By Angelina Cappiello

 

There are visionaries who dream big, and then there are visionaries who create opportunities that transform generations.
    
For nearly 50 years, Charles Modica has done exactly that.
 
What began as the idea of a young law school graduate with an unconventional dream evolved into one of the most significant contributions to medical education in modern history. As founder of St. George's University, Modica helped create a pathway for aspiring physicians who might otherwise have been denied the opportunity to pursue their calling.
  Today, the university has graduated nearly 25,000 physicians along with thousands of veterinarians, public health professionals, and healthcare leaders serving communities throughout the United States and around the world. For more than a decade, St. George’s University has been the largest provider of new physicians entering the American healthcare system—a remarkable accomplishment born from a simple belief: deserving students should be given a chance.

  Yet Modica never set out to build the world's largest medical school. In fact, he simply wanted to solve a problem. As a young man, he personally witnessed talented students being turned away from medical schools, not because they lacked the ability to become excellent physicians, but because there simply weren't enough seats available. That realization ignited a mission that would eventually touch millions of lives.
  Now, in his memoir, Docs on the Bay, Modica reflects on the extraordinary journey that took him from Long Island to Grenada and ultimately to the forefront of global medical education. Preferred Health Magazine had the pleasure of sitting down with Charles Modica to discuss his remarkable story, the students who inspired him, and the enduring mission behind Docs on the Bay.
 

PHM: Your story is remarkable. Did you ever imagine that a young law school graduate would one day build one of the world's most influential medical universities?
Charles Modica: "I did go to law school. I graduated. I have a Juris Doctor degree, but I never practiced law. By the time I got out of law school, my feasibility study for St. George's was almost complete, and we were embarking on the inaugural class. 
   I went to medical school myself for one year in Europe, as tens of thousands were doing in the 1970s because there really were no places in the U.S. for them. One would think medical schools could have simply expanded seats. But they did not. They didn't add any new medical schools or significant numbers of seats anywhere in the United States for decades. That's what really provoked me to want to change the system. I set out to try to create one small school in the Caribbean that would help a little, not recognizing that we would become the largest producer of doctors of any single school to the U.S."

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PHM: The story of discovering Grenada sounds almost unbelievable today.
Charles Modica: "It absolutely is. I don't think it could be replicated now for a lot of reasons.
I did not know where Grenada was, never heard about it. I was looking for an English-speaking country to set up an English-speaking school. I had almost given up. Then on the bottom right-hand corner of a newspaper, I saw a tiny article that Grenada had received independence from Great Britain. That's all I had to see. I wrote a telegram to Grenada congratulating them on their independence and explaining my feasibility study for a medical school. Only a kid in law school with a shoe box on his desk with the letters that he had written already by snail mail would have done this. And you know what? A week later, I got my answer back by telegram and they wanted to be included. I can assure you they were the front-runner that day. It took about two and a half years after that to actually get the charter."

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PHM: St. George's University has transformed both Grenada and healthcare around the world. 
What are you most proud of?
Charles Modica: Grenada was incredibly supportive of our vision, and rightly so. Looking back, we never anticipated the impact the university would have on the country. Today, St. George's University proudly represents nearly one-quarter of Grenada's economy. I've known every prime minister since the first one who granted our charter, and they often tell me that when they travel abroad, one of the first questions they're asked is, 'Is that the country with the medical school?' In many ways, the university helped put Grenada on the map.
   It's a wonderful country, a peaceful country, and one that I'm proud to call home. Our school has become part of the fabric of the nation. We've provided full scholarships to Grenadian students in medicine, veterinary medicine, and our undergraduate programs. Before we arrived, most of Grenada's physicians had been trained in the United Kingdom, with a few coming from Canada. Since then, we've graduated hundreds of Grenadian scholarship students who have gone on to serve their communities and make a difference.
  But if you ask me who really made St. George's University successful, the answer is simple: the students. We recruited outstanding faculty from the United States and the United Kingdom, but what truly set us apart were students who simply would not take no for an answer. They came to Grenada determined to prove that the admissions committees that rejected them were wrong.
    I always believed in them. I used to tell the first class that they would outperform nearly every foreign medical school on the national boards. We had U.S and U.K. faculty teaching in English, and I believed that gave our students every opportunity to succeed. I didn't have data to support that belief at the time—it was more instinct than anything else. But when our students took the national boards for the first time, St. George's achieved the second-highest pass rate in the world, behind only Sackler University in Israel.
   That's why I always tell people that the students are the real heroes. People come up to me and say, 'Thank God for the school. You're a hero.' And I tell them, 'No, you're the hero.' They were the ones who left home, worked harder, excelled on exams, and proved they belonged in medicine. Their determination is the reason we have so many graduates practicing across the United States today.
   I used to tell students that they had more in common with students at Harvard Medical School than they realized. Most Harvard students were rejected by at least one medical school before being accepted. The difference was that our students often had one more rejection letter. That didn't mean they weren't capable of becoming physicians. It simply meant there wasn't room for them somewhere else.
  I wanted them to understand that another admissions committee's decision did not define their worth or their future. They deserved the opportunity to prove themselves, and when they were given that opportunity, they succeeded. In fact, when openings became available at U.S. medical schools, many of our students transferred. We proudly lost nearly a third of our charter class to American medical schools because they had demonstrated exactly what we believed all along—they belonged there."

