Montserrat, a tiny, 39.6 sq miles or 102 sq km, British Overseas Territory, is located in the Eastern Caribbean chain of islands. Antigua lies approximately 25 miles to the North East while Guadeloupe is around 30 miles to the South West. Like many other island microstates, Montserrat suffers from having a small open economy, a small population and as a consequence, a small local market. The island has always had to depend on exports and foreign direct investment for foreign exchange earnings. Economic development thrusts are further exacerbated by the high cost of transportation and a poor resource base.
Prior to July 1995, Montserrat could be described as “a middle-income country with admirable sturdy housing stock, little unemployment and an economy that was in fair shape” (Young, 2000). Since then, the island has been in the throes of a volcanic crisis that has had a major impact on all aspects of life. Two-thirds of the island, including, the capital Plymouth, the seaport, Bramble’s airport in the east, and a significant portion of the tourism plant of historic sites and accommodation in the southern part of the island have been destroyed by pyroclastic flows. The population which for more than 100 years was constant at slightly under 12,000 dwindled to 3,500 once the British Government in 1997 provided an assisted evacuation package for those who found living with an active volcano too difficult. Many persons relocated to neighbouring Caribbean islands, to the United States under a programme offering Temporary Protected Status, while the majority relocated to the United Kingdom.
In 1978, the final year of the Progressive Democratic Party (PDP)’s tenure in government with P. Austin Bramble as Chief Minister, several projects were introduced in an attempt to chart a path to sustainable economic development. One of these projects was the American University of the Caribbean (A.U.C.). In the late 1970s, Paul S. Tien approached the Government with the idea of setting up an off-shore medical school offering pre-clinical training for students recruited mostly from North America. Not everyone in the government supported the idea, but discussions were eventually concluded with the government granting a license for the start of the school. As outlined in the PDP’s 1978 Manifesto, it was expected that “the recently registered Medical School” would “provide many job opportunities and generate significant income and revenues for Montserrat” (p. 6). This was all part of an effort to create full employment on the island. Bramble recognized that having the School on Montserrat would stimulate the economy in a number of ways as well as create linkages with the tourism industry. He saw the direct benefits for the commercial sector and the construction industry.
A.U.C., the first off-shore medical school on Montserrat, was the second school of its kind to be established in the English-speaking Caribbean. In 1977, St. Georges in Grenada started its programme and Ross University in Dominica opened its doors for business in 1979. By the 1980s, there were three more schools operating in the Commonwealth Caribbean, Spartan Health Sciences University in St. Lucia (1980), Ross University School of Veterinary Medicine in St. Kitts (1982) and the University of Health Sciences in Antigua (1983). These for-profit medical schools responded to an unsatisfied demand for graduate medical education and a shortage of doctors in North America. Johnson, Hagopian, Veninga, Fordyce, & Hart explain
Beginning in the 1950s, increasing numbers of Americans trained abroad, either as a first choice or because they failed to obtain entrance into U.S. schools. Between the 1950s and the mid-1970s, U.S. medical school admission became more restrictive and numbers of slots declined relative to residency program opportunities. Competition in the United States, coupled with the ability to return there for residency training made overseas medical education attractive for U.S. students, especially in Italy, Belgium, Spain, France, and Switzerland. In response to the rising demand for medical education from their own citizens, European schools placed restrictions on admissions of American students. Schools in Mexico ... responded by increasing recruitment of U.S. students. Additionally, new “off-shore” foreign schools opened during the late 1970s and the early 1980s” (p. 3).
