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I'm a Saba Doctor.


I'm a Saba Doctor.


I'm a Saba Doctor.

SABA: Eligible for U.S. and
Canadian loans

I'm a Saba Doctor.

SABA: Graduate with less debt

Saba Student Looks at Why Canada Lacks Doctors

Forty years ago, Canada enjoyed one of the best physician-to-population ratios among developed countries. That's not the case today.
Among the 34 countries that are part of the Organisation for Economic Co-operation and Development, Canada now ranks 28th.

What happened? Andrei V. Malko, a student at Saba University School of Medicine, decided to find out. He made the shortage of doctors in Canada the focus for the research paper that is required of all Saba students.

And now Andrei has joined the select group of Saba students who have had their papers published—his paper, Physician Shortage in Canada: A Review of Contributing Factors, appears in the Global Journal of Health Science, Published by the Canadian Center of Science and Education.

 “Assessing medical data is a critical skill for any physician today,” said Jim Bruzik, Associate Dean for Medical Education at Saba.  ”Since we made the research module part of the Saba curriculum, students tell us it gives them a real point of differentiation in their residency interviews. This is especially the case for students like Andrei and others who have had their papers published.”

Andrei looked at a wide range of underlying factors impacting Canada’s physician shortage from government policies and population demographics to medical student career preferences and the decline in physician productivity. Understanding the wide range of underlying causes is critical because, he notes, “decisions that are made today will take at least a decade to reveal their full effect.”

To see Andrei’s’ published paper, click here.  To learn more about the student research program at Saba, including video interviews with Dean Bruzik and other Saba graduates who have had their papers published, go here on the Saba website

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Vogue Discovers Saba

Count Vogue as the latest to discover what makes Saba a Caribbean paradise.

In A Guide to Saba: The Caribbean’s Best-Kept Secret, Vogue declares Saba “one of the last unspoiled havens in the Caribbean…a treasured secret with pristine beauty and incredibly jovial locals.”

Saba is unlikely to become a tourist hot spot. In many maps, its five square miles are barely a dot if shown at all. That was just fine with Vogue which found that what Saba lacks in size, it more than makes up for in quality and diversity. Saba’s tiny local population (it recently nudged just over 2000) encompasses some 54 nationalities—a “diverse and accepting community that resides in whimsical chockablock cottages.”

Noting that you won’t find a “a Cabo Wabo, a Señor Frog’s, or even a branded hotel with white sand beaches” Vogue loved the ambience of the Queen’s Gardens Hotel (the photo above is from the pool of this inn--you can see the medical school in the distance) and Saba’s lively restaurant scene, including the complex cuisine at Brigadoon and steak night at the Swinging Doors.

And of course Vogue loved the waters off Saba—a marine playground offering some of the finest diving in the world and more than 150 species of fish, turtles, sharks and coral. And yes, who needs white sand beaches—Vogue still found plenty of swimming in the bays off the island’s volcanic rocks.

The article has beautiful photographs. Check it out at A Guide to Saba: The Caribbean’s Best-Kept Secret

Photos: Courtesy of The Queen’s Gardens Resort and Spa / Cees Timmers

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Celebrating and Protecting Saba's Spiny Lobsters


Saba is known for good eating—for such a small island there are an unusual number of interesting restaurants and many of the inns on the island are considered culinary destinations.  

And there is also a legendary local seafood specialty—the Caribbean Spiny Lobster (Panulirus argus).

These denizens of the deep aren’t exactly what most people think of when they hear lobster—the spiny varieties from Saba don't have the big claws that Woody Allen made famous in the kitchen scene in Annie Hall.  But there is plenty of succulent lobster inside those hard shells—pound-for-pound more than their clawed counterparts—that is delicious grilled, steamed, roasted, eaten on its own, in salads, etc.

Next week, Saba will be honoring its spiny lobsters with a three-day culinary event—the annual Saba Lobster Fest (November 4th, 5th & 6th). Fabulous lobster-inspired lunch and dinner specials will be offered at participating restaurants all across the island.

Most if not all of these lobsters will have been caught locally in the famous Saba Bank—a 60-mile long stretch of submerged atoll (the third largest of its kind in the world) a few miles off the coast. It's a place particularly rich in biodiversity: sea turtles, migratory Humpback Whales, thousands of seabirds, previously unknown examples of marine algae, critically endangered Staghorn Coral and hundreds of other sea creatures, including lots of spiny lobsters.

