Archive for the 'Medical Schools' Category
2 Comments May 15th, 2009 by Matthew Anderson
The following news (brought to my attention by my dear friend Cristina), from today’s Amy Goodman’s Democracy Now radio show, provides a good exercise in critical thinking: finding the flaws in president Obama’s argument (invalid inferences, false assumptions, etc) that ” it is best to build on the health care system we have”, rather than presumably adopt too radical solutions like single payer (I myself could find four flaws in two minutes! For a fuller argument for why it is misguided at best to build on “the health care system we have” read “Not Change We Can Believe In“).
According to the president, “the vast majority” of Americans get coverage from their jobs, and presumably are satisfied with it.
Another interesting accompanying headline is “Health Industry Says Obama Overstated Pledge to Cut Costs” (surprise surprise!). It looks like, after all, companies “never agreed to specific yearly cuts, but only vague voluntary goals”.
For both clips, click here.
Obama Questioned on Single Payer
At a town hall-style event in Rio Rancho, New Mexico, Thursday, local resident Linda Allison asked President Obama why the White House and the Democratic-led Congress have ruled out single payer.
Linda Allison: “My question is, so many people go bankrupt using their credit cards to pay for healthcare. Why have they taken single payer off the plate? And why is Senator Baucus on the Finance Committee discussing healthcare, when he has received so much money from the pharmaceutical companies? Isn’t it a conflict of interest?”
President Obama: “If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense. That’s the kind of system that you have in most industrialized countries around the world. The only problem is that we’re not starting from scratch. We have historically a tradition of employer-based healthcare. And although there are a lot of people who are not satisfied with their healthcare, the truth is, is that the vast majority of people currently get healthcare from their employers, and you’ve got this system that’s already in place. We don’t want a huge disruption as we go into healthcare reform, where suddenly we’re trying to completely reinvent one-sixth of the economy.”
Obama did not address the second part of Linda Allison’s question about Democratic Senator Max Baucus, who has excluded single-payer advocates from Senate Finance Committee hearings. Allison says she was partly inspired to ask the question after viewing Democracy Now!‘s coverage on Wednesday of single-payer advocates who disrupted Baucus’s hearing.
Add a comment May 5th, 2009 by Matthew Anderson
In case readers missed Dr. Don McCanne’s excellent analysis and commentary on student debt and speciality selection, below it goes, together with links to the original articles Dr. McCanne comments on.
Where Did All the Doctors Go?
The New York Times
May 3, 2009
Letters
To the Editor:
Re “Shortage of Doctors Proves Obstacle to Obama Goals” (front page, April 27), about a lack of primary care providers :
As those of us responsible for delivering health care know, the battle between specialists and primary care doctors has been going on for years, and one side has been winning.
The marketplace has rewarded specialists financially, and like any other special interests, they are amply financed for this conflict. Still, I don’t fault them. They have studied and worked hard, and are responding to market incentives, like good red-blooded Americans.
What we really need is a European-style single-payer system, with primary care doctors who emerge from their training with European-style debt loads: zero.
Georganne Chapin
Tarrytown, N.Y.
The writer is president and chief executive of the Hudson Health Plan, a not-for-profit managed care organization.
http://www.nytimes.com/2009/05/04/opinion/l04doctors.html
And…
Subject: Graduate Medical Education: Trends in Training and Student Debt
GAO (Government Accountability Office)
May 4, 2009
In summary, we found that medical students prefer surgical and procedural specialties, and physician subspecialization is increasing. Relative to the number of available residency positions, more medical students have preferred surgical and procedural specialties over primary care specialties since 1999, according to national data.
Some factors may also lead students to pursue certain specialties while avoiding others. For example, the desire for a controllable lifestyle – a predictable schedule and fewer on-call hours – and high salary may lead students to pursue procedural specialties such as anesthesiology, and avoid other specialties such as primary care.
Medical school tuition and fees have increased significantly since 1998. Medical students can borrow up to $40,500 per year through the federal Stafford loan program with additional funding available through other federal loan programs; these loan programs can cover the full cost of medical school. The median amount of educational debt for indebted medical students graduating in 2008 was $155,000 – a 53 percent increase since 1998, controlling for inflation. Once out of medical school, residents earn stipends — on average about $3,729 a month for a 1st year resident. With $155,000 in debt, a resident’s monthly loan payment could reach over $1,700 (about 48 percent of pretax income). However, residents have repayment options that can reduce their monthly debt payment until they complete postgraduate training.
http://www.gao.gov/new.items/d09438r.pdf
Comment:
By Don McCanne, MD
This statement from a highly respected executive of a not-for-profit managed care organization, and this new GAO report, both further confirm what we already knew. Medical students are graduating with excessive debt, and this is likely contributing to the decline in the numbers choosing the primary care specialties.