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PHM: You share all this and more in your memoir, Docs On The Bay. Why did you feel now was the right time to release it?
Charles Modica: It's our 50th anniversary, and when you go on for half a century and you're still the chancellor, you go for it!  I wanted to tell the real story of how this all happened, preserve it for future generations, and share the incredible journey that brought us to where we are today. That's one of the reasons I wrote the book because I really wanted to memorialize what happened. We always have those days where you say, 'You really ought to write that down.'
   Luckily, I found David Fisher, a wonderful real author. My biggest thing about the book was don't put anything in there that's not absolutely truthful. There's no need to dramatize it or embellish it in any way. It's such a crazy story—with interventions, revolutions, volcanoes, and hurricanes—that the truth is interesting enough.

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PHM: The United States continues to struggle with a physician shortage. 
Where do you see the greatest need today?
Charles Modica: I think the physician shortage exists across virtually all specialties, but it's especially acute in primary care. Many graduates from institutions like Harvard and other top medical schools have opportunities to pursue highly specialized fields, and rightly so. They have earned those opportunities.
  One of the people who generously endorsed my book was Dr. Jeffrey Flier, former dean of Harvard Medical School. That meant a great deal to me because he understands something very important: if we don't produce enough primary care physicians, the healthcare system simply doesn't work.
   While many of our graduates go on to specialize, St. George's has traditionally been a major contributor to the primary care workforce. We are helping provide the physicians who serve communities across America, particularly in areas where access to healthcare is limited.
  Primary care doctors are the foundation of the healthcare system, yet they often don't receive the recognition they deserve. I believe our graduates are making a meaningful difference, not only throughout the United States but around the world, by filling critical healthcare needs and caring for patients where they are needed most.

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PHM: How is St. George's University expanding its mission to address physician shortages, particularly in underserved and rural communities?
Charles Modica: One of the ways St. George's University is looking to expand its impact is by helping address the physician shortage in rural America. We're developing programs to identify future physicians much earlier in their educational journey, particularly in communities that have struggled for years to attract doctors.
  We're reaching out to mayors, city councils, and town boards in small and rural communities and asking them to look around their own towns. The future physician they need may already be there. It could be a high school student who dreams of becoming a doctor but is discouraged by the obstacles and long odds of admission.
  Our goal is to create a pathway that gives those students a clear opportunity to succeed. We can work with undergraduate institutions in the United States and establish academic benchmarks that, if met, would provide a guaranteed pathway to St. George's University. Students would still be free to apply to U.S. medical schools, but they would also have the security of knowing there is another route available to them.
  Too often, talented young people abandon their dreams because the process seems overwhelming. We want communities to identify those students early and encourage them to stay the course. That future physician may be a neighbor's son or daughter, someone who ultimately returns home to serve the very community that helped support them. I would be very proud if, a few years from now, this becomes a recognized and successful model for bringing more physicians into rural America and improving access to healthcare where it is needed most.

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PHM: When you reflect on your own legacy today, what would you hope people would remember most about you? 
Charles Modica: I hope people remember that I believed in the students. It wasn't really about Charles Modica. It was about recognizing that these individuals deserved the opportunity to become physicians. Not every student would succeed, of course, but I believed that if you gave them a chance to prove themselves, most of them would do very well.
  All I did was recognize that potential and create a pathway. They did all the hard work. They put in the long hours of studying. They made the sacrifices. They completed their residencies and dedicated themselves to caring for patients.
  Today, as a 79-year-old man, many of my own physicians are St. George's graduates. I walk into their offices with tremendous pride and a deep sense of loyalty because I know what they went through to get there.
  That's why I always say the credit belongs to them. It's not me. I was just a somewhat wacky law student who believed he could do something that probably shouldn't have been logically possible. Looking back, it was the students—their drive, their intelligence, their perseverance, and their commitment to a calling—that made it all happen.

And it's still happening today.

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