In 2012, the Saba Bank was designated a Particularly Sensitive Sea Area (PSSA) by the International Maritime Organisation (IMO), which has led to extensive conservation efforts including steps to prevent over fishing.  While catches of spiny lobsters have in fact gotten smaller in recent years, according to an article posted by the Dutch Caribbean Nature Alliance, a number of regulations have been put into effect that show promise in stabilizing the population--such as bans on catching lobsters that are too small or are carrying eggs.

Conservationists are watching closely to see if this will enable long-term, sustainable harvesting of one of the Caribbean’s best known delicacies. Let's hope for the best and a safe, sound way to enjoy future Lobster Fests.

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White Coat Ceremony—the Start of the Journey

It’s the high point of the first semester: the White Coat Ceremony.

Students in the matriculating class don the White Coat and recite the Hippocratic Oath—words and a simple piece of clothing that symbolize the promise and responsibility of their chosen profession.

At Saba University School of Medicine, the White Coat Ceremony took place on Friday September 2, with Associate Dean Michael B. Laskowski and Assistant Deans Roger J. Young and Lockie McGehee Johnson guiding a room full of students through the formal start of their medical education--and what is likely to be THE journey of their lives.

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Don’t Let These Five Reasons Keep You From Becoming a Doctor

On the long list of life’s great questions, deciding whether or not to attend medical school ranks well up there. Will you take the plunge or not? It’s a dilemma and we humans hate dilemmas. When we come to the fork in the road, we look for an easy way out. That often makes us grab at seemingly credible reasons to not do something, when upon closer inspection those reasons really don’t add up.

The website PreMedStar recently identified five reasons that keep people from going to med school. Here they are along with our take on them:

1.       I am not smart enough. Well, what is “smart?” Is the person who is “smart” in mastering organic chemistry also “smart” when it comes to evaluating a patient with a complex medical condition? In terms of the classic view of being “smart”, e.g., getting good grades on academic work, PreMedStar notes that if you are "smart" enough to successfully make it through college then you are also "smart" enough to succeed in medical school. If you don’t like academic work, and do not want to put in the effort to do well, that’s another issue. But it has nothing to do with being “smart,” whatever that means.

2.       My scores aren’t good enough. Unfortunately, scores have a lot to do with getting into medical school.  Standardized tests such as the MCAT, once intended to create a level playing field and eliminate favoritism, have morphed into hard-and-fast admissions cut offs. Everyone agrees that there are plenty of students who do not do well on standardized tests who would make great doctors. So, don’t let a bad test score psych you out. It’s a hurdle to overcome, not an insurmountable barrier. Here at Saba, we have seen numerous students who impressed us in many ways beyond their MCAT and GPA, and have gone on to become very successful physicians.

3.       I can’t afford medical school. No question, medical school is a big investment.  Here at Saba, we are proud that our tuition is one of the most cost-effective of all the leading international medical schools (see a comparison here), but we still know the burden this places on our students and their families. Government loans are one way that many manage this—Saba is one of the few international schools eligible for the U.S. Federal Direct Student loans. (Learn more here.) And keep in mind that there are many repayment options through the military, federal programs, or practicing medicine in underserved areas. Doubts over finances tend to bleed into other doubts and amplify them. Don’t let that happen. What seems like a major financial undertaking today, may seem far less onerous once you have successfully done it.        

4.       Doctors work too hard. Yes, this is true.  So do medical students. In fact, so do most people who want to accomplish something valuable. And as PreMedStar notes, this is true for many other professions that offer less job satisfaction and pay much less.

5.    It’s too late. While the average age for entering medical students is 24, more and more students are entering medical school at later stages in their lives. Here at Saba we have seen outstanding success from students who have come to us after careers as teachers, engineers, paramedics and more.  Read about them at

As in all big, life-changing decisions, you are going to be wracked by doubts. It’s natural. But make sure those doubts are really based on something—before you allow them to destroy your dream.

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Mistakes to Avoid While Studying for the USMLE

The USMLE is a rite of passage for every medical school student. Here are some tips from Brian Radvansky, a USMLE Tutor, on mistakes to avoid while studying for USMLE Step 1 & 2 CK:

·         On test day, you will need to be focused and present for about 8 straight hours.  Start building that stamina now. Avoid giving yourself those “mini-rewards” for just completing a question block. Keep going.

