Cuban medicine is a world reference for quality and this is widely known by all those interested in the area. What few people know is that universities on the Caribbean island attract a somewhat unexpected audience: North American students. Through the ease of scholarships, blacks and Latinos from Uncle Sam go to Havana with the objective of attending the graduation of their dreams without contracting student debt.
The incentive is granted by the Latin American School of Medicine, ELAM. Founded in 1999, the institution offers free education to underprivileged youth from poor nations in the Caribbean and Central America hit by hurricanes Georges and Mitch. Currently, students born in more than 124 countries are part of the organization's student body. The partnership with the United States began in 2001, during the government of Fidel Castro.
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It all started with a visit by black US congressmen from the Congressional Black Caucus to Cuba. At the time, the leaders reported that there was a lack of doctors in areas populated by minorities and, in response, the Cuban leader offered scholarships to low-income students. From then on, the Inter Religious Foundation for Community Organization (IFCO) became responsible for the selection, endorsed by ELAM.
The average number of applications is 150, but only 30 actually apply. Of these, ten are sent to Cuba. The course lasts six years, two years longer than in the United States where, by the way, it is offered as a graduate degree. In addition to the time devoted to graduation, there is an additional year dedicated to preparatory classes focused on learning Spanish and science.
As for the scholarship, this includes accommodation in dormitories, three meals a day offered in the cafeteria on campus, as well as a uniform, books in the local language and monthly financial aid. About 170 North American physicians have already graduated from ELAM, having, in return, the commitment to work in areas lacking medical services when they return to the United States.
Two factors cause some astonishment when talking about North Americans studying medicine in Cuba. The first is the political tension between the two countries. However, students claim that the issue is left out when it comes to studies. The second is to think about what makes students leave a rich country to participate in a program aimed at low-income students.
The answer to that question lies in statistics. In the United States, a medical course costs, on average, between USD 200,000 and USD 300,000. Most Latin American and black students in the country cannot afford these costs. So much so that they are part of only 6% of enrolled students. When analyzing ELAM's student body, 47% of American graduates are black and 29% are Latino.
During the admission process, North American students are informed about local particularities, such as simple accommodation and difficulties in accessing the internet and power supply. However, a point that surprises students is the education method aimed at interacting with patients and prevention. Sarpoma Sefa-Boakye, a graduate of ELAM, reports that contact is made from the beginning of the course.
In an interview with the BBC, the doctor says that, in the United States, actors are used by schools to represent patients. In Cuba, in the first class, students learn how to give injections and everything is learned directly in the clinics. Melissa Barber, also a graduate of ELAM, highlights the community character of the Cuban medical system. The young woman describes that each team is responsible for a certain geographic region.
In it, doctors and nurses maintain direct contact with its residents, getting to know it in depth and making house-to-house visits. Thus, professionals are able to make a diagnosis that takes into account psychological, social and biological elements. If the situation requires special care, the patient is referred to polyclinics equipped with all specialties.
Again, the system is compared to the North American one. The two doctors recall that, in the United States, many patients do not even have health insurance. Therefore, medical consultation is done when the case requires urgency and, no longer, there is time for prevention.
When they return to their home country, doctors trained in Cuba must pass previous exams and also pass the medical residency program. Most of them work in primary care, an area that lacks physicians in the United States. In this, they play a fundamental role in reducing child mortality and other problems typical of poor sections of the population.
One of the biggest difficulties reported by recent graduates is the time spent with patients. In Cuba, they get used to long service while on US soil, the consultation lasts, on average, 15 minutes. Sarpoma confesses that the habit is frustrating because he feels the need to know more about the patient. She also claims to have received little training in more common cases in the United States.
As examples, she cites emergencies related to overdose and gunshot wounds, which are less frequent on the Caribbean island. There is another difference between the two systems, this time related to the use of imaging and laboratory tests. In the US, their application is greater than in Cuba where, in most cases, they are recommended as a complement to the initial diagnosis.
In any case, professionals trained in other countries warn that there is no reason to be suspicious of the preparation acquired in graduation. BBC interviews point out that, even with this mentality, the reality of doctors in Cuba is different. Over there, they are very welcome in the communities, including for reaching where professionals from other countries do not reach.
