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ProjectTulipONLINEMEDICALEDUCATION

SABos,MDBOSS@PROJECTTULIP.COM+31(0)614399274

Freeonlinemedicaleducation,foreveryone,worldwide.

ProjectTulip

ORGANIZATIONNAME&LEGALREGISTRATIONSFoundationname:StichtingProjectTulipFoundationname(English):TheProjectTulipFoundationChamberofCommercenumber(KvK):71433996RSINfiscalnumber(Dutchtaxfilenumber):858713834Bankaccount(ABN-AMRO):NL93ABNA0819381942TheProjectTulipfoundationhasaDutchtax-deductiblestatus(PBO/ANBI).

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PROJECTTULIP

ANONLINECURRICULUMFORFUTUREANDCURRENTDOCTORS

1. THEGOAL

2. THEPROBLEM

3. THESOLUTION

4. THEMARKET

5. THECOMPETITION

6. THEPRODUCT

7. THEBUSINESSMODEL

8. THETEAM

9. CALLTOACTION

APPENDIX1 CURRICULUMVITAE

APPENDIX2 FAQ

APPENDIX3 ROADMAP

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1.OURGOALATPROJECTTULIP

We’re something thathasneverbeendonebefore.We’rebuilding an onlinemedical curriculum. Andwe’re giving itawaytothewholeworld,forfree.

AtProjectTulip,weareafoundationcommittedtobuildinga full, rich and diverse curriculum of medicine to helpstudentsandprofessionalsbecomebetterdoctors.Weareentering theeraof life-long learning inadigitalworldandstudying medicine never stops. It’s why we believe thatprecioustimespentstudyingmustbeusedasefficientlyaspossible. You should be able to learnwhatever youwant,whenever you want and however you want. This meansstudents and professionals need the right tools to studyonline.

Through Project Tulip, you’ll find eLearning modules thatcompriseamodernBachelorofMedicine.Tohelpyouwiththose modules, there’s the Synopsis; a library with theessentials of all your textbooks. Test yourself with ourquestionbankandflashcarddatabasefilledwithhighqualitymaterial from our staff and your universities. To helpstudentswith their clinical rounds, themoduleswill allowthemtopracticethemostcommonandinformativepatientcases for each specialty. They’ll get a head start on everyclerk-orinternshipsotheywon’thavethefeelingofbeinglostandcontinuouslyhavingtostartover.Especiallywhenyoudownloadourhandytools tohelpyouquicklypeekatthose neurologic tests, high yield associations tables(strawberry tongue = scarlet fever) or check those labreferencevalues.

ProjectTulipis100%freeand100%open.Sonomatterifyouarewithorwithoutaccesstoauniversity,nomatterifyoucanorcannot afford textbooks and no matter where you are; throughProject Tulip anyone can study the foundations of modernmedicine.

Doctors indeveloping countries coulddo somuchmore if theyhad access to high quality educational content. There arecountlessexamplesofclinicswhereyou’llfind20-yearoldyellowtextbooksthatarefallingapart;thesebookswereoncedonatedandusedeversince.TheycaneasilyuseProjectTulip’scontentnow,eitherthroughtheInternetoraprintedversion.

WithProjectTulip’scontentasateachingresource,teacherscansupplementorevenreplaceyour traditional learningresources.Teachers can use it to flip the classroom, allowing students topreparetheirfundamentalsattheirownpaceintheirowntime.This way, ‘offline’ student-professor hours are better spentdiscussing and answering questions, instead of explaining thesame concepts over and over to a wide variety of students.Becausethereisnocopyright,teacherscantakeanymaterialandtransformitthewaytheywant.Nolongerdoeseveryuniversityhavetocreatethesameexpensivecontenttheirselves,andhideitawayonaprivatenetworktoprotectagainstcopyrightclaims!

Theworldofmedicineandteachingare inevitablygoingdigital,catchthedigitalwavewithProjectTulip.

1) http://www.who.int/hrh/news/2015/e_learning_4_hrh/en/

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2.THEPROBLEM

Medicinehasbeentaughtinaverytraditionalwayforcenturies.Classroomsforthemasses,hugetextbooksandfinallysomepracticeonthehospitalfloors.However,sincethebeginningofthiscenturywe’reheadinginacleardirectiontowardsdigitalization.Notonlydostudentspreferonlinesolutionstoregulartextbooks;educationischangingwithit.Blendedlearningisacombinationofofflineandonlinemethodsworkinginharmonytoprovidethebestlearningexperience.Oftenthiscomeswiththeconceptofflippingtheclassroom,whichusuallycomesdowntostudentsstudyingthebasicsathomeandrelyingonin-classhourstopractice,discussandaskquestions.Asaresult,forbothstudentsandfacultyinmedicinethedemandforonlineeducationishigh.Thesupplyhowever,islacking.Whyisthat?

Inshort;doctorsdon’thavethetimetocreateandupdatetheironlinematerial,andoftenlacktheskillsettoworkwithweb,videoandonlinecoursedesign.Supportingfacultystaffdohave this skillset, but areheavily reliantondoctors fortheirdesignsandknowledgeon thematerial.Bridging thisgaphasprovendifficultasthisproblemisknownforsometime, but has seen only a handful of solutions mostly bydoctorswhocommittedfulltimetotheeducationalcause.

Asawhole,theacademicmedicalcommunityhasstartedcuttingbackonthetimefor in-classeducation,butfailedtoprovideanonlinealternative.

Meanwhile, Western students are left scavenging for onlinerecourses, with widely varying levels of quality from so manyincomplete sources.With every organ system or specialty, theavailableresourceschangecompletely.Someofthematerialmayevenbeoutdatedorno longersupportedbymodernbrowsers.The process of searching for reputable sources alone is afrustratingcyclethatrepeatsitselfoverandover.Withthiscomesthe problem of curation. How do you know howmuch of thisinformation(whichisallnew)oneshouldstudy?Thereisaclearneed of professionalization of the material guaranteeingstructure,quality,curationandaccessibility.