In addition to getting an investment package which included a 15-year tax holiday and duty-free importation of materials and equipment, Tien had negotiated for assistance with the acquisition of land on which he would construct a Campus. The Bramble government asked that Tien put some EC$250,000 in escrow for construction of the campus. Tien also wanted the government to get the school listed in the World Health Organisation’s (WHO) Directory of Medical Schools. The request for WHO Listing, coming as it was from a British Colony and not a member of WHO, was unsuccessful and Chief Minister Bramble, accompanied by Tien, went to the Foreign and Commonwealth Office in London to present their case for the British Government to make the request on Montserrat’s behalf. According to Bramble (personal communication, September 27, 2006), the British Government was concerned that by recommending the listing it would be accountable for something over which it had no control. It needed reassurance that the School would not bring its name into ill-repute. It was only when Tien agreed to finance an internationally recognized review team to assess the school’s academic programme for the maintenance of standards that the British Government agreed to make the application for WHO listing. This listing enables students to apply for federal grants/loans for their medical education.
The island’s weekly newspaper, the Montserrat Mirror, (New Caribbean School Holds First Classes on Cincinnati Campus, 1978) using an excerpt from the American Medical News (1978, September 1), reported as follows:
A new British West Indies-chartered medical school began its classes in Cincinnati, Ohio, last week because the school’s $3-million campus on Montserrat island wasn’t ready for occupancy.
The American U. of the Caribbean, School of Medicine (A.U.C.) which bills itself as “the closest foreign medical school to the continental United States offering an MD program in English,” has rented space for its 107 first-year students on the Cincinnati campus of the College of Mt. St. Joseph. A.U.C. has rented classrooms, labs, and office space for one year.
The new school, which offers a 33-month curriculum, has attracted mostly American students. Tuition is $2,500 per trimester plus a $500 registration fee.
A.U.C. officials say the school has been certified by the United Kingdom and will be listed in the World Directory of Medical Schools, published by the World Health Organization.
The article went on to explain that the new medical school was founded by Paul S. Tien, Ph.D., listed as the institution’s chief executive and administrative officer and that he was a former President of Belmont Technical College in St. Clairsville, Ohio, a two-year state school and a former chairman of engineering technologies at Cincinnati Technical College (p. 5).
A.U.C.’s early days in Ohio were not without problems and Tien has to be given credit for not abandoning the project at that point. According to Lawrence, who refers to Tien as a China-born electrical engineer claiming to have a Ph.D. in educational administration from Union Graduate School,
One of the newest of the Caribbean medical schools that have sprung up to cater to U.S. Students unable to gain admission to schools here is still operating -- in Cincinnati, Ohio—despite more than six months of legal and administrative battles with Ohio educational authorities… Although Ohio authorities have been arguing since before A.U.C. opened that it cannot hold classes within the state without being certified by one of Ohio’s two educational boards, the school claims it is exempt from state regulations because it is a foreign institution, incorporated on the tiny British dependency of Montserrat … and it is only in Ohio temporarily (153-4).
Lawrence goes on to describe further legal complications affecting A.U.C. Two former A.U.C. students had filed a lawsuit against the school charging it with fraudulent misrepresentation in several areas. They wanted their money back in addition to $100,000 in punitive damages. They also asked that “for the class of all students, former students, and future students of A.U.C., a permanent injunction prohibiting defendants from soliciting students and promoting A.U.C. in a false and fraudulent manner, and compensatory damages of $1,500,000.”
At the same time Lawrence’s report shows that the student population ranging in age from 22 to 62, had increased to 210, with 90% of the student body American and 10% from other countries but with US resident status. The faculty of three had been increased to 6.
Almost a year later, it was finally reported (A.U.C. Ready to Break Ground, 1979) that tenders were to be awarded to local contractors with fourteen of them bidding for a slice of the 72,000 square foot structure. Dr. Tien was still optimistic that the buildings would be completed in time for an early January move of students from temporary quarters in Ohio. However, there were several delays that affected the construction process including delays with procuring materials and delays caused by bad weather. But by the end of the year the school had long outstayed its welcome in Ohio and Tien had little choice but to move to Montserrat in January of 1980. The resulting unhappy state of affairs that led to students walking the streets of Plymouth with their beds and mattresses in protest over conditions in the dormitories (Three Weeks of Classes at A.U.C., 1980) was eventually resolved once the dormitories were completed. When the Campus itself was completed, it became a tourist attraction on Montserrat. As Model says:
The Campus at A.U.C. is an impressive purpose built brick complex consisting of an administrative block, two teaching blocks containing large lecture rooms (one with closed-circuit television along the aisles), laboratories, and a library, and dormitory blocks containing 160 large two-bedded rooms each with bathroom. In addition, there is a recreation room and a restaurant open to the Caribbean (p. 952).
