Does the Cuban model of medical education offer any lessons for medical training in the UK?

Dr Neil Squires, Director of Global Public Health, from the Public Health England will be hosting a lunch-time seminar with Prof Shah Ebrahim, of the London School of Hygiene and Tropical Medicine, the WHO representative to Cuba and Cristian Morales, World Health Organisation Country Representative to Cuba.

Wednesday 26th April 2017 (12:00-14:00), Refreshments will be provided from 11.30am

DCB1102 Moot Court, David Chiddick Building

Please note that places are limited – to book your place email lih@lincoln.ac.uk

For over 50 years Cuba has been training health workers for both its domestic needs and to meet global health workforce needs, with significant number of doctors trained and deployed throughout Africa and Latin America, but with a substantial number (80)  also trained to meet US needs. The training programme has a strong focus on serving poor populations that might otherwise be under served. Cuba has achieved remarkable improvement in health at home, given its low resource base, and its health care model focuses significantly on training health workers in communities and to provide primary care services. An important research question is whether this model of training is applicable in other country contexts and whether there are any lessons for wealthy countries like the UK, which struggle to produce enough health workers and to provide sufficient incentives for them to work in a primary care setting.

As a result of an agreement between President Mandela of South Africa and Fidel Castro, a massive programme of medical training of South Africans, primarily from poor backgrounds, was agreed. Initial small pilots of training in Cuba for South Africa have met with mixed results, with some questioning of whether the primary care orientation of those trained meets the needs of South Africa’s health system, which places a significant emphasis on hospital care and which is also struggles to provide specialist services, such as emergency obstetric care. However, the Government of South Africa is committed to the ‘re-engineering of Primary Health Care (PHC), and the Cuban training model provides a significant opportunity to change the narrative on health care in South Africa and increase its focus on meeting the basic health care needs of a population that has, in many way, been neglected.

The first of a batch of 700 from a programme to train 2000 new doctors is due to start returning from Cuba to South Africa in 2018. This large influx of new doctors presents a significant challenge to the South Africa healthcare system, which can either try to mould these doctors to confirm to the existing model of health care, or embrace the primary care orientation that they bring in support of the re-engineering of PHC.

The UK Department for International Development Funded NICE International (now the Institute of Global Health Innovation at Imperial) to evaluate the impact of the Cuban model of medical education and determine its relevance for other country contexts. This seminar will highlight the research undertaken to date, will provide a platform to the World Health Organisation’s Country Representative to Cuba and a Cuban Government Official to describe the Cuban model, and will consider whether there are lessons to learn from Cuba’s engagement in South Africa which might be relevant to the UK . This is an issue that will be of interest to Lincoln, as it considers its own development of a medical school and how it will contribute to the UK’s future medical workforce needs.