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One day in the early 1990s, an old friend of David Gill's called in a favor. The friend was working for an offshore medical school in the Caribbean, and wanted Dr. Gill to be a mentor for some of its students.
Offshore schools, set up primarily for U.S. citizens who were rejected by American medical schools, have been dogged by distrust and the occasional scandal. They are an unregulated industry producing doctors and degrees. They have attracted a fair amount of negative press and Congressional attention.
Dr. Gill, a Hubbardston resident and Gardner psychiatrist, was willing to give them a shot. He had come to believe that the American medical school system was too rigid, he said, and he saw this as an opportunity to test students who didn't fit the mold.
He was impressed, he said. The students he met were dedicated and intelligent, not tricksters looking for an easy way out. After working with dozens of them, Dr. Gill went even further into the industry - becoming at times an offshore medical school dean, president and even co-founder of a new school.
It's a decision that has put him at odds with many in the medical community, but he said that doesn't bother him. While some see potential for fraud in what they call "diploma mills" and the loosening of medical standards, Dr. Gill sees an egalitarian cause served by devoted educators.
"There's something morally wrong with education being rationed by any guild," Dr. Gill said. "I say, if a guy wants to be a doctor and can pass his exams and do well in a hospital with patients, he deserves the opportunity to try."
Offshore medical schools began growing in the late 1970s, most notably with the 1977 launch of St. George's University on the Caribbean island of Grenada. Like many schools of its type, it had been started privately by Americans as an alternative for aspiring doctors.
The schools crop up almost exclusively in small countries, which the U.S. Government Accountability Office says have lower accrediting standards than the United States. Students who attend them typically apply to do their residencies at American hospitals, and they aim to become licensed and practice in America, as well.
Their numbers appear to...