Model gives us an idea of the costs involved for the student attending the A.U.C. in the 80s. “Tuition fees are about $10,000 a year, and the students tell me that board and food cost a further $4,000. The Montserrat course thus costs about $42,000 to which must be added the cost of fares back and forth to the USA. Hospitals that accept students from A.U.C. for clinical training are paid $2,000 a year for each student” (p. 952).
The impact of the presence of the School on Montserrat was significant. By 1984, it was reported in the Montserrat Times that a World Bank report credited A.U.C. with the economic boom on the island. “Because of its small size, the economy of Montserrat tends to be extremely sensitive to major investment projects.” The report attributes the 14.5% growth in GDP during 1979 and the first half of 1980 to construction of the college and to the arrival of 450 students. Almost two years later, when the Montserrat Times reported (Brandt Represents A.U.C) that Government had threatened to close the off-shore medical school by January 3, 1986 for non-payment of license fees, the question was asked “What will happen if A.U.C. is forced out of Montserrat next January? Over sixty Montserratians will be thrown out of work, many persons would lose rental income on which they have been depending, taxi men would suffer and shopkeepers will lose their business.”
During the 1980s, the school faced several challenges while on Montserrat. The People’s Liberation Movement (PLM) government which got into power in 1978, replacing the Bramble regime, immediately set about extracting direct benefits from the presence of the school on island. The PLM government introduced The Universities and Colleges (Licensing and Control) Ordinance in 1980 and also introduced a student permit fee of US$500. A license fee for the school was also introduced, which according to a report in the opposition newspaper, (How Osborne’s PLM has Harassed the A.U.C., 1983) moved from EC$60,000 in 1981 to EC$120,000 annually thereafter. Tien saw this as a breach of the agreement arrived at with the PDP government and took the PLM Government to court arguing that the license fee was a violation of the School’s 15 year tax holiday.
On December 17, 1985, Tien received a letter from Attorney General Odel Adams (A.U.C. Pays Up, 1986) indicating that “With effect from the 3rd day of January 1986, no further issue of work permits will be made to the academic staff of your institution and all existing work permits shall be reviewed. Secondly, no person shall be allowed admission to Montserrat either as an existing or prospective student of the A.U.C. Finally it is Government’s intention to withdraw its support for the inclusion of your medical school in the sixth edition of the WHO’s listing of medical schools now in the preparatory stages of publication.” The Montserrat Chamber of Commerce had to intervene to settle the problem and Tien paid EC$240,000 which he claimed was a gesture of goodwill.
Tien was also embroiled in an industrial dispute with the Montserrat Allied workers Union in 1982. It seems (MAWU Sets Out its Case Against A.U.C., 1982) that the Union attempted to have dialogue with Tien once the school started operating in Montserrat but Tien refused to meet with Union Delegates and asked instead for a list of members working at A.U.C. In February 1982, a shop steward was fired and the following day, there was a sick out by all Union members and picketing the day after that. Locals were concerned about the signals being sent to potential investors. Tien finally agreed to meet with Union officials and an agreement was signed on February 18. However, Tien threatened on the following day to close the cafeteria and to outsource janitorial services, actions that would have affected 14 and 20 workers respectively. Students and faculty indicated their displeasure over the disruption of classes by what they regarded as “industrial foolishness” (Our Readers Say, 1982).