·         Avoid doing too great a proportion of your practice blocks in Timed Tutor mode and getting overly used to expecting a green check or red X after every question. That obviously won’t happen on the exam.

·         Try as much as possible to physically emulate the actual test conditions, i.e., working at a desk vs. lounging with your iPad on the couch.

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Great Books by Michael Collins on Becoming a Doctor


For more than 30 years—in fact ever since he completed his residency—Michael Collins has been an orthopedic surgeon in a practice just outside of Chicago. He’s also the author of two acclaimed memoirs: Hot Lights, Cold Steel traces the arc of his four-year surgical residency at the Mayo Clinic from eager but clueless first-year resident to accomplished chief resident. His second memoir, Blue Collar, Blue Scrubs, goes back further in time to his pre-medical school life working construction jobs.

Both books are great reads, as is a recent interview in which he reflected on his life and the changes he has seen in medicine. Some of the most interesting takeaways from the interview:

·         Back when Collins went to medical school at Loyola University (today the Loyola University Chicago Stritch School of Medicine), the curriculum was completed in three years. He says today’s four-year curriculum is better.

·         Collins matched in pediatrics before his first experience with orthopedics. He finished out the year in pediatrics and then switched to a four-year orthopedics residency.

·         In going for his residency, he didn’t do any visiting rotations. He got into the orthopedics residency because he played hockey with a guy who was high up in the department. He is staggered by what medical students today have to do to get a residency.

·         After practicing for over thirty years, how does he keep from burning out? “Burnout occurs when there is a disconnect between expectations and reality. It’s important to go into things with an understanding of what it’s going to be like. There are negatives: you probably won’t make as much money as a generation ago, plus the other things like paperwork, and the business of medicine. These are all true, and they are a problem. But I think if you focus as a clinical practitioner, basic things haven’t changed in thousands of years. You go into a room, talk to the patient, figure out the patient’s problem, and do whatever you can to help them. Helping people with their problems is the greatest thing about medicine. If you focus on that instead of the paperwork you have to do, you’re less likely to burn out.”

Collins has many more interesting observations. Ready them in the interview or take some time to read one of his memoirs.

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Doctors, Skilled Workers and Protocols

It’s a never-ending debate, made more intense in this era of cost-control and evidence-based medicine: What kind of latitude should doctors have in treating patients? Should doctors be looked upon as “skilled workers” performing highly complex work, but following strict protocols or should they be seen as professionals, working independently and applying their knowledge to an unending stream of unique situations.

Consider just a few examples:

  • A 57- year old man slips on the ice, breaks his hip and goes to his local hospital where a general surgeon pins the shattered bones back together—well, almost. When the hip failed to heal correctly the patient sought out an orthopedic surgeon specializing in trauma conditions at a large urban hospital who said simply, “I can see the problem right away. They followed the protocol, but in your case it wasn’t enough.”
  •   A resident being "trained" by an attending doctor was about to administer a drug using the protocol developed by that hospital's clinical department. The attending doctor interrupted and said, "Don't do it that way. I've been a doing this for over 20 years, and that way is stupid."
  • An ob/gyn practicing in an extremely rural environment—the nearest other ob-gyn is more than an hour’s drive away—says that “the only thing keeping my patients and me safe is well established and tested protocol and procedure.”

Here at Saba University School of Medicine, our students wrestle with questions like these every day—in the clinical training that starts from virtually the moment they step on campus, in classes on medical ethics, and in the research program on medical literature all students are required to complete by the end of their fifth semester. Learn more about Saba’s Curriculum

Of course, there are no simple answers. Today’s protocols are in many cases based on extensive clinical research that far exceeds the independent experience of any one physician. At the same time, no protocol can be right 100% of the time and there are numerous examples in the history of medicine of practitioners who bucked the prevailing consensus and were proved right.

For interesting discussions of these questions see Doctors are more than just skilled workers. Here’s why. And "Protocols are for nurses."


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Saba Makes the Smithsonian


If you are considering medical school in the Caribbean—or just a fabulous trip—check out the gorgeous account of Saba in (@SmithsonianMag)

Calling it The Best Caribbean Island You’ve Never Heard Of, this mouth-watering article extols Saba’s natural beauty, from the lush, 5,000-foot high rain forest to the waters around the island with their remarkable formations, the legacy of Saba’s volcanic origins.

