141st APHA Annual Meeting

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Becoming a doctor at the latin American school of medicine in havana, Cuba

Monday, November 4, 2013 : 12:30 PM - 12:50 PM

Claudia Chaufan, MD, PhD , Institute for Health & Aging, School of Nursing, University of California, San Francisco, San Francisco, CA
Akua Brown, MD , School of Nursing, University of California San Francisco, Institute for Health & Aging, San Francisco
While Cuba is island nation of merely 11 million inhabitants ranking 110 among 226 according to GDP, its health achievements often outperform those of far wealthier countries, a phenomenon known as the ‘Cuban miracle'. At least partly, this ‘miracle' results from Cuba's treatment of health as a constitutional, social and human right, revealed in a healthcare system premised on primary care and virtually free at the point of use, and in a unique approach to medical diplomacy. This includes sending healthcare workers to assist the underserved worldwide and offering free medical education to youth from disenfranchised backgrounds, including US nationals, at the Latin American School of Medicine (ELAM) in Havana. However, as ELAM graduates return to their countries they face multiple challenges incorporating themselves into environments premised on radically different values than those underlying Cuban society. Such is the case of US ELAM graduates, who upon their return face a healthcare system that even after the major 2010 federal reform poses substantial barriers to equitable care. Our study examined the experience of a convenience sample of twenty US ELAM graduates through semi-structured, in depth interviews that were qualitatively analyzed to identify key themes. Our aims were to identify the challenges and facilitators to these graduates' reinsertion into the US healthcare system and society more generally, and to understand how the Cuban medical curriculum contributes to the development of graduates' professional identity, ethic of service, and good ‘fit' with an egalitarian system of care. We present preliminary findings of our investigation.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Program planning

Learning Objectives:
Describe the organizational structure of the Cuban health care system Describe medical training in Cuba Assess medical training in Cuba Identify key challenges faced by US ELAM graduates Formulate strategies to facilitate the reinsertion of US ELAM graduates into the US health care system

Keywords: Global Education, Professional Training

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed and conducted the study
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.