Despite his rocky relations with the Government, Tien did not avoid opportunities to demonstrate that he was a good corporate citizen. As early as 1980, he donated all of the fencing for the western and northern sides of Sturge Park and provided financial assistance to the various sporting associations on the island (A.U.C. to Help Sturge Park, 1984). The community was allowed to use the sports facilities at AUC including tennis and volley ball courts and it was only in the 1990s that a fee was charged for the use of the tennis courts.
The students also played a part in building bridges of friendship. The A.U.C. against the Montserrat Amateur Athletic Association meet was regarded as an opportunity to further improve the “bonds of friendship between A.U.C.[‘s] students and the local community” (A.U.C. and M.A.A.A. Compete, 1981). The first A.U.C. Tennis Tournament had involvement and participation from the Montserrat community (A.U.C. Tennis Tourney: An Outstanding Success, 1985).
In addition to difficulties with the government and the Union, Tien also had internal problems and external forces creating threats to the survival of his school. In 1982, he fired Dr. DiVirgilio who was the first Dean of the Faculty of Medicine. According to the report (A.U.C. Threatened, 1982), DiVirgilio was involved in the formation of a new school in Antigua, a school that was trying to lure faculty and students away from A.U.C. The report goes on to say
There has been much talk within the student body of late, concerning problems at A.U.C. It is alleged also that some faculty members have not been terribly happy with the conditions under which they have been operating. Whereas they enjoy Montserrat and like teaching, some faculty members have complained about the School’s administration.
Tien placed the blame for the problems on the fact that the supply of students had been steadily falling with only 250 expected to attend A.U.C. the following semester as opposed to 320 the previous semester. “Dr. Tien blames the economic conditions in the United States for this poor showing. In addition new off-shore schools are springing up in different places and drawing some of the students who would otherwise come to A.U.C.”
Not long after, Tien dismissed another member of faculty, Dr. Ranjit S. Nagi, Associate Dean of Medical Studies and expelled Mr. Nelson Bolagi Akande, a second semester student, and Miss Bosede Kufodu Uboh, a third semester student who were accused of being (New Medical School, 1982) “guilty of subversion in that they were actively involved with the formation of a new medical school in Antigua and carried out a campaign to recruit A.U.C. students for the Antigua School” (Antigua School No Threat, 1982).
Then in 1984, (Tricks Pulled on A.U.C.) it seems that staff from St. Georges University were on the A.U.C. campus attempting to “recruit students and staff members from A.U.C.” According to Tien, “our students were offered one free semester and told that they could be assured of good clinical rotation. They were even offered a free flight to Grenada and our faculty members were told that they would get higher salaries.” By April, Tien took action against St. Georges University (A.U.C. Files Writ Against Grenada’s Medical School, 1984) taking out an injunction against all of the defendants to restrain them from carrying out similar acts against A.U.C. in the future.
Yet another threat reared its head on the horizon. It would seem (What’s A.U.C.’s fate, 1986) that the U.S. Senate was considering a bill “that could mean the death of A.U.C. and the 4 other off-shore medical schools presently operating in the Caribbean. The bill states, that in order for U.S. students attending off-shore schools to be eligible for student grants, the schools must have an enrollment of at least 60 per cent nationals.” But “students, graduates and parents, have written to their congressmen in support of the school, asking that the senate bill be thrown out.” It would seem that their efforts were successful.
In the wake of the 1984 closure of the University of St. Lucia School of Medicine (USLSM) which started in 1983, Tien claims (A.U.C. Takes Stand on The Issue Of Academic Excellence, 1984) that the success of his school was as a result of placing priority on high standards of medical education and having a first rate faculty. According to Tien, of the fifty students from USLSM that were interviewed by A.U.C. representatives who had flown to St Lucia, only five met A.U.C.’s entrance requirements.