Students and doctors in e.g. Third World countries often lackaccessto(affordable)educationinthefirstplace,andhavenofreealternativeforhighereducation.Furthermore,studyingonlineinone’s own pace means that it is no longer required to attendclassesduring‘businesshours’whichmeansit’snotnecessarytoquitone’sdailyresponsibilitiesinordertostudy.

1)http://www.who.int/hrh/news/2015/e_learning_4_hrh/en/

63.THESOLUTION

“Electronic learningcouldenablemillionsmorestudents to

train as doctors and nurses worldwide, according to the

latest research. A new systematic review of the literature

commissionedbytheWorldHealthOrganization(WHO)and

carriedoutbyImperialCollegeLondonresearchersaimingat

establishingtheevidence-baseforeLearning,concludesthat

eLearning is likelytobeaseffectiveastraditionalmethods

fortraininghealthprofessionals.”1

Project Tulip aims to solve the problem of supply anddemandbycreatingandrefurbishingonlinestudymaterialandoffersareliableplatformthatisaccessible,free,logicallystructuredanddiverse.

Ononehand,teachingfacultycanimplementProjectTulip'scontentintheirblendedlearningmodules,andsavealotoftimeandmoneyotherwisespentoncreatingandpublishingtheir own content. The default quality is high and followseducational scientific methods, while still allowing forindividualtouches.Ontheotherhand,studentsarefreetolearn,self-analyzeandexplorethisknowledgeintheirowntimeandpace.Studentsexperienceunparalleledfreedominlearning styles; from traditional textbook chapters oreLearning modules to large question banks and timelinebased learning. The product will be further outlined inchapter6ofthisdocument.

So not only can Project Tulip be an additional learningresourceandvaluablestudyaidforthestudent,itmayalsobeusedasonlinecontentforthefaculty’sblendedlearningstrategy.

Thismeansthatthetargetdemographicmodelistwo-sided:individualstudents,andmedicalfaculty.

Theplatformisuniqueinitscombinationoftargetdemographic,contentanddiversity.Whiletheglobalaimoffersgreatchancesfor growth, the content team should always account forinternational differences in factors such as epidemiology orimperialvsmetricsystems.Thesechallengesareexpectedtobelimited since Project Tulip focusses on essential content asencountered in the European Medical Bachelor degree andAmerican USMLE standards. International textbooks, servicessuchasUpToDate®andexamquestionsfrombothAmericanandEuropean faculty will be used as references to offer aninternationallyrepresentativeproduct.

WithrespecttothelocalDutchmarket,thecontentofonlinetextscoveringthecurriculumbasics,structuredbyatimelineorjustthemassive question bank alone could make Project Tulip anappealingproductforDutchstudentsevenduringitsearlystages.AsProjectTulipreachesitsfinancialgoals,studentsanddoctorsfromdevelopingcountriesshouldbenefitaswell.Academicandpublichealthvaluesrepresentcorevaluesofthisproject.Wideruseof eLearningmighthelp to address theneed to trainmorehealth workers across the globe. According to a recent WHOreport,theworldisshortof7.2millionhealthcareprofessionals,andthefigureisgrowing.1

2)Docebo-Elearningmarkettrendsandforecast2017-2021

3)AmbientInsight-The2016-2021WorldwideSelf-pacedeLearningMarket

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4.THEMARKET

ThischapterismeanttoillustratehowhighthedemandforeLearningisasawhole,throughdataonfinancialstreamswithinthesector.

ELEARNING

ThesizeoftheeLearningmarketwasestimatedtobeover$165 Billion in 2015 and is likely to grow by 5% per yearbetween 2016 and 2023, exceeding $240 Billion. TheeLearningmarkethasbeengrowingforyears,and‘edtech’startups attracted 416 funding deals in 2016, worth over$2.5billion.Currently,fundingto‘edtech’startupsremainsprimarily concentrated in the United States of America,where angel investors and venture capital firms are lesshesitanttoinvest.Factorssuchasthepossibilitysavingcoststhrough eLearning purposes (compared to traditionaleducationmethods)togetherwithincreasinguseofblendedlearningareexpectedtodriveindustrygrowth.2

Source:Docebo-Elearningmarkettrendsandforecast2017-2021

LinkedIn acquired eLearning company Lynda.com for $1.5billion–abusinessthatofferscoursesonmainlycoding,ITandbusiness(notmedicine).

HEALTHCARE

Ambient Insight, an ethics-based market research firm thatidentifiesrevenueopportunitiesforlearningtechnologysuppliers,tracksmarkets in122 countries. The following ismostlyderivedfrom their thorough reports. Ambient Insight states that thehealthcaresegmenthasayearlygrowthrateof7.4%andrevenuesforself-pacedeLearningproductswillreach$1.7billionby2021.The growth rate for self-paced continuing medical education(CME)issimilarat7.6%peryearandrevenuesforself-pacedCMEwillreach$528.3millionby2021.

