Education of U.S. primary care physicians at the Latin American medical school in Cuba

Abstract

Background: Growing global health disparities have led to an international call for reform in physician education to meet the need for more responsive providers, emphasizing social accountability, with its four main criteria being relevance, quality, cost-effectiveness, and equity. In contrast to traditional models, Cuba’s Latin American Medical School (la Escuela Latinoamericana de Medicina, ELAM) promotes primary healthcare for disadvantaged populations by providing free medical education to foreign students from low-income communities, including United States (U.S.) citizens. This study examines the processes and standards by which the Latin American Medical School provides socially accountable education, with an emphasis on current and former students from the U.S. The objective of this study is to assess the efforts of ELAM to educate medical students in socially accountable and ethical ways. Methods: Guided by the four abovementioned criteria of social accountability, we thematically analyzed survey comments from 56 past U.S. graduates of the ELAM and interviews with four current U.S. students and eight instructors. Results: Relevance of the ELAM´s training was reflected in the integration of public health practices (e.g., community assessments) and medical care relevant to local and international health concerns. Quality is manifested in the school’s promotion of evidence-based care through tailored academic content for the U.S. students, expanded educational facilities throughout Cuba, and extensive clinical experiences. ELAM exhibits cost-effectiveness via free education and other financial assistance. Promoting equity in healthcare is evident in students’ desire to care for underserved populations with whom they identify. Graduates, current students, and instructors demonstrate that educating physicians from marginalized communities helps to answer the call for social accountability; this was supported by the educational processes and achieved outcomes. Discussion: These findings indicate that the Latin American Medical School’s mission and core activities meet the WHO’s criteria for social accountability and advance current understanding of such programs.