There is evidence that efforts were made over the years to ensure that the medical programme at A.U.C. was regularly assessed. In 1983, a team (New York State Looks at A.U.C., 1983) visited the school to evaluate the pre-clinical progamme and also visited the hospitals in New York where students would be placed for the clinical programme. One year later (California Officials expected at A.U.C. Next Week, 1985), representatives of the California Legislature Senate Committee on Business and Professions, the California Medical Association and the California Dental Association were reported as being expected to review Medical and Dental schools in the Caribbean for accreditation and licensure. These reviews would have been costly to A.U.C. but necessary since student placements in US hospitals were and still are dependent on positive reports on the school. This is supported by a Sounding Board report:
Several States have developed mechanisms to permit students at certain foreign medical schools to take part in clerkships within the states’ jurisdiction…New York State Board of Medicine jointly grants approval to certain foreign medical schools that want to place students in New York-based clinical clerkships. Such approvals have been given to St George’s University School of Medicine on the island of Grenada, Ross University School of Medicine on Dominica, the American University of the Caribbean on St Maarten, Netherlands Antilles (formerly Montserrat) (p. 1603).
Having overcome various man-made challenges, the School continued its operations in Montserrat until faced with the fury of nature in the form of Hurricane Hugo which battered the island on September 17, and left the Campus in shambles. Tien found a new home for the School at the Wayland Baptist Church in Plainview, Texas, while plans were in place for rebuilding the Campus. Keynote speaker at the 1991 graduation, Kenneth Cassell, Kenny Cassell remarked
This event is important for the A.U.C. because it exploded the myth, popular at least for a brief while, that Dr. Tien and his associates would take the opportunity to close down their operations here and perhaps permanently relocate to another country.
The fact that Dr. Tien and his associates achieved their target of restarting classes here just one year after the massive damages to the campus by Hugo, is testimony to their continued interest in the island, but more so to their dedication and determination to succeed in whatever they undertake (p. 13).
Once the volcanic crisis started, there was not only an exodus of persons but an exodus of several businesses from the island, among them the A.U.C. Tien’s contingency plan was for the school to relocate to St Maarten. As reported in Campus Connection
After the Soufrière Hills volcano began erupting on Montserrat in July 1995, American University of the Caribbean found a new home about 100 miles southeast on the island of St Maarten. Today A.U.C. students find themselves on a beautiful, contemporary campus specifically designed to meet a medical student’s needs.
The academic facilities offer future doctors the tools for earning a high-quality medical education including fully equipped gross anatomy, histology and microbiology laboratories, and clinical patient examination room. The four lecture halls on campus feature the latest audio/visual technology, and the extensive library subscribes to more than 100 medical and scientific journals.
It would seem that St. Maarten has seen some benefits from having the School on its shores. The Daily Herald (A.U.C. Expanding Third Phase Soon, 2003) reports that “Wescott-Williams, who is also Second Lt. Governor, described A.U.C.'s 25th anniversary as a milestone. 'A.U.C. has committed itself to St Maarten and stuck to this commitment since 1996,' she said. She alluded to the school's Department of Community Services, which contributes significantly to the community. Similar sentiments were expressed by Commissioners Laveist, Heyliger and other speakers.”
It has been recognized that the lower cost of providing medical education in the Caribbean (off-shore medical schools run an accelerated programme which eliminates holidays and they also avoid the costs associated with research and a teaching hospital), along with investment incentives including tax holidays and other concessions dangled by Caribbean Governments, have made the region an attractive environment for off-shore medical schools. Indeed, it is now being suggested that off-shore medical education could very well be a niche market for Caribbean countries. In 2005, a World Bank report noted that
off-shore education, and, in particular, medical schools, represent a small but growing services sector that has responded to a growing (and unfulfilled) demand for physicians in the United States. St George's University School of Medicine in Grenada and Ross University School of Medicine in Dominica are two of 23 primarily off-shore medical schools in the region, whose graduates together account for close to 70 percent of the international medical graduates entering the US. Demographic trends suggest continued demand for international physicians in the US, suggesting a significant opportunity for continued growth of this sector. To continue to meet this demand, and deepen the economic impact of the sector, the region should focus on creating a robust investment climate by raising accreditation standards, supporting regional accreditation agencies, and moving towards a harmonized and transparent investment regime, including encouraging FDI [Foreign Direct Investment] in the higher education sector (xxix).