“There are still significant eLearning revenue opportunities inspecificverticalssuchashealthcareandforcontentthatmapstocontinuingeducation forprofessional licensure.Thedemand formanaged education services continues to rise in the corporatesegment and in both academic segments. […] The healthcaresegment is not a monolithic vertical, but rather an amorphousclusterofbuyers.Thebuyersinthehealthcaresegmentarespreadacross the consumer, corporate, academic, government, andassociationsegments.Thissectiondoesnotincludeexpendituresmadebyconsumersorhighereducationstudents.”3

These"non-user"buyersinclude:

• Pharmaceutical, device, electronic medical records (EMR), andpublishingcompanies

• Public and private providers that buy products for theirstaffs/students

• Associationsthatdevelopand/orlicensecertificationandlicensingcontentfortheirmembers

2)Docebo-Elearningmarkettrendsandforecast2017-2021

3)AmbientInsight-The2016-2021WorldwideSelf-pacedeLearningMarket

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Table1:2016-2021USHealthcareRevenueForcastforSelf-pacedeLearningProducts(inUS$millions)3

Table2:2016-2021USHealthcareContinuingMedicalEducation(CME)ExpendituresbyMedium(inUS$Millions)3

“The aggregate global growth rate for eLearning in thehealthcare industry is7.4%.ThedemandfordigitalEnglishlanguage learning content is also relatively strong in thehealthcare segment at 6.6%. In July 2016, HealthStreamreported that "For the first six months of 2016, revenueswere$108.9million,anincreaseof10percentoverrevenuesof $99.3 million in the first six months of 2015." OrbisEducation is a private company that offers managededucation services for the healthcare industry. The reportthattheoverallhealthcareeducationindustryintheUSisa$4billionmarketandtheyaredoublingrevenuesannually.Wiley's corporate-facing CrossKnowledge brand hasexperiencedyear-overyeargrowthsinceWileyacquiredthecompanyinearly2014.CrossKnowledgeiscorporatefacingand focusses on business andmanagement content. Theyhaveadiversecatalogofcontent,platforms,andtools.MostoftheirclientsarelargeenterprisecompaniesinEurope.”3

Market analysts differ in opinion on the definitions andpredicationsoftheeLearningmarket.Thereishoweverconsensusthatbothhealthcareproducts,as innovativeeLearningsolutionsare inaquicklygrowingmarket.Furthermore,newcloud-basedplatformsarereplacingtraditionalLMSsystems.2,3

Publiclyavailableinvestmentdatadidnotresultinmajorinsightsoninvestmentsinmaincompetitorsinthemarket.

2)Docebo-Elearningmarkettrendsandforecast2017-2021

3)AmbientInsight-The2016-2021WorldwideSelf-pacedeLearningMarket

USBUYINGSEGMENT

2016 2017 2018 2019 2020 2021 5-YEARCAGR

HEALTHCARE $1,236.4 $1,392.5 $1,542.5 $1,651.8 $1,716.7 $1,763.1 7,4%

2016-2021USHEALTHCARECMEEXPENDITUREBYDELIVERYMEDIUM

2016 2021 5-YEARCAGR

PhysicalCMEClasses&Events $461.54 $182.40 -16.9%Self-pacedeLearningCME $367.09 $528.39 7.6%MobileLearningCME $97.32 $227.27 18.5%OtherCMEMethods $109.16 $72.66 -7.8%TotalUSCMEMarket $1,035.11 $1,010.72 -0.5%

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5.THECOMPETITION

Theplatformismadeupofseveralservices.Projectsandcompaniesonmedicaleducation(Dutchaswellasinternational)willbenotedbelow.

COMBINEDSERVICEPLATFORMS

1. OsmosisThiscompanymostlyreliesonvideoandcollaborationfunctionsforstudents.Theycanorganizetheirdocumentsonasharedlocation,whichallowsgroupsofstudentstobuildtheirstudymaterialdatabasetogether.ProjectTulipisprimarilydifferentintheseaspects:

a. Pricing:Osmosisisabout$200ayear,comparedtoProjectTulipwhichisfree.b. Text:ProjectTulipoffersasignificantreplacementfortextbookcontent,Osmosisdoesnot.c. eModules:ProjectTulipoffersmodulestoactivelyteachthematerial,Osmosisdoesnot.

2. Lecturio

This company founded in2008 is strong inbite-sizedvideosonvarious subjectspresentedbyphysicians. Theyalsoofferarticlesonmedicaltopicsandaquestionbank.ProjectTulipisprimarilydifferentintheseaspects:

a. Pricing:Lecturio’slowestpricingplanisabout$20amonth,ProjectTulipisfree.b. Structure: Project Tulip offers a smart timeline and allows student to create their own (e.g. tomatch their university’s

program).ProjectTulip’suserinterfaceisdifferentaswell.c. eModules:ProjectTulipoffersmodulestoactivelyteachthematerial.Lecturioteachesonlythroughvideoandpassivetext.d. Content:Lecturiohasbeenaroundforabout10yearsandalreadyhasaccumulatedasignificantamountofhigh-qualitytext-

andvideocontent.Itishowevernotdidactic,inawaythatthiscontentismoreacollectionofreferencearticles,butcannotbeusedtoteachoneselfthematerialfromscratch.

3. AMBOSS

Foundedin2012andoffersauser-friendlyquizbankandsummarynotesonallessentialmedicaltopicsandisfocusedontheGermanandUSAmarket.Theproductisaquickreferencetool,itdoesnotteach.Pricing:$48/monthor$365/year.

SINGLESERVICEPLATFORMS

1. eModulesa. BMJLearning

Modulesonmanysubjects.Goodquality.Around€50 forayearsubscriptionasastudent.Practicalandaimedatclinicalstudents.Doesnotoffermucheducationonthetopics.Doesnotuseatimeline,whicheffectivelyresultsinadatabaseofmodulestobrowse.

b. eIntegrityModulesaimedatprofessionals,mostlyGeneralPracticeandAcuteMedicine.

c. MedischOnderwijs.nlAplatformforlinkingandhostingeModulesinDutch.Itisfree,butoffersnotimeline,littlestructure,followsnorecognizableformatandasignificantportionofthemodulesisnolongerfunctional.Itisprimarilyaplacetohostthemodules,tolinktofromelsewhere(suchasBlackBoard®).

2. Videoa. KhanAcademy

Largelibraryofdrawing-stylevideosonvariousmedicaltopics,includesatimelinefunction.Freeservice.