The absence of a large-scale beach culture keeps the aquatic environment pristine (and jealously protected by local conservation groups), home to shallow patch reefs, deep-water seamounts, and plenty of underwater action—Hawksbill turtles, dolphins, lobsters, stingrays and scores of bright tropical fish. All of which makes Saba one of the top destinations in the world for scuba divers.

If the natural beauty of the island is breathtaking, its man-made diversions are no less enticing. Saba is part of the Netherlands, and that lineage is reflected in the local architecture of white-washed exteriors, red zinc roofs and green shutters, outlined in decorative Caribbean gingerbread trim.

The article gives a shout out to Saba University School of Medicine, noting its beneficial impact on local healthcare and the economy. But the main focus is on how spectacular it is to spend time on Saba.

Smithsonian calls it “the low-key, more sustainable version of the Caribbean—a place where polluting superyachts and mass resorts that harm the environment will hopefully never moor.”

Just don’t tell anyone.

Photo Credit: DND PR

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Wearing a White Coat—Who, What, When, Where and Why


At Saba University School of Medicine, all first semester students undergo the rite of passage known as the White Coat Ceremony—you don a short white coat, a symbol of your status as a full-fledged medical student. Upon graduation from Saba, that short coat will be replaced by a long one, a sign of your status as a full-fledged physician. End of story? Not by a long shot.

 For starters, a lot of professionals in the medical world now wear long white coats. To an anonymous, young, female physician blogging on KevinMD, this is troubling: “As a female physician I often will enter a room and introduce myself as Dr. (last name), and I cannot tell you how many times the patient or family member will remark to another person in the room or on the phone, and say “Oh, the nurse is here.”

 This physician isn’t putting down non-physician colleagues—simply wondering if there isn’t a way that other medical practitioners can acquire a distinctive, professional attire, symbolizing the dedication and skill they bring to healthcare, without it being the long white coat traditionally worn by physicians.

 For Shivam Joshi, MD, the issue is not who wears the white coats, but where. Writing in his blog AFTERNOONROUNDS, he reports being aghast at running into a fellow physician wearing his white coat at the grocery store.

 Dr. Joshi cites studies showing how much bacteria has been found on white coats and notes that Britain’s National Health Service now bans doctors from wearing white coats in the hospital and the United Arab Emirates’ Ministry of Health bans them outside the hospital.

 The Society for Healthcare Epidemiology in America (SHEA) recently recommended that healthcare providers should possess two or more white coats, launder them regularly and have access to hooks where the white coat (or other long-sleeved outerwear) could be placed prior to patient contact.

 So, that first-semester White Coat ceremony? It’s a rite of passage into the world of healthcare in more ways than you might have realized.

Photo: White Coats at Saba


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Going to Med School—Yesterday and Today

Genomics. Statins. Targeted Biopharmaceuticals. PET (Positron Emission Tomography). The world of medical treatments never stands still—and the same is true for going to medical school.

As What Medical Schools Are Doing Now That They Weren’t 20 Years Ago notes, a physician who graduated years ago might be surprised at the curriculum of today’s med student in which classes on medical ethics carry equal weight with those on anatomy and pharmacology.

Yes, today’s med students are trained in interpreting the various symptoms of disease, but they are just as likely to get trained in biostatics and evidence-based medicine. And while they are tested on their ability to assimilate vast quantities of information, today’s med students are also evaluated on their progress in developing an effective bedside manner.  All of that is a big difference from what medical school was like in the past.

Finally, a physician trained years ago might be surprised by the experiences of today’s medical residents: Instead of being on call almost around the clock, regulations now limit a resident’s weekly workload to 80 hours.

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To Be a Great Resident, Think Critically


What’s the best predictor of success in residency and beyond? The answer is critical thinking, according to a recent study. When researchers analyzed four different sets of data on a group of Canadian medical residents—including the results on a family medicine certification exam, MCAT scores, the resident’s Canadian Residency Matching Service (CaRMS) file and the results on a critical thinking test (known as the California Critical Thinking Skills Test or CCTST)—it turned out that it was the results on the CCTST that were the best harbingers of a successful residency outcome.  According to the researchers, while many residency programs use a variety of criteria and tools to choose students, “the results of this study suggest that [critical thinking test] may be useful as a tool for improving resident selection.”