The recently registered British International University (BIU) with investors from Dubai, is being regarded as a possible reincarnation of an A.U.C. project. The School was registered in April, 2006 and has already received provisional accreditation from the Caribbean Accreditation Authority for Education in Medicine and other Health Professions (CAAM). It is now important for this school to be listed in the Avicenna Directories which replaces the World Directory of Medical Schools. The University of Copenhagen has taken responsibility for maintaining the Avicenna Directories and describes it as “a publicly accessible database of schools, colleges, and universities for education of academic professions in health. The database will, in sequence, include medical schools, schools of pharmacy, schools of public health and educational institutions of other academic health professions.” BIU needs to be listed to facilitate its student recruitment drive.
This project has the potential for a positive impact on Montserrat’s economy, unlike those schools licensed in previous years. The St John’s University of Medicine that was registered in 2003 was the brain-child of Dr Daniel Harrington who once taught at A.U.C. The School rented accommodation for a short period and had to face various legal battles, including infringement of copyright (New off-shore Medical School Hopes to Open in Early 2004, 2003). The University of Science Arts and Technology was incorporated when the Government of Montserrat and the Medical School of London signed an agreement (Medical School of London Signs Accord to Start Here, 2003). To date, this School, which has bought property and converted it into a Campus, needs to be listed to be able to effectively recruit students. The Atlanta Seoul University was licensed in 2003, rented space and for a short period used local talent for delivering its teaching programme. The School currently has no presence on island.
The A.U.C. story suggests that it is necessary to plan with contingencies in place for the unforeseen. Entrepreneurs wanting to get into the now highly competitive off-shore education business need venture capital and a commitment to maintaining standards. The student recruitment process, the teaching programme, faculty and facilities should be able to stand up to scrutiny. At the same time, the Government of Montserrat needs to give serious consideration to the types and numbers of institutions that can feasibly operate on the island. Projects without a significant investment component will hardly attract the kind of benefits that were realized with A.U.C. Each application should be considered carefully and taken through a rigorous due diligence exercise. The danger is there that the Government could, as has happened with the off-shore banking industry, be held liable for activities undertaken by schools that it has allowed to operate with little regulation on the island. This is to be avoided and would require proper monitoring mechanisms, policies and procedures for the efficient management of the off-shore education sector. Attention needs to be paid to the proposed programme delivery methods and their implications for the island economy. Currently, on-line programmes do not have a positive impact on the economy of the island.
The process of approving a school’s operation on the island has to be efficient and it should be recognized that untenable delays on the part of Government when processing applications and requests affect the serious investor negatively. In the absence of a national accreditation authority, links should be maintained with reputable institutions that can assist with the accreditation process to ensure that standards are maintained in the schools that operate on the island. The quality assurance process has to be rigorous.
It is understandable that governments are eager for any economic activity which will result in growth. However, it is important that these activities and their possible impact on the society are thoroughly assessed before they are implemented.
A.U.C. and M.A.A.A. compete. (1981, July 21). Montserrat Times, p. 9.
A.U.C. expanding, third phase soon. (2003, August 15). The Daily Herald, retrieved September 30, 2006, from http://thedailyherald.com/news/daily/g76/auc76.html.
A.U.C. files writ against Grenada’s Medical School. (1984, April 19) Montserrat Times, p. 10.
A.U.C. pays up. (1986, January 10) Montserrat Reporter, p. 8.
A.U.C. ready to break ground. (1979, June 23) The Montserrat Mirror, p. 12.
A.U.C. to help Sturge Park. (1984, February 3). Montserrat Times, p. 11.
A.U.C. takes stand on the issue of academic excellence. (1984, March 23) Montserrat Times, p. 8.
A.U.C. tennis tourney: An outstanding success. (1985, December 13) Montserrat Times, p. 9.
A.U.C. threatened. (1982, April 23) The Montserrat Mirror, p. 1.
