Cuba's free medical education for US students.

Antonio Gordon, M.D., Ph.D.
Director, Finlay Institute of  South Florida
Clinical Professor of Medicine, Nova Southeastern University, Florida.


Indeed we had news of this offer from Castro to the American legislators. The merits of the offer are obvious. Consider the free trip to the Caribbean!
Consider the fact that most American medical students owe more than $ 75,000 from educational loans at graduation! Consider the fact they will not have to serve in physician deprived areas or pay back to the US Armed Forces or Public Health Service the number of years of service required! Even when you consider these factors, Castro's offer must be refused!

A fundamental consideration in assessing the offer of Castro for free medical training to low income Americans is that medical education has been known to be easily adapted to fit one or another system of indoctrination. (1) In fact, some technical aspects of medical education are well known to use
indoctrination into some biological or social principle. Therefore, during the so-called free medical education offered by Castro, despite the
assurances of his diplomatic service, one could easily expect that students will be subject to the systematic indoctrination that goes on in the Cuban
medical education under Castro. Cuban medical indoctrination (2) has been applied to Cubans and Latin Americans enrolled in medical schools in the
island since the early 1960s.  The indoctrination begins with the premise that the physician owes to society and the Castro regime their medical
education. It continues in terms that the physician must become socialist and he or she must pledge to improve his or her skills as a socialist activist in
parallel to his or her skills as a physician. Finally, the graduate swears to be like Che Guevara.(2) Although this last goal of Castro's medical education
may provide a new venue for fashion to European designers, the fact remains that violent revolution, destruction and death were all part and parcel of
the preaching and deeds of the revolutionary martyr.

Medical education cannot be assessed in a social vacuum. Medicine is in reality a social science that uses the methods of the natural sciences to
define and solve human problems centered in the biology and psychology of people.  The practice of human medicine is obviously carried out in a social
environment with a wide spectrum of features and characteristics in various locations and times. Such social order cannot be ignored or assumed - in the
real world- to be totally controlled or controllable unless- of course- one practices medicine in a totalitarian society. While it is no secret that Cuba
is a totalitarian and closed society ruled by a single leader for the past 42 years, no one must be intimidated into accepting an "offer that could not be
refused."  Unless, of course, the entry of 500 low-income and minority students into the Cuban Latin American School of Medical Sciences is
accompanied by an ample and wide opening in the island's sociopolitical order. Such openings must include all parties concerned but particularly
those who were expelled and/or excluded from that social order for reasons that perhaps have "gone with the winds of communism."  Such opening would be faithful to the prayers of His Holiness John Pall II during his courageous visit to the island three years ago when he said:" Que Cuba se abra al mundo
y..que el mundo se abra a Cuba."  Evidence that Cuba has not "openend up" are abundant. In the context of the Cuban offer to train for free low income and minority Americans one must raise the dangerous possibility that some of these minority disciples of medicine may turn in Cuban soil into dissidents joining Oscar Elias Biscet, Desy Mendoza Rivero,( 3) Omar del Pozo Marrero, (4) and others. (5)  Until clear evidence is supplied that such openings are real, there is no need to guide the vocations of young people in the United States from any race, creed, nationality or income bracket to become physicians in Cuba, a society that will likely turn them into dissidents looking for some scheme to escape from repression, recovering their individual freedoms, rights, and wholesomeness of vocation.

The argument in favor of improving the number of minorities in American medical schools through the Cuban offer does not hold substance. Even if 500
students are recruited, graduated, and returned intact to the US, that will only increase the presence of blacks and hispanics in American medical
schools by an insignificant 0.7% ( 500/64,000 students) Obviously, another factor must be important other than the propagandized rate of
African-Americans in American medical schools. Perhaps the caption in the picture appearing with the news article of The Lancet is appropriate, " More
propaganda?" The question mark may be left out!

References:

1.- Stetten, D Jr. The Medical School Curriculum: The Indoctrination Of The Medical Student. Bull. New York Acad. Med. 1973; 49(4): 285-288.

2.- Gordon, AM. Medicine in Cuba. Lancet 1983, Oct 29 ; 2 (8357) : 1026.

3.- Cuba: Doctors Imprisoned. Lancet 1998; 351:439-440.

4.- Gordon, AM de. Omar del Pozo Marrero, physician prisoner of conscience. 
Lancet 1995. Aug 19; 346 (8973): 509.

5.- Amnesty International. Cuba: Government Crackdown on Dissent. April 1996.
AI Index: AMR 25/14/96.

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