103. Questionbanksa. BMJOnExamination

Largequestionbankforprofessionalsandstudents.IncludingBest-of-fiveandEMQformats.Subscriptionmodelscostsaround$120peryear.

b. USMLERxFirstaidinactivestudyformwithOKquestionsandOKanswers.Thecorrectanswershavegoodexplanations.2300q,$99-299peryear.

c. UWorldEverywrongandrightanswerrepresentadiseaseorprocessthatisplausibleandneedtoknowinformation.Probablythebest question bank for USMLE students. Excellent rationales. 2400q, $170-600 per year. Not web-based, applicationinstallation.

d. KaplanLowyieldfactoidsanddifficultquestionstostressone’sunderstandingoftopics.Onewillstillmissquestionsontopicsyouunderstandwellbecausethey'representedpoorly.2200q,$99-299peryear.

e. NBMEMostaccurateUSMLEStepscorepredictor.Noexplanationsonquestions.200q,$60peryear.

4. Othera. Yesculaap

ADutchsitethat(amongstothernon-educationalfunctions)offersseveralseeminglyrandomstudytoolsvaryingfrompocket-dermatomemapstobasicdifferentialdiagnoses.Userinterfaceisratheruser-unfriendly.

ThewayProjectTulipsetsitselfapartfromthecompetitionisthatProjectTulipaimstoteach.Plus,ProjectTulipoffersmultiplestudystylesachievingthesamegoal,andprovidesthisinatimeline.Thisoffersfreedomwithinasetofboundariestoallowstudentstofocusonthematerial,nottheselection.Free,highyieldquestionbanksareinplacetosupporttheinevitablecrammingbeforeexams.Butingeneral,oneshouldbeabletolearnthebasicsoftheoreticalmedicinethroughProjectTulip.Learnmedicineonline.

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6.THEPRODUCT

TheProjectTulipproductisbuiltaroundanonlineplatformwhichoffersdifferentlearningtoolstohelpmedicalstudents(ordoctors)reachtheirprimarytargets:1)becomea(better)doctorand2)passtheirexams.

THEKEYCOMPONENTSARE

1. Timeline.Throughatimeline,studentsgetstructureandpurposewhilestudying.Whereotherplatforms‘dump’materialin a seemingly endless list of categories, Project Tuliptakes the next step through smarter organizing anduser-friendlypresentation.ProjectTulipoffersadefaulttimelinethatgivesstudentsinsightonwhattolearninalogical order. It also offers the freedom to choosewhethertocoverjusttheessentials,orfurtherexploreadvanced material. The timeline covers the entirecontentoftheplatform,whereonecanzoominone.g.Cardiology. No more clicking a random Cardiologysubject,andrealizing30minuteslaterthatthesubjectturnsouttobearareconditionorthatthematerial istoocomplicated.In the timeline, students are also free to choose theirpreferred study style: text, eLearning modules,questions,flashcards,etc.Seebelow.

2. TheSynopsisAn online ‘textbook’ that covers the essentials of thematerial,writteninthestyleoftextbooksandteachingfrom the ground up. It covers most of the materialavailableontheplatform,andsometimesmore.IntheNetherlands, it would serve the same purpose as theCompendium® textbook series; only in English andonline. The Synopsis is continuously under review tostay up to date and to expand where needed.

3. eModulesIf your traditional textbookarticlesare toopassive,expandyour knowledge through active learning. With the ProjectTulip eModules, students can expect a truly well-designedmodule ranging from 15-60 minutes depending on thesubject.We’renottalkingsixpagesoftextandsomemultiple-choice questions, but truly engaging and professionalmodules. A huge advantage will be that the style andstructure won’t vary as much as from other sources. Thismeansstudentscanfocusmoreonthematerialandlessonsecondarymatters. Ina laterstage,thesemoduleswillalsoallow students in their clerkships and residency to practicethemostseencasesperspecialtywhichwillgreatlyimprovetheirlearningcurveintheclinic.Themoduleswillbedesignedto support LMS systems such as BlackBoard® and Canvas®shouldtheproductbenefitfromit.

4. QuestionbanksCarefully labeled questions in a huge database. Useful forcrammingbeforeexams,toevaluateyourcurrentknowledge,ortolearnbytrial-and-error.TheProjectTulipquestionbankwill cater to European and American students by offeringdifferent styles (e.g. board-style questions) aimed atEuropeanandUSMLEexams.

5. FlashcardsMost popular amongst American students, flashcards canoffer a very high yield of retention when used correctly.

HowdoesProjectTulipguaranteehighqualitycontent?

a. Thecontentisrequiredbasicmedicalknowledge;thismeansthatallourcontentiswidelyknowninthemedicalcommunity.AnyMDwillbeveryfamiliarwiththematerial.Beingabletotrustyourstudyresourceiscrucial,especiallyinthemedicalfield!Advancedmaterialisavailableforyouwanttogofurther,andit’sclearlymarkedsoyou’llkeepoversightonhowdeepintothematerialyouare.

b. Madebydoctors.Wehaveadedicatedstaffofmedicaldoctorsthatareresponsibleforallpublishedmaterial.

c. Checkedbyspecialists.Everythingwemakeisalsoverifiedbyspecialistsintherespectivefieldsofmedicine.

d. Continuouslyreviewedandupdated(that’stheadvantageofonline:publishingnewversionsofthesamebookisexpensiveandcan’tkeepup)

126. Various(handytools).

Rangingfrompocketdermatomemapstolaboratoryreferencevalues,thissectionoffersvarioususefultoolsthatarecurrentlyscatteredacrossvariousplatforms.

7. (Video)Video isasurprisinglyeffectiveandattractivemediumforonline learning. It is alsovery time-consumingandlabor-intensive to produce. Since there are twomedium-sizedcompetitors-focusedonvideo-activeonthemarketalready,ProjectTulipoptstoprioritizeotherstudycontentduringthestart-upphase.Videowillplayabiggerroleinthefuture.

EXAMPLES

Imagine three examples of why online blended learningthroughProjectTulip issuchanadvantageforthemedicalstudent.

