<p>in Cuba:</p>
<p><a href=“http://www.iht.com/articles/ap/2007/07/24/news/CB-GEN-Cuba-US-Students.php[/url]”>http://www.iht.com/articles/ap/2007/07/24/news/CB-GEN-Cuba-US-Students.php</a></p>
<p><a href=“http://en.wikipedia.org/wiki/Latin_American_School_of_Medicine_(Cuba[/url])”>http://en.wikipedia.org/wiki/Latin_American_School_of_Medicine_(Cuba)</a></p>
<p>mini, I wonder if the student who said “in Cuba I learned medicine is not a business” will practice in the US for free ;)</p>
<p>Is it possible we should license the Cuban education system from kindergarten to medical school?</p>
<p><a href=“http://ed.stanford.edu/suse/news-bureau/displayRecord.php?tablename=susenews&id=282[/url]”>http://ed.stanford.edu/suse/news-bureau/displayRecord.php?tablename=susenews&id=282</a></p>
<p>
</p>
<p>Interesting.</p>
<p>They’ll practice for free right up to the point they need malpractice insurance or an X-ray machine.</p>
<p>They don’t have to practice for free; they just can practice without having to worry about paying off those loans.</p>
<p>Why is it that the poorest country in the hemisphere can train 12,000 doctors from around the world for free, and at their expense, but my state capital of a town, middle class, 90% white, no urban blight, has a primary care doc shortage?</p>
<p>Let’s not make it into a Cuba thing, either. In the UK, docs are trained virtually for free (the local education authority pays for most of it). The state-paid GPS make $200k a year, and the government provides malpractice coverage. No loans to pay off, no malpractice to pay, and there are more than enough x-ray machines to go 'round.</p>
<p>But…but…but…they wait for months, maybe years for an MRI in Canada…and…and…and…we have the finest health care system in the world…</p>
<p>Don’t hear as much of that these days, do you?</p>
<p>I was kidding mini – I have great respect for the attempt in Cuba, as well as in other poor nations, to offer low-cost education and health care. </p>
<p>What made me smile is the fact that these people can’t WAIT to come to the US where they’ll turn their free education into quite a tidy business for themselves. I know a doctor in Poland, a neurosurgeon. He’s salivating at the same prospect. A fairly low-paid fellowship here is about 3x what he can make as a surgeon there.</p>
<p>I have actually seen a quite serious suggestion that we close most U.S. medical schools and move them south of the border. Operating them here is uneconomic, both for the schools and for the students, and is not turning out the kinds of physicians the nation requires.</p>
<p>All that great education and if they are lucky they might get to drive a 1957 Chevy if they can earn some real $$$ with a small private business.</p>
<p>“Why is it that the poorest country in the hemisphere can train 12,000 doctors from around the world for free”</p>
<p>Becase everything from food to underwear and bras are rationed (one of each a year). Fidel introduced the rationing system in 1962 and it has never been lifted. There is a Black market and foreign currency stores (also rationed) and of course special stores for the privileged.</p>
<p>Despite the rationing of food stuffs the shelves are often empty of meat and other items and the rationed store provide perhaps 60% of the caloric intake. All this in a country with abundant farmland, three growing seasons a year, and sufficient rainfall.</p>
<p>Fidel and the party would rather train foreign doctors including Americans for free than feed and cloth his people. In a command economy all abundance and scarcity are determined by the government including the food ration coupons they cannot produce enough food to meet.</p>
<p>There will always be scarcity of some things even in the richest societies. It is just a question of who decides what will be scarce. It can either be a few Williams graduates or a lot of consumers and producers free to make and produce what they want. Cuba has a surfeit of doctors and relatively good basic medical care to go with their shortage of food and underwear. We have a bunch of fat people who don’t want to pay for their next heart attack or stroke or diabetes. </p>
<p>There is no such thing as a free lunch and in Cuba no such thing as a free economic decision. If it appeals to you go for it. I’ll stay here, eat too much, and pay to cut to the head of the line if I need a bypass surgery.</p>
<p>“I have actually seen a quite serious suggestion that we close most U.S. medical schools and move them south of the border.”</p>
<p>Actually we have already sort of done that. We have twice as many residencies open up every year as we have medical school graduates to fill them. The balance are filled by immigrants. In Britain it is even worse. Only a third of new doctors are British. The remainder come from around the world with a very large number from the Near East and South Asia.</p>