Without increasing total health care spending, a few policies could be adopted which would realign incentives to improve our primary care infrastructure, while relieving students of the necessity of accumulating debt. That would be much easier to accomplish through a single payer monopsony than through a dysfunctional, fragmented, multi-payer, health care financing system.
1 Comment April 28th, 2009 by Matthew Anderson
Our thanks to Diane Appelbaum of MEDICC for sharing this link to an interview with former NFL player Pasha Jackson. Pasha is one of approximately 100 US students studying medicine on full scholarship in Cuba at the Latin American Medical School (ELAM).
Here is a link to the program The World According to Gary. The specific interview is entitled: Gary chats with NFL Player Leaving Football to Study Medicine in Cuba.
For other information about ELAM on the Portal, see this link.
posted by Matt Anderson, MD
1 Comment April 23rd, 2009 by Matthew Anderson
We recently received the following letter from Joanna Mae Souers, one of the US students studying medicine at the Latin American Medical School (ELAM) in Havana:
It is my pleasure to introduce to you a project we have been working on since December.
Inspired by the MEDICC Conference, we put our minds together to manifest the ¡Salud! Southwest Tour:
July 28th, 2009, 12 American students from the Escuela Latinoamericana de Medicina (ELAM – Latin American School of Medicine) in Havana, Cuba will board a Recreational Vehicle (RV) for two weeks to travel across the Southwest region of the United States visiting a number of tribal settlements of American Indian Nations, community colleges and universities.
While at the various sites the students will share their personal experiences of what it’s like to study at ELAM while promoting the availability of full scholarships for students, volunteer their services while learning about some of the more significant health concerns affecting American Indian populations and to build personal and professional relationships with health care practitioners and members of Native American communities.
These 12 students are among the 104 Americans on full scholarships currently studying medicine in Cuba alongside their peers from 27 different countries across the world. They represent not only some of the brightest and most courageous medical school students this country has to offer, but also originate from some of the toughest and poorest communities in the U.S. The settlements they plan to visit represent one example of the type of historically underserved communities where all the U.S. ELAM students have pledged to work upon graduation.
We are seeking funding support and medical donations that will provide the substance with which lifelong alliances will be built between future American physicians dedicated to underserved communities and our national predecessors.
For those interested in making a donation please visit the MEDICC Website (http://www.medicc.org/ns/index.php?s=30&p=4), or under ¨programs¨you´ll find ¨ELAM Students Southwest Tour¨ or email our communications director, Tasha Rassuli, at saludswtour@gmail.com or directly at tjrassuli@gmail.com
posted by: Matt Anderson, MD
3 Comments February 13th, 2009 by Matthew Anderson
- J.M. Souers and V. Lezcano at the Institute of Genetic Engineering and Biotechnology
Joanna Mae Souers, a US student studying at the Latin American Medical School (ELAM) in Havana, has sent us this update on her studies. For additional information on the ELAM program you can other posting at this link:
January 2009
Every year, at the beginning of second semester, second-year students of the Latin American School of Medicine (Project ELAM), are responsible for choosing an elective course. 108 courses are offered on a variety of themes including, Microbiology, Pathology, Anatomy, Histology, History, Geography, Math, Medicine and Culture, etc.
Some of the courses I found more interesting include: “Clinical Microbiology and Infectious Pediatrics,” at the Pediatric Hospital of Central Havana, “Bacterial Diagnosis of Respiratory Illnesses,” at Hospital Calixto Garcia, and “The Practice and Theory Behind Sexually Transmitted Diseases” at the Ramon Gonzalez Coro Hospital of Gyno-obstretics. Some other students may have chosen “Preventative Detection of Cervical Cancer Associated with STDs,” “Acupuncture,” “Obesity Treatment,” “Effects of Electrical Current on the Human Body,” “Nanotechnology,” or even “Religions of African Origin and Health Care.”
After course selections were listed, I was pleased to be placed in “Preparation of Histological Slides for Morfophysiology,” a course in the theoretical and practical techniques of preparing and mounting histology slides. The course included several classes in the basic preparation of slides using different preservation, coloration and mounting techniques and a trip to the Herber Biotech Institute of Genetic Engineering and Biotechnology here in Havana, Cuba.