1.Astudentusesapaperbundleofoldexamstopractice.Sheguestimatesthatshe’sdoingpoorlyonasthmarelatedquestions.Shetakesoutanhourtoscanthewholebundlelooking for extra asthma questions and takes out hertextbookstoreaduponit.

WithProjectTulip,theanalyticswilltellherwhatarea’sneedwork. With one click of the mouse, she’s now workingthrough countless asthma questions and is starting tounderstandthepatientcasethatmatchesthediagnosis.ShequicklyheadsovertotheSynopsiswhereshereadsuponthecondition. She understands the basics, but doesn’t quitegraspasthmainthecontextofapatientcase.So,shedecidestoactivelyuseandexpandherknowledgebycompletingtheeModuleandisnowreadytoevaluateherprogress.Thisisamuch more effective and efficient use of her time andenergy.

2. A student is expecting a busy semester caused byextracurricularobligations,andtriestogetaheadoftheupcomingCardiologycourse.HeboughtanexpensiveCardiologybook,butonly10%ofthematerialisrelevantforthecourseandexam.He’safraidhe’llwastevaluabletimeonirrelevantcontent.Hetakesafewhourstocurateonlinematerialhecanfind,butafterafewhours he can only find some individual Cardiology eModulesabove his knowledge level and he continues to doubt therelevanceofthematerialhe’stryingtostudy.

ThroughProjectTulip,heheadsovertothetimelineandclicksonCardiology.HeoptsfortheSynopsisandreadstherecommendedbasics.Thisgetsboring,soheswitchestotheeModulessohecanlearnabitmoreactively.Thepatientcasesserveasgreatmemoryanchors.Anhourlater,hetestshisknowledgewithsomeboard-stylequestionsandthetrial-and-errormethodmotivateshimtoperfect his fundamentals. This is a much more effective andefficientuseofhistimeandenergy.

3.AstudentisstartingherclerkshipNeurologyandalthoughsherefreshedherNeurologynotesandbooks,itallseemscompletelyuseless in the clinical context. She has no ideawhat to expectduring patient rounds and in the outpatient clinic. After a fewweeksshe’sstartingtolearnwhatthemostcommonpresentingsymptomsanddiseasesareandhowtoproperlymanagethem.Assoonasshestartsfeelingcomfortableinhernewrole,it’salreadytimetomoveontothenextdepartment.

ThroughProject Tulip, she heads over to the eModules sectionand clicks on the Clinical Top 20 under Neurology. She’s nowinformedof the 20most commonpatient cases in the averageNeurology department. Entering her Neurology clerkship, she’sbetter prepared and has more freedom to improve hercommunicative and differential diagnostic skills (whichwas herfeedbackduringpreviousclerkships).

4.AyoungwomaninIndiasupportsherfamilythroughadailyjob.There’snouniversityinherregion,thoughherfamilyhasnofundsto afford it either how. At night, she studiesmedicine throughTulip. When the Internet is out, she uses her downloaded orprintedmaterial.

In a region without doctors, she does what she can for thecommunity with her newly acquired knowledge. As she gainsexperienceinthelimitedmedicalhelpshecanprovide,sheslowlygainssomefinancialindependence.

ThesearefourclassicexamplesofcurrentproblemsthatcanbetackledbyusingProjectTulip.

For the first time, democratization of medical education is apossibility.Wejustneedyoutohelpus.

Byintelligentlystructuringthematerial,andsimultaneouslyallowingstudentstoblendthesesources;ProjectTulipcreatesaplatformthatallowsstudentstoexcelandstudymedicineonline.

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7.BUSINESSMODEL

So what’s in it for donators? Let’s put the targetdemographicaside forabitand focusonwhy itwouldbewisetofinanciallysupportProjectTulip.

CorporateunderwritersofProjectTulipenjoythebenefitofsupportingaglobalintellectualphilanthropyeffortaswellastheimpactoftraditionalwebmarketing.

It's an effective way to build business and brand yourcompany while helping to provide free educationalresourcestomillionsofteachersandlearnersworldwide.

ProjectTulipunderwritingopportunitiesinclude:

1. On-site and newsletter brand advertising to a highlyeducated global audience, including large numbers ofvisitorsfromtheUnitedStates,ChinaandIndia

2. On-site recruitment messaging reaching students atDutch universities, other global top universities andemployeesattopcompaniesworldwide

3. RecognitionasaProjectTulipunderwriterateventsontheUvAcampusandaroundtheworld

4. Co-branded custom course lists highlighting materialsmostrelevanttoyourcustomersorworkforce

5. Tulip underwriter logo for use on your company's site andmarketingmaterials

6. CompliancetotheDutchANBIratingmeansthatdonationsaretaxdeductible.AdependencelocatedintheUnitedStatesis to be opened in the future to attract foreign supportthroughtaxdeductibledonationsasa501(c)(3)institution.

MEDICALFACULTIES

Possible savings for medical faculties may vary enormously,depending on their current efforts to build eLearning and thecurrent/futureroleofonlinecontentintheircurriculum.There’salso possible savings in accreditation rates, teacher flexibilityissues, student data analyses and student progression.Furthermore, some medical faculties have digital content thatfrankly makes them look bad to (future) students and otherinstitutions.With Project Tulip as a partner, they can advertisethrough progressive and modern brand elements. There’s alsoacademicquality,asProjectTulipusesevidence-basedcognitivetechniques such as test-enhanced learning, spaced repetition,memoryanchorsandgamification,amongothers.

What follows is a profit and loss prediction model that alsoindicatesfuturetargetsinusersandstaff.

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INCOME&LOSS.