<p>Britains medical system is socialist and higher education is cheap but effectively rationed because the government doesn’t want to pay for more. Medical educatio in this country has a demand that far exceeds the supply and somebody probably should look into why the number of seats in medical schools are not increasing. I suspect the reason why is because hospitals would rather hire immigrants without a lot of debt to pay off because they will work for less.</p>
<p>Well said, higherlead.</p>
<p>I agree with P2N. Good posts.</p>
<p>“Medical education in this country has a demand that far exceeds the supply and somebody probably should look into why the number of seats in medical schools are not increasing. I suspect the reason why is because hospitals would rather hire immigrants without a lot of debt to pay off because they will work for less.”</p>
<p>There are many new medical schools opening in the US. Check in your state, mine already has 4 and is getting 3 more opening in the next 1-2 years (actually one is opening next month.)</p>
<p>The “immigrant doctors” in the US are hired at the same pay rate for residency programs as US grads. They are required to do a residency here. They are NOT treated as second class citizens. They also have the same practice opportunites.</p>
<p>The market price for residents is set by the supply. Take out the immigrant doctors and all of a sudden the competition for US graduates (some of whom are immigrants themselves) would skyrocket.</p>
<p>Letting India educate our doctors and engineers is god for the American consumer but not especially good for the kid graduating with $50K or $100K in school loans. Most of them would be better off financially if they got themselves an electrical apprenticeship. You can’t have a house wired by a guy in Bangalore but a radiologist can read your x-rays in Mumbai.</p>
<p>“Never took that intro econ course did you collegialmom? The market price for ewsidents is set by the supply. Take out the immigrant doctors and all of a sudden the competition for US graduates (some of whom are immigrants themselves) would skyrocket.”</p>
<p>Why the personal attack? I actually have had several courses in economics, with widely-renowned experts.</p>
<p>So let’s not attack each other, I think that that is really not called for.</p>
<p>Back to topic on hand:</p>
<p>Many of the immigrant resident doctors are by no means inferior to US grads. Many of them emigrate to the US after years of practice in other countries and bring a wealth of experience to hospitals. </p>
<p>They are very important to the running of the US health care system and I would put many of them up against any US grad.</p>
<p>The pity of it is the brain drain from their countries. We get the best and the brightest from all over the world, who are attracted to practicing in the US for various good reasons.</p>
<p>In my town, they’ll take any kind of medical school graduate they can get. In Washington State, many rural communities used to be staffed by doctors and physician assistants from Afghanistan, but that was before the change in awarding of J1 visas. No longer the case.</p>
<p>The food supply in Cuba is so poor that folks are living longer than here. What’s wrong with this picture? Why aren’t they dying like their Dominican ahd Haitian neighbors? Is it because they’re stubborn? Meanwhile, GPs in England earn $200k a year, debtfree, malpractice insurance free, and 18,000 people a year don’t die for lack of medical insurance.</p>
<p>Wouldn’t you proud to live in a United States that produced 12,000 doctors a year, free of debt, to send to the rest of the world?</p>
<p>As for the quality, my adopted sister in Chennai has twice been approached by UNICEF in East Africa to take over operations. They’ve just discovered repeatedly that American doctors, even those trained with specialties in tropical medicine, are so poorly trained that basically they are phasing them out. (She’s not leaving South India, though). I think they’ve just hired someone from Aga Khan University in Pakistan.</p>
<p>I can tell it is no pity in India, though, as they are way oversupplied. Practice patterns are different as well. My other adopted relatives, all doctors, live on the top floor of houses which are dispensaries, doctors’ offices, and “low-intensity” emergent care hospitals all rolled into one. They are on call all day and all night, and, yes, as in France, they make housecalls.</p>
<p>Actually the salaried GPs in the UK make less than that, and the average debt is about $20,000 now after med school. The government is now doing loans more for the 1st years of training, and then 1/2 loans and then finally grants in the later years of training This is all easily available information.</p>
<p>In the past they were more subsidized, but the government is now going more towards loans instead of the straight grants that they used to give. Of course, this is nothing compared to the average medical school debt here.</p>
<p>The debts (when they have them) are for living expenses and, yes, local education authorities, in some areas, are less commonly covering them. (And average salaries, which I HAVE looked up, are a little over 80,000 pounds, PLUS benefits that bring the total up to a little over $200k. And no malpractice premiums, and no practices to set up.</p>