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To Get Into Med School, Don’t Underestimate the MCAT


Every year at college commencements there are many graduates accepting their diplomas whose next stop might have been medical school had it not been for a disastrous experience with the MCAT . Considered by many to be the most demanding of all the graduate school entrance exams, a sub-par result on the Medical College Admissions Test (MCAT) is a key reason that so few of those who set out for medical school ultimately make it there. But it’s not the difficulty of the MCAT exam itself that keeps success rates low. A common culprit is inadequate preparation.

The MCAT is a seven-hour exam with three science sections (Biological and Biochemical Foundations of Living Systems, Chemical and Physical Foundations of Living Systems, and Psychological, Social, and Biological Foundations of Behavior) and a critical reading section.

According to 10 Things I Wish I Knew Before I Started Studying for the MCAT, by a student who “flunked” the MCAT the first  time around, the big mistake is treating the MCAT as just another end-of-semester exam—i.e., a few hours spent going over notes and readings. Instead, treat it like you are training for a marathon, allocating solid, dedicated time every day. How much is enough? According to 4 MCAT Myths, most students who do well on the MCAT spend between 200 and 300 hours preparing for the exam.

And it’s not just about hitting the books. You also need to eat right, manage your social life, avoid straining your eyes and don’t plan something big for right after the exam—that’s likely to be an unnecessary distraction that will rob you of precious points on your score.

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A Track Record of Recognition

Saba University School of Medicine is one of the few international medical schools whose graduates can be permanently licensed to practice medicine anywhere in the U.S. and Canada. This important distinction is made possible by the wide range of accreditations, recognitions and approvals that Saba has earned:

International Medical Authorities: A fundamental pre-requisite for recognition is to be listed with the World Health Organization (WHO) and the International Medical Education Directory (IMED) of the Foundation for the Advancement of International Medical Education and Research (FAIMER).  Saba University School of Medicine is listed in both.

NVAO: The NVAO (in Dutch: Nederlands-Vlaamse Accreditatieorganisatie), the Accreditation Organization of the Netherlands and Flanders, is a leading international accreditation organization. It was established by international treaty and ensures the quality of higher education in the Netherlands and Flanders. Because the island of Saba is part of the Netherlands, Saba’s medical program is accredited by the NVAO and is the only medical school located in the Caribbean that has this distinction.

U.S.: The United States Department of Education has approved Saba University for participation in the U.S. Federal Direct Student Loan Program.

State Medical Authorities: New York, California and Florida actively evaluate international medical schools.  Approval by these states enables students to obtain clinical clerkships and residencies in those states. These approvals are then recognized by other states, Canada and Puerto Rico, enabling students to be able to practice medicine virtually anywhere. Saba University School of Medicine is one of the few international medical schools to have received ALL of these approvals:

  • Approved by the New York State Education Department
  • Recognized by the Division of Licensing of the Medical Board of California
  • Licensed by the Commission for Independent Education, Florida Department of Education.

This is a substantial track record of recognition and is the reason why Saba University School of Medicine is one of the few international medical schools whose graduates can be found practicing medicine in a wide range of locations across the U.S. and Canada.

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Saba: One of the Most Affordable Medical Schools

When it comes to choosing a medical school, cost is a major consideration. After undergoing what is unquestionably one of the most difficult educational experiences of any specialist, the reality is that the loans you are carrying are likely to have a significant impact on what you practice, where you practice, your ability to pursue more education and how much you can “give back” in charitable and community work.

Here are a few quick things to know about Saba’s tuition and fees:

Affordable: Saba has always been committed to maintaining an affordable tuition. Among the top tier international medical schools located in the Caribbean, Saba has one of the most affordable tuitions: a full 30-40 percent lower than some of the others. (See the chart below.)

Straightforward: We publish our fees and tuition on our website ( and work closely with students on loans and payment arrangements. Our goal is to make the process as straightforward and transparent as possible. We don’t do a lot of marketing and advertising. We also don’t suddenly discover “scholarship” funds to attract students. We focus on being affordable and attracting the best possible students.