ProjectTulip

x1000€ Year 1 Year 2 Year 3 Year 4 Year 5 Remarks

Income 150 203 273 369 498Donations 150 203 273 369 498

Growth 35% 35% 35% 35%

COGS 0 5 10 20 41Users (n) 0 100 300 900 2700Growth 200% 200% 200%

COGS/user 0,05 0,03 0,02 0,02Growth -33% -33% -33%

Overhead 71 111 252 303 363Medical Director 30 30 30 30 30Full-stack dev. 0 0 75 0 0Front-end dev. 0 0 0 40 40Back-end dev. 0 0 0 40 40Graph. design 0 0 15 15 15

Content creat. (MD) 35 70 105 140 175no. FTE 2 3 5 6 7

Subtotal personnel 65 100 225 265 300

Hardware 2 4 6 7 8Software 3 5 8 9 11

Rent 0 0 5 5 5Travel and training 0 2 3 3 4

Product redacting costs 1 2 3 3 4Marketing 0 0 4 11 32

Subtotal other 6 11 27 38 63

EBITDA 79 86 11 46 95Margin 53% 43% 4% 12% 19%

Hardware is leased. Software licenses are spent mainly on WordPress plugins and Articulate 360 for businesses. Perhaps a collaboration with the AMC/UvA could save some costs. When the team expands in year three, an office is required. Preferably in a start-up building across the street from the AMC or a University building.Aging of the online product is a pitfall that needs attention from the start of content creation through redacting cycles. Marketing focusses on online presence, mainly new medical students and faculty should be reached.

The foundation will set out with a founder responsible for early content and overall management, in possession of aMedical Degree. Initially, an early build is developed through existing code and plugins in a WordPress-based learningmanagement system (LMS). In year three, a site content migration away from the early build is a possibility. The purposewould be to adopt a more solid and scalable platform. To satisfy users however, the platform needs quantity and qualityof content. This is why the team expands with a medical content developer every year.Please note that this projection is for the minimum personell required to be professionaly operational. Scalingdepends on income, Project Tulip hopes to quickly expand in staff and through outreach programs towardsvolunteer content creators. We want to build!

These costs of goods and services sold are mostly reserved for server costs and other IT infrastructure. The costs per user should decrease significantly as the user base grows. Back-end development should focus on scaling.

In this projection, income is solely based on donations from academic institutions, medical centers, charities, NGO's and large businesses. Project Tulip will aim for yearly contributions starting from €25,000. Naturally, Tulip will prioritize pursuing grants from different sources as well.

The user growth is directly related to the completeness of the platform. An incomplete platform will not draw many users, so the initial barrier is high. However, the platform user base may grow ahead of this projection depending on collaboration with external partners on the question bank and textbook-like content.

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8.THETEAM

Phase1:Buildingproofofconceptplatformandearlycontent.Coachingbyexperiencedmedicalprofessionalsandteachers.

1. Founder/MedicalDirector

2. Contentcreators:youngMD’sdedicatedtomodules,textsandquestionbanks

Phase2:Increasingcontent.

1. Contentcreators:youngMD’sdedicatedtomodules,textsandquestionbanks

2. Front-enddevelopers

3. Back-enddevelopers

4. Graphicaldesigner

Phase3:Refiningcontent.

5. Learninganalyticsspecialist

6. Marketingandpr-professional

7. Educationalscientist

PERSONNEL

The foundationwill setoutwitha founder responsible for

early content andoverallmanagement,with an ambitious

background,medicaldegreeandrichhistoryineducational

innovationanduseofnewmedia.Initially,anearlybuildis

developedthroughexistingcodeandpluginsinaWordPress-

basedlearningmanagementsystem(LMS).Inyearthree,a

site content migration away from the early build is a

possibility.Thepurposewouldbetoadoptamoresolidand

scalableplatform.PleasenotethatanyITprofessionalswill

behiredasindependentcontractorsduringatleastthefirst

twoyears.

To satisfy the user base, the platform needs quantity and

qualityofcontent.Thisiswhytheteamexpandswithatleast

onemedicalcontentcreatoreveryyear.Thesecreatorswill

also coordinate a volunteer writing staff from around the

world.

When the platform has matured, new advanced and

adaptive learning analytics will be needed to meet the

demands of students and faculty. Basic analytics are

availableearlyon.Marketingbudgetsmayvary.

ONTHEFOUNDER–SABOS

An important variable iswho leads the start-up;who leads the

initiative?Mystorybeganin2010;asamedicalstudent,Irelied

heavilyononlinestudytools.Imostlyusedmyuniversity’sweb-

lectures so I couldpauseandaddnotes, images,diagrams,etc.

Physical classes in massive lecture halls usually cover basic

materialandhaveverylittleinteractionanyways.

Istarted‘blending’thecurriculumtomyneeds,andgotinvolved

inseveraldigitaleducationinitiativesatmyuniversityandmedical

faculty.Here Iencounteredtheproblemsoutlined inchapter2,

and sawmedical faculties struggle to create andpublish digital

contentwhileblendedlearningandflippingtheclassroommade

their definitive entrance. If universities are cutting back on

physical education and instruct students to learn the basics in

theirowntime,studentsshouldbeprovidedanadequate(digital)

alternative.Duringmyfinalyearsofmedicalschool,Ienrolledin

thehonorsprogram,spent6monthsintheUSAtodoresearchat

Harvard, co-published in Science, built a home-studio for

educational videosandcreated loadsof studymaterial through

videos,writingexamquestionsanddevelopingonlinecourses.Six

months before graduation I had to choose between Pediatrics,

pursuing a PhD and a career in education. My passion lies in

education,theeLearning issuesfrustratedmeforyearsandnot

enough doctors dare the path of entrepreneurship. In the past

years,Ihaveproventomyselfandothersnottobeafraidtotry

somethingdifferentandtobefairlysuccessfuldoingit.Ibelieve

intrinsic motivation, determination and vision are the key to

makingthisprojectasuccess.

