In an unusual arrangement that was described as benefiting both institutions, a for-profit Caribbean medical school has offered Kern Medical Center $35 million over 10 years for nearly exclusive rights to have its students rotate through the county facility.

For the financially struggling county hospital, the money would help improve its medical student program and overall academic mission, said CEO Paul Hensler.

The students, most of whom will be U.S. born, will come from Ross University, located on the Caribbean island of Dominica. Only 29 miles wide and 16 miles long, Dominica lies at the top of the Windward Islands in the West Indies.

The move benefits Ross by securing coveted medical school rotation spots in California, a region that has not offered as many opportunities for offshore schools.

The arrangement needs the approval of the Kern County Board of Supervisors, which will consider the matter on Tuesday. It may raise questions because Caribbean schools have a reputation for attracting Americans who can't get into U.S. medical schools.

Medical students typically spend their first two years on basic science coursework and the last two years in clinical rotations. U.S. schools often have affiliated hospitals where students can do those rotations, without having to pay additional costs.

Most Caribbean schools have no nearby associated hospitals, so they must seek out U.S. teaching hospitals willing to host their students.

KMC already receives about $750,000 per year from a variety of Caribbean schools in exchange for hosting about 100 rotation slots for med students. They also get a handful of students from UCLA, which, like other American medical schools, does not pay for the opportunity.

Medical students observe and participate in clinical care under the supervision of a faculty member or resident. Residents, on the other hand, already are licensed doctors, and are in the process of training in a particular speciality, such as family medicine.

If the KMC proposal is approved, Ross will be given priority for those slots. UCLA students will still be allowed to come, as well as students from other offshore schools with Kern County connections.

Ross is a division of a conglomerate called DeVry Inc., a for-profit higher education organization that is also the parent organization of a nationwide group of management schools, the American University of the Caribbean and other educational institutions.

Ross is considered a sister school with American University of the Caribbean, though for the time being it's not planning on sharing its slots, said Ross Dean Joseph Flaherty.

"I think it's a win, win, win for the county, KMC and our students," he said.

The $35 million package, which includes allocations for student scholarships in Kern County, is the largest amount Ross has ever offered a U.S. school, Flaherty said.

That could be because it had competition: St. George's University, another Caribbean medical school.

St. George's, on the island of Grenada in the West Indies, was also pursuing KMC in hopes of securing those coveted rotations. Over the past three months, leaders of both schools had presented KMC with their proposals.

"Ross made a better financial offer," Hensler said. "Also, their academic philosophy is more closely aligned to ours."

The news surprised St. George's founder, Charles Modica, who said school officials plan to look into the situation further before Tuesday's board meeting.

That school had offered nearly $2.4 million a year for just 72 students, a lower number it selected to ensure closer supervision and instruction.

Ross' annual contributions would provide $2.9 million directly to KMC, which may be used for faculty helping with the rotations, library improvements, labs and anything else that benefits the hospital's academic mission, Hensler said.

Each year, $300,000 would go to the Kern Medical Center Foundation, which supports patient care and education. And $300,000 would go to scholarships for Kern County students interested in attending Ross.

In addition, Ross and the county hospital would become more closely academically tied, with KMC faculty possibly serving as visiting professors and vice versa.

With a 10-year contract, the move would assure that a pipeline of mostly American students from Caribbean schools will continue to flow into the county.

That's a good thing, Ross' Dean Flaherty said. Since many of Ross' students go into primary care, it could fuel an influx of those doctors into the Central Valley.

"The hope is that many students will go there, think of spending time as a resident, and settle in Kern County or the Central Valley region," he said.

Addressing concerns about the academic strengths of U.S. residents who attend Caribbean medical schools, Hensler said KMC has picked the best of the dozens of Caribbean schools, and carefully examined Ross students' test scores and board pass rates.

Medical students at KMC reacted to the news with interest Thursday. Non-Ross students were concerned they wouldn't able to stay at KMC after the new agreement would take effect Sept. 1.

Having more guaranteed slots in California will likely attract more of the state's students to Ross, said Andrew Michael, a Ross medical student doing his rotation at KMC. Currently, there are Ross students who want to do rotations in California but have been unable to find an open spot since clinical availability is hard to come by, he added.

Michael and fellow Ross student David Aguirre said KMC's current diverse student population -- one that attracts the best from a variety of Caribbean schools -- has been an asset to their own studies.

Students from other schools may be studying for exams at different times, which fosters a culture of constant academic pursuit.

"It's just motivation," Aguirre said. "If they're trying harder, I have to try just as hard."