( ll. But most of the time Cuba covers t...)Cuba is Exporting Healthcare Now,Health

ll. But most of the time, Cuba covers tuition, living expenses, books, and medical care. In return, the students agree that, upon completion of their studies, they will return to their own under-served communities to practice medicine.

The curriculum at ELAM begins, for most students, with up to a year of "bridging" courses, allowing them to catch up on basic math, science, and Spanish skills. The students are treated for the ailments many bring with them.

At the end of their training, which can take up to eight years, most students return home for residencies. Although they all make a verbal commitment to serve the poor, a few students quietly admit that they don't see this as a permanent commitment.

One challenge of the Cuban approach is making sure their investment in medical education benefits those who need it most. Doctors from poor areas routinely move to wealthier areas or out of the country altogether. Cuba trains doctors in an ethic of serving the poor. They learn to see medical care as a right, not as a commodity, and to see their own role as one of service. Stories of Cuban doctors who practice abroad suggest these lessons stick. They are known for taking money out of their own pockets to buy medicine for patients who can't afford to fill a prescription, and for touching and even embracing patients.

Cuba plans with the help of Venezuela to take their medical training to a massive scale and graduate 100,000 doctors over the next 15 years, according to Dr. Juan Ceballos, advisor to the vice minister of public health. To do so, Cuba has been building new medical schools around the country and abroad, at a rapid clip.

But the scale of the effort required to address current and projected needs for doctors requires breaking out of the box. The new approach is medical schools without walls. Students meet their teachers in clinics and hospitals, in Cuba and abroad, practicing alongside their mentors. Videota
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