Formyresume,pleaseseeAppendix1

16

17

9. CALLTOACTION

Asyou’vereachedtheendofthisdocument,IcalluponyoutohelpmakeProjectTulipasuccess.Spreadawareness,letmeknowyour

feedback,askquestionsand let’s cooperate!AlthoughProjectTulip startsoutwitha ‘skeletoncrew’, ineveryphase itwill relyon

academic-,philanthropic-,andfinancialpartners.ItismybiggesthopethatI’vemadeProjectTulip’sandmypersonalambitionsclear,

andthatyouhavebeenconvincedofthegreatpotentialthisfoundationandproducthave.Ifyouwanttogofast,goalone.

Ifyouwanttogofar,gotogether.

Reachout!

StijnBos,MD

boss@ProjectTulip.com

ProjectTulip

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APPENDIX1:CURRICULUMVITAE

Personalia

Name StijnA.BosEmail boss@ProjectTulip.comPhone +31614399274Languages Dutch,English(fluent)Education UniversityofAmsterdam MasterofScience(M.Sc.),Medicine(M.D.)2013–2018 +HonoursProgramUniversityofAmsterdam BachelorofScience(B.Sc.),Medicine2010–2013HetBaarnschLyceum Atheneum2004–2010Presentposition Founder&MedicalDirectoratProjectTulip.comExperienceResearch

ResearcherdepartmentofRadiologyatAcademicMedicalCenterAmsterdam(AMC)+ DevelopmentbusinesscaseforinnovativeOlympictopsportsoutpatientclinic+ Developmentofeducationalcoursesforstudentsandmedicalprofessionals

August2016–February2017(6months)ResearcherMusculoskeletalRadiologyatMassachusettsGeneralHospital(MGH)/HarvardUniversityFebruary2016-August2016(6months)

Student-ResearcherattheTraumaUnitoftheAcademicMedicalCenter(AMC)September2013–May2015(1year9months)Master’sthesis:IncidentalfindingsbyTotalBodyCTscanningofseverelyinjuredpatients:resultsfromtheREACT-2trial.SubstudyoftheREACT-2trial,aninternationalmulticenterRCT.��StudyProposal,StudyProtocol,DatabaseDesign,DataGathering,Analysis&Statistics,Writing

19

EducationalFoundedAMCOS.nl–awebsiteaggregatingeLearningcoursesandbite-sizededucationalclipsformedicinestudentsandbeyond2016–present(betaawaitinglaunchnewLMSCanvas)

DevelopedprofessionalonlinemedicalcoursesandvideosonPhysiology,Pharmacology,etc.aimedatmedicalstudents2015–present

MentorinscientificwritingformedicalhonoursstudentsofUniversityofAppliedSciences(HBO)2015–2017

MedixPublishers-EducationalcontentdevelopmentandmedicalconsultingSeptember2013–September2016(3years)|Keizersgracht,Amsterdam

Completedsummerschoolonteachingandeducationalscience2015

JuniorAssessorDecentralizedSelectionAMC2012–2015

Organization,businessandleadership

FoundedProjectTulip.com–adiverseonlinemedicallearningplatformJanuary2018–presentCo-founderTrialOnline-start-up2014

ClerkshipwiththeBoardofDirectorsoftheAcademicMedicalCenter(AMC)2016 Shadowedtheboard,attendedallmeetings,discussedindepthmanagerial, financial,andhealthcareorganizationproblemsfrommicrotomacroscale

Publications,Presentations&Awards.TotalPublications:6TopPublications1. CEngblom,CPfirschke,RZilionis,J.daSilvaMartins,SABos,[27],MJPittet.Osteoblastsremotelysupplylung

tumorswithcancer-enhancingSiglecFhighneutrophils.Science2017December-1

2. TreskesK,BosSA,BeenenLFM,Sierink,JC,GoslingsJC.Highratesofclinicallyrelevantincidentalfindingsbytotal-bodyCTscanningintraumapatients;resultsoftheREACT-2trial.EuropeanRadiology2017.

3. HuangAJ,BosSA,TorrianiMF,SimeoneJ,PomerantzSR,BredellaMA.Long-termoutcomesofpercutaneouslumbarfacetsynovialcystrupture.SkeletalRadiology2017

4. DeAmorimBernsteinK,BosSA,VeldJ,Lozano-CalderonSA,TorrianiM,BredellaMA.Bodycompositionpredictorsoftherapyresponseinpatientswithprimaryextremitysofttissuesarcomas.ActaRadiol.2017

Presentations(oral)1. RSNA2016-Long-termoutcomesofpercutaneouslumbarfacetsynovialcystrupture.

BosSA,HuangAJ,TorrianiMF,SimeoneJ,PomerantzSR,BredellaMA.2. DutchTraumadays2015-IncidentalfindingsinTotal-BodyCTscansofseverelyinjuredtraumapatients

(REACT-2trial).BosSA,TreskesK,BeenenLFM,SierinkJC,GoslingsJC.

20

AwardNutricia-TheiHaumannawardforbestpresentationofscientific,clinicalresearchinPediatrics.HobbiesIndoorhockey,football,tennis,healthcareinnovation,debate,teachingandtravellingfar.ReferencesProf.dr.MarioMaas,ProfessorofMusculoskeletalRadiologyattheAMC,Amsterdam(m.maas@amc.nl)Dr.MiriamA.Bredella,AssociateProfessorofRadiologyatMassachusettsGeneralHospital(MGH),HarvardUniversity,BostonMA(mbredella@mgh.harvard.edu)

ProjectTulip

21

APPENDIX2:FAQ(FREQUENTLYASKEDQUESTIONS)

You probably havemany questions. Check below if we’ve

alreadyansweredyours…

1. How is Project Tulip different from other educationalsources?

a. Freeandopen.b. Use,copy,editanything.Nocopyrightmeanswe’ll

make it easy for you to extract anymaterial you

wantforyourstudyworkflowoutsidethewebsite.

c. One place, one style. Stop wasting time judging

countlesssourcesonstructure,qualityandsimply

beingworthyourtime.

d. Up to date.Continuously reviewed and updated

materialisabigadvantageoverlotsoffreecontent

thatisabandoneduponcreation.