Student Loans: In addition to being one of the very few international medical schools that are approved to be part of the U.S. Federal Direct Student Loan program, Saba’s tuition structure fits in with the financial resources available to Canadian students, both for provincial loans and private sources of funding. (Learn more at


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Just Getting to Know Saba—Here Are 5 Fast Facts


  1. A Leading International School: Saba has been educating physicians for more than 20 years and is one of the most established and experienced international medical schools in the world.
  2. 99% USMLE Pass Rate: Saba students have a 99% first-time pass rate on the USMLE.  Based on data compiled by U.S. News and World Report, that not only exceeds any other Caribbean school, it’s better than most U.S. schools.
  3. Residencies: Saba graduates earn residencies at a rate consistent with U.S. medical schools, including appointments in 2016 at Boston University, Hershey Medical Center/Penn State, McMaster and Queen’s Universities (Ontario) and Yale.  Many Saba graduates become family doctors, addressing the critical need for primary care in the US and Canada.
  4. Approvals: Saba has received all approvals needed to enable our students to practice anywhere in the US and Canada. Saba was approved for participation in the Title IV U.S. Federal Direct Student Loan Program after the U.S. Dept. of Education determined that Saba’s academic program was comparable to that of U.S. medical schools. Because Saba, the island, is actually part of the Netherlands, Saba University has undergone a rigorous accreditation to meet European standards.  In effect, Saba is a European medical school that happens to be on a Caribbean island. 
  5. Tuition: In addition to Title IV loan availability, Saba aggressively manages tuition, keeping it 30-50% less than other international schools with comparable ranking.


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Saba Grad Develops Top Selling Radiology App

Radiology 2.0, an iPhone/iPad app, is changing how radiologists learn. Using thousands of images, it enables the user to simulate reading and interpreting CT scans the way a radiologist would in a clinical setting. Downloaded by nearly 1 million users, it’s the top Radiology app and iMedicalApps ranks it as one of the top 10 all-time medical apps for the iPad. And it was developed by Mohammed Kaleel, MD, 2011 Saba grad and currently a 5th year Radiology resident at Hartford Hospital.

Learn more about Mohammed and Radiology 2.0 at

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Saba Grad Takes Part in Canada’s First Successful Hand Transplant Operation

Photo Credit: University of Toronto, University Health Network

Canada’s first successful hand transplant operation had special meaning for Saba University School of Medicine. Giancarlo McEvenue, MD, a 2010 Saba grad, was part of the team of surgeons who successfully attached a donated hand and forearm on a 49 year old woman who lost her arm below the elbow in an accident several years ago.

A native of Toronto, McEvenue completed an undergraduate honours degree in Human Biology at the University of Toronto before heading to Saba for his medical degree. He is currently a senior resident in the Division of Plastic & Reconstructive Surgery at the University of Toronto. The 14-hour operation was performed at Toronto Western Hospital. While 110 transplants have been completed around the world, this was the first time it was done in Canada.

Learn more about Giancarlo and the operation at

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Saba—“The 18th Canadian Medical School?”

Getting into medical school is no easy task. That’s because there are simply not enough seats in medical schools to meet the number of students who want to become physicians. This is especially true in Canada where there are only 17 medical schools. A typical year sees more than 30,000 applicants competing for about 2,500 places. While Saba is located on a Dutch island in the Caribbean, it actually plays a significant role in the Canadian healthcare system. In fact, well over half of Saba alumni hail from Canada and stop in at almost any major Canadian medical center and you will find Saba graduates on staff. Learn more about the Saba-Canada connection, including interviews with some of our Canadian alumni, at

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Saba—‘The European Medical School in the Caribbean’

Many people know that Saba has received ALL of the approvals needed to enable our students to practice anywhere in the US and Canada. Also, Saba has been approved for participation in the Title IV U.S. Federal Direct Student Loan Program based on the U.S. Dept. of Education’s determination that Saba’s academic program is comparable to that of U.S. medical schools.

What you may not know is that because Saba (the island) is actually part of the Netherlands, Saba University has also undergone a rigorous accreditation to meet European standards.   Saba University School of Medicine has been accredited by the NVAO (in Dutch: Nederlands-Vlaamse Accreditatieorganisatie), the Accreditation Organization of the Netherlands and Flanders. This organization was established by international treaty and ensures the utmost quality of higher education in the Netherlands and Flanders. So when it comes to international medical schools, Saba really is quite unique:  a medical school with European accreditation that happens to be located in the Caribbean.

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