14 Mar Jonathan Cartu Reports: How This Doctor Created An Education Empire From His Dorm
More than two million students around the world have used UWorld—an online learning platform used to prepare for high-stakes exams from the SAT to the United States Medical Licensing Examination (USMLE).
Founder Dr. Chandra Pemmasani came to the U.S. from India for his residency—borrowing thousands of dollars to pay for USMLE prep materials to ensure he passed his exam with flying colors. Despite the investment, he didn’t find them highly useful to achieve his target score. The test prep resources he found offered a passive approach to learning, and he knew that mastering a subject involved active learning.
Several of his colleagues were in the same position and sought help, so as he started his residency, Pemmasani decided to write 200 pages of case-based scenarios for the USMLE.
Pemmasani’s dorm room was the birthplace of UWorld, which now earns 100+ million dollars in annual revenue. They also have nearly 300 employees.
In this article, which has been edited and condensed, I had the chance to interview Dr. Pemmasani, where we talk about the motivation behind founding UWorld, his journey in building a multi-million dollar business, and essential tips for aspiring entrepreneurs.
A Doctor’s Calling
Robyn Shulman: Before we talk about the founding of UWorld, coming from a working-class background in India, what made you want to begin studying medicine in the first place?
Dr. Chandra Pemmasani: A cousin I grew up with was diagnosed with a brain tumor when he was 18-years-old. I spoke with his neurosurgeon, and he told me there’s nothing they could do—the tumor was in an inoperable place.
He made this statement without any empathy, and I couldn’t take it. My cousin died within the year, and his own mother was soon diagnosed with cancer and died quickly after him. Our whole family turned upside down.
Shulman: So empathy was your calling to become a doctor?
Dr. Pemmasani: Yes, I have a few other family members who died of cancer very young, and it made me realize that medicine was the best way to see why this is the case.
These personal losses taught me about empathy, patience, and they also showed me how to look at life with a big-picture perspective.
I didn’t want to worry about the small things in life. That’s what inspired me to become a doctor.
Shulman: While you were in medical school, what was your immediate inspiration to start writing your USMLE study guide at the same time you were doing your residency?
Dr. Pemmasani: Walking out of an exam room, I knew there was a better way to prepare and learn when I was becoming a doctor.
Shulman: What did you do to ensure this outcome?
Dr. Pemmasani: Looking at the learning pyramid, I figured the best way to retain complex information was by teaching others. The second best way was to actively practice the topic with others. Writing out this study guide—even if nothing were done with it, it would still make me better at what I do—practice medicine. The best case scenario was that someone would actually use it, and it would help them.
Shulman: As you wanted to help other students, how did you try to reach them with your new guide?
Dr. Pemmasani: I sent the guide to several publishers, but they told me to come back when I had finished my medical training. In the year 2000, I was sitting in the library looking at all their new computers.
I thought, “This is the future and could potentially replace a physical book. I don’t need a publisher. Let me put this online by myself.”
My wife and I decided to type everything onto a website.
Shulman: How did you craft the information from a learning perspective for other potential students?
Dr. Pemmasani: Everything we posted was based on the simple but powerful idea that if practice questions felt like the actual exam, then the real thing would feel as easy as practice. There was such a high demand for these materials that I asked my brother and his roommate who were both software engineers to help me build an online platform.
Shulman: What was the reaction once the guide was online?
Dr. Pemmasani: Once we put it online and told a couple of students in forums that this study content was available for a small fee, people started buying it within two days.
Building A Business
Shulman: At what point did you realize this was not going to be just a sideline, and that you were building a business?
Dr. Pemmasani: Based on the overwhelmingly positive online response, it wasn’t long before I realized there was significant demand for the type of products we’d built. By the end of my residency, we had made somewhere in the area of $250K, and our two products were gaining momentum in the medical market. That’s when I realized UWorld had the potential to make it big.
Shulman: And that’s how UWorld was born?
Dr. Pemmasani: Yes, that’s how UWorld was born: in my dorm room, while I was maintaining my full residency schedule.
I built the online platform at the beginning of my residency, so I had three years remaining until I finished. During those three years, I was learning and seeing more and more patients, and I spent nearly all of my spare time building case-based medical practice questions.
I was so energetic and passionate about what I was creating. I knew that I could have a positive impact as a doctor, but I realized that I could have an even larger impact by helping others become better doctors.
Shulman: Did you have a mentor or someone helping you build this into a scalable business?
Dr. Pemmasani: I came to the States as a first-generation immigrant, so I didn’t have a lot of people to consult.
None of my family members in India are in business—we are more working class.
I spent countless hours reading the best biographies and watching interviews. Steve Jobs’ focus on design simplicity was an inspiration to me. I learned leadership skills from many different people—whether through books or observation.
Branching Out Into Other Areas Of Education
Shulman: Over the years, UWorld has expanded far beyond products focused on the USMLE. Now the company provides learning tools for the SAT, ACT, NCLEX, MCAT, CPA, CFA, and more. You’re branching out beyond the medical field.
What is the importance of this expansion to the UWorld universe?
Dr. Pemmasani: A guiding principle I follow when we are deciding to take on a new vertical revolves around whether we can teach the subject in the most simplistic way possible.
Our sweet spot is finding high-stakes exams with complicated material and low pass rates. Our secret to success is then taking those difficult concepts and making them easy to understand.
The importance of this approach and our expansion into other verticals is that we want students and professionals to succeed in their academic or professional careers because they fundamentally understand the principles being tested by the exam, not just to perform well on the exam itself.
Although we certainly expect superior exam scores as a natural byproduct of focused study.
Shulman: At UWorld, how do you find your students learn best?
Dr. Pemmasani: Students have the best chance of understanding and retaining a topic if they can actively learn it in a visual way. For example, the subject matter in the SAT or ACT isn’t as complex as the content on the USMLE, but many students struggle with math. For those tools, we needed to create content that teaches math with lots of visual support.
Shulman: What was a significant challenge you faced while growing the company, and how did you overcome it?
Dr. Pemmasani: I’m particularly averse to debt. I never took outside investments because I knew I’d feel obligated to investors. I wanted to balance my growth and maintain control of the personal vision I wanted to reach.
It may have taken longer than it would have with outside investment, but I knew I could do it on my own terms.
Shulman: You’ve learned many…