2. Doyouofferadegree?a. No. Project Tulip is not a replacement ofmedical

school,andwecan’tverifyofficialexamresults.See

Project Tulip as a study resource to help you

throughmedschoolorfreelyteachyourself.

3. Can I teach myself to become a doctor through ProjectTulip’scontent?

a. Innowayistheoreticalmedicalknowledgeenough

tobecomeacompetentdoctor; that’swhere real

examsandreallifesupervisedpracticingcomesin-

which we can’t offer. However, in environments

wherethereisnoeducationalalternative,onemay

usegainedknowledgetodoatleastsomethingforpeople inneed (e.g.healthworkers indeveloping

countries).

4. What type of content will Project Tulip offer?See also The Productformore details. Unfortunately, noconceptimagesareavailable(yet).

a. Timeline(knowwheretostartandwhentostop)

b. Synopsis (an online ‘textbook’ that covers the

essentialsofthematerial)

c. eModules

d. Questionbanks

e. Flashcards

f. Various handy tools (Ranging from pocket

dermatomemapstolaboratoryreferencevalues)

5. IsProjectTulipaMOOC?a. WithProjectTulipyoucanbrowseyour topicand

go; no need to enroll in any distance courses.

MOOC’shavetheiruses,butthinkofProjectTulip

morelikeaKhanAcademytypeofplatform,where

youfreelyteachyourselfwithouthavingtocommit

weeksormonths toa course.Alsonote that free

MOOC’s that teach basic medicine are almost

impossibletofind:mostlythetopicsareonpublic

health.

6. HowdoesProjectTulipmatchtheircontentwiththatofmedicalschools?

a. Rearrange the timeline tomatchyourmedical

school'sprogram

b. Basic theoretical knowledge of medicine has

large overlaps. For example,we all learn how

the heart works and how insulin works. That

doesn'tdifferasmuchbetweenmedicalschool

aswesometimesliketothink.Additionally,your

schoolmightnotofferimportanttopicssuchas

nutrition or cost awareness that Project Tulip

does(markedasoptional).c. Usedbyteacherstoworkwith.

7. HowwouldProjectTuliphelpstudentspassexams?It’stheirprimaryconcern.

a. Digitalpracticeexamsinsteadofpaper

b. Learning analytics. Quickly spot gaps in your

knowledge.

c. By closely studying exam questions from

universities and commercial exam questions

from various countries*, the Project Tulip

questionbankwillprovidehighqualitycontent.

It won’t be as good as a USMLE predictor as

some question banks charging hundreds of

dollarspermonth,but itwillbecloseenough,

open, user friendly and free. (*USA, UK,

Netherlands,Germany).

8. HowdoesProjectTulipguaranteehighqualitycontent?a. The content is required basic medical

knowledge; thismeans that all our content is

widely known in themedical community. Any

MDwillbeveryfamiliarwiththematerial.Being

able to trust your study resource is crucial,

especially in the medical field! Advanced

materialisavailableforyouwanttogofurther,

andit’sclearlymarkedsoyou’llkeepoversight

onhowdeepintothematerialyouare.

b. Madebydoctors.Wehaveadedicatedstaffof

medical doctors that are responsible for all

publishedmaterial.

c. Checked by specialists. Everythingwemake is

also verified by specialists in the respective

fieldsofmedicine.

d. Continuouslyreviewedandupdated(that’sthe

advantageofonline:publishingnewversionsof

thesamebookisexpensiveandcan’tkeepup)

22

9. Whywouldmedical doctors help create freemedicalcontent?

a. They practically do already through writing

textbooks, but they deliver mostly to big

publisherswhosellthatcheapcontentforsteep

pricesonpaper.Ifonline,expecthugestudent-

unfriendlymeasurestostopyoufromprinting,

copyingoranyactionsthatwouldactuallyhelp

youstudyyourway.Sometimestheyjustneed

someoneelsetomanagetheprocess.

b. Doctors who want to go online, often lack a

platform and/or technical skills which create

barriers. With Project Tulip as a ‘platform to

publish’, it becomes worth your time and helps

peoplearoundtheglobe.

c. Theyrecognizetheneedfordigital(andpreferably

free)educationalcontent

d. Somedigital content has alreadybeenmade, but

needs to be updated. Oftentimes, people

enthusiasticallycreatesomecontentinsparetime

and then drop it. Maybe today, it won’t run in

modern browsers, or the content might be

outdated. You need people to look after it.With

permission, Project Tulip can refurbish valuable

existingresourcestogivethemanewlife.

e. They’re fed up with the concept that every

university creates this content for themselves

and locks it behind their digital gates. Maybe

because of copyright issues (e.g. anatomy

pictures used in eLearning modules) or silly

political games. Think bigger. Stop reinventing

thewheel.

f. Theycanre-useanycontentonProjectTulipfor

theirownmaterial.

10. Whydonate?a. Helpyourstudents

b. Helpdevelopingcountries

c. Helpsavelives

d. Helptheopeneducationmovement

e. Help yourself: use your donator status as a

marketingtool

f. Helpbecauseit'sagooddeal:it’staxdeductible

11. Willyoubedoingeducationalresearch?a. Definitely, these are academic core values.

Whentheuserbasegrowsand fundingallows

for it, we’ll work with universities and

institutionsgloballytostudysubjectslikestudy

success outcomes, student learning behavior

andblendedlearningmethods.

12. Don’tyouneedmorepeople?a. Morefundingmeansmorepeoplemeansmore

contentandfaster.Butwearepreparedtostart

working as soon as we have funding for the

absoluteminimumofpeopleneededtocreate.

ProjectTulip

23

APPENDIX3:ROADMAP