Thursday, August 20, 2015

A medical student in Cuba is looking for advice

Someone writes: I am trying to help a friend's brother who is not a US citizen and currently a medical student in Cuba, and I came across your very informative web site. The brother most likely is going to be able to come to the United States in the fall.

My friend is wondering if he should complete the last year of medical school there in Cuba or come here and continue on. It seems like there is no benefit from completing med school in Cuba, given the difficulty to be licensed in the U.S. And the difficulty in getting a residency position.

Does any of the course work from his studies in Cuba transfer over to U.S? Is it likely that he'd have to get a bachelor's degree here before ever going to a U.S. Med school? My friend says that he has an outstanding record in the Cuban medical school, speaks excellent English, does well on tests, etc. Any advice you could give?

As far as I know, no medical students from Cuba have transferred to a med school in the United States recently or possibly ever. Regarding your questions, I can only give you my best guesses.

I doubt very much that a course from the Cuban medical school would be accepted here in the US. US med schools that accept a few transfers from Caribbean schools like Ross or St. George's usually take those students at the beginning of the third year of medical school.

A few schools are doing combined BS/MD degrees in five or six years, but I don't know of a single US school that would take a student directly out of high school into a 4-year program.

A possibly more reliable way to become a physician in the United States would be to graduate from an American university, take the Medical College Admission Test, and apply to med school.

Last month, the ECFMG posted this on its website: "The ECFMG is pleased to announce that it will resume processing of service requests in relation to applicants from and institutions in Cuba. As previously announced, ECFMG was not processing such requests, pending approval of its license application for Cuba by the Office of Foreign Assets Control (OFAC) of the U.S. Department of the Treasury. Today, ECFMG was advised that OFAC has approved the license application."

There are 14 medical schools in Cuba. I do not know if any or all of them will be acceptable to the ECFMG or what position residency program directors will take on applications received from students in those schools. Many current offshore graduates are having problems obtaining residencies in US programs. What will happen with the addition of 14 more schools with an unknown number of graduates is anyone’s guess.The fact that he is a non-US citizen is not helpful.

One of the 14 is the ELAM medical school which has 19,550 students. Wikipedia says it is accredited by the ECFMG and the Medical Board of California.

It is not clear how that many students can be clinically trained in a country with only about 11 million citizens and 13 other med schools. For comparison, the US, which has 30 times the population of Cuba, has 140 allopathic medical schools with about 80,000 total students.

I don't know if I've clarified things for you or made them more confusing. Your friend's brother is going to have to decide for himself what he wants to do, but if he is a truly outstanding student, maybe he should stay in Cuba and finish his education. However, he must understand that there is no guarantee he will be able to obtain a residency in the US, and no residency means no ability to be licensed and no way to practice medicine here.

If any of my readers have other thoughts, I hope they will comment.

Addendum on 8/20/15 at 11:25 a.m. The medical student is not a US citizen.


Anonymous said...

There's no way they would consider a residency here. He would do better to finish school there and get some years under his belt, then come here. That way he would be a "proven" doctor and have a better chance at getting hired in a speciality that is in demand here (FP would be first on the list).

Skeptical Scalpel said...

I agree. Someone emailed me to say that med schools in Cuba take kids right out of high school and the course of study in their med schools is 24 to 36 months. I don't think that's acceptable in most states.

Anonymous said...

This is DrMuchoGusto from twitter. Over here in Miami there is a Global Observership program for students specifically from spanish speaking schools. I myself am not latin, cuban, or mexican, so I cannot speak from experience. I can only provide advice based on my observations of the students visiting from the medical schools in Mexico, Latin America, and South America.

Listen, you need to finish your degree in Cuba. You need to do it! I see too many students who come observe who are really intelligent and would be great doctors here, but it's such a waste of time what they are doing in order to become a doc here. They come here with the dream of becoming a doc here, but not realizing the hurdles they have to go through are just really stressful. First, let's try to ignore all the immigration issues, visa concerns, and the fact if your school is approved through ECFMG. Lets say that is taken care of, you got to pass and do well on all three usmle exams. We have had students come and observe, they never get through the first one and I really hate it because I root for these students. Really I do! Because I spend a lot of time with them and they teach me things too. The docs who have finished and did residency in their country they have a lot to offer and I love it. However, for some reason it takes a lot of discipline to pass these board exams. I wish people would just get through the tests and then come here to observe.

That is the negative aspect of my message. Now here is the positive. I have seen people get through it, a small few. They worked hard and they got through all the tests and they did the observership. In every department here in miami, there is a spanish speaking doctor and this is why they created the observership program. I hate saying this but if you are a spanish speaker with excellent scores, you will be taken over an American who cannot speak Spanish in some programs here in Miami. Not all of them! So there are success stories.

So what am I saying in the Cuban student case. The reality of transitioning here is daunting, not for everyone, and you need to really look into how to study for usmle. Right now graduate from your home school. Then see what it takes to come here. Don't waste time. The process is long. By the time a lot of people study for each usmle 1 year if not more goes by. Some people need a lot of time to study the first usmle because it covers concepts from the initial yrs of med school. The American board examinations are no joke, so say your school is accepted here. The next question is if your school prepared you for such a test and I have my doubts. So now you have to study and prepare all on your own. That is where the problems are for students in this situation. Doing this on your own is tough. Med Students get through it here with study partners, review courses, etc. This after they had detailed courses in the first two yrs. I wish you best of luck and please understand I am all for med students from Cuba to come here or any other country. It's nice to dream, but see what it takes to come here before making a decision. Its not always so glamorous as it seems to be.

Anonymous said...

This is DrMuchoGusto, twitter. I forgot to mention. Here in Miami I saw a sign the other day at the train station that said, "MD to RN." So I imagine there are a lot of foriegn MD's who are looking for options here. I'm just stating what I saw, there has to be a reason to it. Keep an open mind, there is a lot out there Nursing, PA's, NP's. You can live an excellent life here without being an MD. Out of everything we mentioned, I have no idea if you have wife, kids, financial background. This on top of the pressure to take exams and get a foot in the door, it can be too much.

Skeptical Scalpel said...

Mucho, thanks so much for your thoughtful comments. I'm sure they will help our Cuban student to decide what to do.

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