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Stanford physician on what Cuba can teach the U.S. about medical education

In a blog post published today on Wired Science, Stanford physician Paul Drain, MD, MPH, discusses what the United States can learn from Cuba's medical education and health-care system.

One main difference between Cuba and the U.S. is Cuba's ample supply of primary care physicians. Drain says Cuba's approach to training doctors helps prevent the type of shortage currently threatening America's health-care system:

Starting in 1964, they encouraged all medical school graduates to do at least two years of service in a rural area. That program became so popular that by the mid-1970s, almost all new physicians were doing rural service. From there, almost all medical graduates were channeled into a three-year family medicine residency. That’s where they do clinical training, making the transition to full doctor from medical student.

Almost all their residents do family medicine. They focus on primary care for all ages. Once everybody learns primary care, about 35 percent go on and specialize. It’s quite the opposite of what we have here

Our medical students choose what they want to do. Only about 7 or 8 percent go into family medicine, which is our primary care system. In Cuba, everyone becomes a primary care doctor. They learn to prevent diseases.

Cuba also provides very good access. In the mid-1980s, they created a system of neighborhood doctors’ clinics. One doctor is responsible for a catchment area of a couple of city blocks. They get to know their patients well. If somebody has a problem, they can see the doctor in the clinic that day.

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