Academic outsider on a mission: how an off-shore, for-profit institution is helping to solve the nursing school seat shortage in the U.S.

BY AGE 63, I HAD BECOME A successful, wealthy entrepreneur many times over. Incensed that the son of an employee had been denied admission to medical school despite having adequate credentials, I decided to open my own institution.

Although I had very little experience with education or academia, I was hoping that my street-smarts and business instincts, combined with the recruitment of some credentialed administrators of other medical schools, would enable me to succeed in my mission. Why shouldn't anyone who has the determination and aspiration to become an M.D. (or veterinarian) have the right to do it, provided that they meet the accepted standards and criteria?

Condensing 20 years into several sentences: The American Medical Association and its liaison committee on medical education were in opposition to such an initiative. However, the Ross University School of Medicine grew into one of the largest medical schools in the world. It now has more than 3,500 alumni practicing medicine, many of them in the United States with appointments at recognized hospitals and medical centers. Similarly, about 23 years ago, I founded the Ross University School of Veterinary Medicine, which now has about 2,000 alumni.

(I sold both of these universities in the year 2000. Today, they are owned and operated by DeVry.)

I've noticed a growing respect in for-profit higher education and off-shore education. For-profit education has the ability to provide very dear focus in building skills, offering specific training and knowledge in particular fields. The graduates of for-profits have been embraced by their particular industries and in their work environments. An increasing number of alumni from these for-profits further demonstrates the purpose for enrollment at these institutions.

In American medicine today, more than one-quarter of all practicing physicians are foreign-trained. As an example, where Ross University was one of several off-shore institutions feeding graduates into American medicine, today there are more than a dozen such universities, and this method of entry has become quite acceptable. Especially in the past two decades, a world global philosophy has prevailed among Americans that embrace international education.

Students at off-shore colleges and universities have enjoyed huge improvements and a more equitable playing field with today's cost-efficient travel and internet technology. No one can deny the impact of online education. And this element has become a positive benefit to off-shore schools.

Somewhat similar to the vacuum of medical school graduates in proportion to the need for doctors, an even more serious crisis has emerged with the lack of nurses available to staff hospitals, nursing homes, private practices, and other health care concerns. The deficit in the profession appears to be growing to 700,000. Meanwhile, there are an estimated 125,000 students who are wait-listed for enrollment in schools of nursing!

Perhaps, administrators at colleges and universities are fearful of stepping out with a significant, additional capital investment in their infrastructures and permanent tenure-track faculty, which nursing schools require (when compared with other more traditional classroom academic offerings). They may view this initiative with grave financial risk, if the nursing personnel picture changes say, in the next five to 10 years.

The timing was optimum for a for-profit entrepreneurial approach. The International University of Nursing uses the business model from my two previous schools. Working out of the same New York City office where I founded the other schools, I was able to obtain a charter for the new school from the government of St. Kitts in the Caribbean. For many students throughout the world, flying to St. Kitts and taking up temporary residence there is an easy, even attractive, proposition.

St. Kitts officials had been pleased with their experience in hosting my veterinary school. It seems that they saw my new multi-million dollar investment opportunity as another boost to their economic development.

BUILDING THE SCHOOL

I had my son, Warren, an attorney (who is now the president of this enterprise) begin building the campus on 20 acres of land I had acquired.

At the same time, I began recruiting deans and administrators with good reputations at other nursing schools. Many times more senior career people welcome the professional challenge of starting out fresh to develop a curriculum and academic program that truly represents their philosophy and has their personal imprints on it. I demonstrated my financial commitment, where administrators would have one, simple source with direct access to requisition funds for their courses, tools, and facilities. They would not have to go through multiple levels seeking different budget approvals.

Linda Simunek from Purdue University and Florida International University, and Paula Trupello from Wagner College, to name a few, reviewed my record with my two former academic centers. They recognized that they would not have to face extended political battles with inaccessible decision-makers (in contrast what happens on many college campuses) to get their scholastic initiatives underwritten.

Together, we understood that we had to offer superior quality in our academic programs and campus facilities, in order to convince students that there was an advantage to studying at International University of Nursing over a school in the States. And we had to make the upfront financial investment that would produce graduates who were well-qualified to staff America's health-care concerns. The new deans and academic officers gave the school some quick awareness and status among many schools of nursing. Next, we had to convince faculty members to start a new career in St. Kitts. We found many professional people motivated to make changes within their careers--something different, even radical. This can be especially true for professors in their maturing years, who feel that being innovative through this new setting is an excellent approach to professional fulfillment.

The compensation package and financial incentives ($70,000 to $80,000 a year, plus a Section 911 tax code benefit) International University of Nursing offered to these faculty members had to be at least comparable, if not better than, their present situation. Some had designs about one day living in the Caribbean, but didn't feel they would ever be able to go about it, without a solid job opportunity lined up like my school was offering. (For example, IUON's housing director was able to help many faculty members and students identify worthwhile accommodations.)

After several faculty members signed on, the momentum grew. We pretty much had our faculty in place within a matter of four months. At this point, we are filling occasional vacancies or new positions.

STUDENT SEARCH

With student recruitment, we are following all of the traditional methods that most colleges and universities have come to use, including an emphasis on internet marketing with e-mails and an interactive website. We are specifically targeting the wait-listed students at other nursing schools.

Applying a technique from my earlier business models would create partnership agreements with higher education institutions that have waiting lists of nursing students. With these students coming to us for study at International University of Nursing, the college could maintain the student as part of their enrollment. They could take their first three semesters, 15 weeks each at IUON, and then they study 34 weeks of their clinical rotation at these United States-accredited schools.

Meanwhile, these nonprofit schools, often strapped for funds, can generate revenue for their nursing programs, by payments IUON would make for each student they accept for their participation. Initially, there were no takers. But once the first and second nonprofit schools came aboard, more have steadily continued to sign on to our approach.

Student loan programs through Sallie Mae and Citibank have now been established, which indicates that these loan sources have been satisfied that a student studying at the university represents a fair credit risk.

This coming May will mark one year since the inaugural class of IUON. The school will be seeking accreditation from the appropriate academic bodies. And this will hopefully be just the first of many successful years to come.

Robert Ross is chairman of International University of Nursing, www.iuon.org, in St. Kitts.