Antigua School No Threat. (1982, August 20) Montserrat Mirror, p. 10.
Brandt Represents A.U.C. (1985, December). The Montserrat Times, 5(34), p. 1.
Campus connection: Welcome to the St. Maarten campus. (2006). AUC Connections, 1. Retrieved Oct 7, 2006 from http://www.aucmed.edu/aucconnections/Archive/WinterSpring06/campuswelcome.htm.
Cassell, K. Greater co-operation between Government and A.U.C. needed. (1991, April 5). Montserrat Reporter, p. 13, 18.
Former U.S. A.G. to speak at A.U.C. graduation. (1984, January 20). The Montserrat Times, p. 1.
How Osborne’s PLM has harassed the A.U.C. (1983, February 11). Montserrat Times, p. 10.
Johnson, K.E., Hagopian, A., Veninga, C., Fordyce, M.A. & Hart, L.G. (2005). The changing geography of Americans graduating from foreign medical schools (Working Paper No. 96. Washington: University of Washington, Department of Family Medicine. WWAMI Center for Health Workforce Studies.
Lawrence, Susan V. (1979, March 10). A moveable med school. Science News, 115 (10): 153-155.
MAWU sets out its case against A.U.C. (1982, March 5) Montserrat Times, p. 6.
Model, D. G. (1984, April 28). Montserrat: An off-shore medical school. Lancet, 323 (8383): 952-3.
New Caribbean school holds first classes on Cincinnati Campus. (1978, September 23) Montserrat Mirror, p. 5.
New medical school. (1982, May 7) The Montserrat Mirror, p. 1.
New medical school enmeshed in fight over accreditation. (1978, August 25). The Washington Post, p. A11.
New off-shore Medical School Hopes to Open in Early 2004. (2003, August 15). The Montserrat Reporter, p. 2.
New York State looks at A.U.C. (1983, March 25). Montserrat Times, p. 10.
Our readers say. (1982, February 26). Montserrat Times, p. 4-5.
Progressive Democractic Party Manifesto 1978: A Charter for Continued Progress. (1978). St. Johns, Antigua: Antigua Printing & Publishing Ltd.
Sounding board: Nonaccredited medical education in the United States. (2000) The New England Journal of Medicine, 342 (21): 1602-5.
Three weeks of classes at A.U.C. (1980, February 2). Montserrat Mirror, p. 12.
Tricks Pulled on A.U.C. (1984, March 30). Montserrat Times, p. 10.
University of Copenhagen. Avicenna Directories, retrieved November 12, 2008, from http://avicenna.ku.dk/.
What’s A.U.C.’s fate. (1986, September 19). The Montserrat Reporter, p. 1.
World Bank. (2005). A time to choose: Caribbean development in the 21st century. Washington, D.C.: World Bank. Retrieved March 9, 2009 from http://siteresources.worldbank.org/LACEXT/Resources/317250LAC.pdf
Young, I. J. (2000). Montserrat: Post volcano reconstruction and rehabilitation – A case study. Montserrat: Department for International Development. Retrieved January 30, 2006 from http://www.corporate.coventry.ac.uk/content/1/c6/01/02/90/MONTSERRAT%20POST%20VOLCANO%20RECONSTRUCTION%20AND%20REHABILITATION.pdf#search=%22ian%20jardine%20young%20montserrat%22.
An earlier version of this paper was presented under the title “The American University of the Caribbean: Montserrat’s Loss, St. Maarten’s Gain” at the Conference Re-Thinking Education in the Caribbean: Yesterday, Today and Tomorrow: A Local Imperative in a Global Context which was held in St. Martin, Netherlands Antilles, October 10–13, 2006. It was subsequently published in St. Martin Studies 2006 1-2, edited by Maria Cijntje-Van Enckevort, Milton A. George and Silvio Sergio Scatalini Apóstolo, St. Martin: University of St. Martin, 2006, p. 61-68.
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