane damages of 2017.”
Dr. Tulp estimated that more than 2,000 students will be enrolled at the university within five years, but that only a few hundred will actually live on the VI’s physical campus. Instead, the medical school will operate by allowing students to complete some basic classes online through a “special programme” called a SPOC, or small private online courses, Dr. Tulp explained.
“That is the most effective way statistically to teach high-performing students,” he said.
Typically, offshore medical students would complete clinical training in the US, but Dr. Tulp said UHHVI students will likely be able to complete that training on island, too.
The VI has a “much more robust medical system” than many other Caribbean islands, with “government hospitals” and “private hospitals” and “the other things,” Dr. Tulp said.
“So they see just about everything that a student ever needs to see and they can receive really excellent training,” he said of potential VI clinical training.
Professors in villas
As for the UHHVI faculty, Dr. Tulp said the school will find a villa close to campus to house professors during two or four-week modules in specific subjects. Those professors will receive a salary and stipend for living expenses while in the VI, he added. When faculty members are off island, he explained, they will hold lectures via broadcast.
Dr. Tulp described all UHHVI professors — many of whom he said also taught at USAT — as “credentialed.” Asked to name them, Dr. Tulp listed himself, his wife, Dr. John DiRuzzo, Dr. H. Dennis Harrison and Dr. Bruce Robinson. Some new professors will hail from “the local islands,” including Tortola, he added.
Despite USAT’s troubles in the US, UHHVI appears to be pushing ahead in the territory undeterred. Its website, at least, makes no mention of the lawsuits, ECFMG’s disciplinary action against USAT, or its connection to the Montserrat school.
“As a relatively new university, founded in 2018, we are designing graduate level programmes that we believe will be most beneficial in creating a better tomorrow,” the about page of UHHVI’s site reads. “Although our university is relatively young, we are rapidly expanding and have great hopes for the future of this exceptional university.”
Freeman Rogers contributed to this report.