At the institute, doctors and technicians analyze trials to develop new vaccines, methods of diagnosis and new pharmaceuticals every year. We met with Dr. Viviana Falcon Cama, the director of the Electron Microscope Laboratory, who gave us an introductory overview of the institute and a history of the microscope.
Students practicing their technique with the ultramicrometer
After the introduction we were shown the step-by-step the process of preparing slides from samples of rat cerebrum infected with dengue fever. The samples were prepared using immunotechnological techniques to tag traces of dengue virus with gold particles to identify infected samples with the electron microscope.
We started the process with preserving the prepared sample tissue in resin, processed the resin imbedded samples using an ultramicrometer and finished the process mounting the samples on thin copper discs. After the preparation process we viewed our samples with the electron microscope.
The course was a success. It was a phenomenal experience and my first opportunity to manipulate an electron microscope. I was fascinated by the work they are accomplishing at the institute and amazed at the technology and tools available for research. Most people believe Cuba is suffering from a lack of resources. Though the embargo has greatly affected their ability to do business with many countries, they work hard to stay on the cutting edge of medical research and education.
written by Joanna Mae Souers
posted by Matt Anderson, MD
Add a comment January 14th, 2009 by Matthew Anderson
January 1, 2009 marked the 50th anniversary of the Cuban Revolution. Monthly Review, the US’s independent socialist magazine, devoted its January 2009 issue to the topic of Why Cuba Still Matters. Among the articles in this issue, one particularly caught our attention: Steve Brouwer’s The Cuban Revolutionary Doctor: The Ultimate Weapon of Solidarity. Brouwer’s article provides a readable synopsis of the development of the Cuban medical system, first within Cuba and then increasingly overseas.
It is important to begin this story with 1958 Cuba where there was only 1 doctor for each 1,051 Cubans. This statistic actually hid very large geographical disparities. Most of Cuba’s doctors were concentrated in the towns and particularly Havana. There were very few doctors in rural areas. In the years immediately following the Revolution this situation only grew worse. Many doctors emigrated, including much of Havana Medical School’s faculty. By 1967 there was only 1 doctor for every 2,000 Cubans. The health care system had, quite literally, to be rebuilt from scratch.
In a way this provided the Cubans with the opportunity to create an entirely different type of medical system, one established on principles of primary care and equal access to all. By the mid-80′s the country had adopted a system of Comprehensive General Medicine (Family Medicine in US terms) based on doctor/nurse teams who served (and lived in) a neighborhood, typically of 800 people. By 2007 there were 3 Cuban generalists per 1000 population as compared to 0.7 in the United States. Many people attribute Cuba’s excellent health statistics to this commitment to primary care and equality of access.
However, developments on the island of Cuba are only half of this story. Cuba had sent physicians on missions of medical solidarity since the early 1960′s. This solidarity has accelerated notably in the past 10 years. The 1998 Programa de Salud Integral (Comprehensive Health Program) sent brigades of Cuban doctors to Haiti, Guatemala and Honduras in the wake of Hurricanes George and Mitch. These brigades led to semi-permanent Cuban health presences in these countries, particularly in the countryside. Brouwer also examines the crucial role of Cuba in the Barrio Adentro program in Venezuela.
Sadly, the response of the Bush Administration has been the Cuban Medical Professional Parole Program, an attempt to lure Cuban medical personnel to the US. The existence of such a program is a backhanded compliment to the quality of Cuban medical personnel. And a statement of the threat they posed to the Bush Administration.
The article closes with a discussion of Cuban medical training. Brouwer highlights the Latin American Medical School (ELAM) as well as Cuban training in Venezuela and Yemen. Brouwer notes that:
Cubans, with the help of Venezuela, are currently educating more doctors, about 70,000 in all, than all the medical schools in the United States, which typically have somewhere between 64,000 to 68,000 students enrolled in their programs. The U.S. students emerge from their four years of study burdened with an average of $140,000 of debt. So it’s not surprising that they have a desire to earn high salaries, either to pay that debt or simply enjoy the upper-middle-class lifestyle to which most first world physicians are accustomed. Consequently, very few U.S. medical school graduates go into residencies in family practice, the lowest paying specialty.
Interested readers are encouraged to consult the full text of the article which is available free online.
Further reading
One of the best English sources for current news about health and medicine in Cuba is the MEDICC Review, publication of Medical Education Cooperation with Cuba. Those who read Spanish may also want to visit the official Cuban Health Portal.
Our online journal, Social Medicine, has published articles on Barrio Adentro, the Latin American Medical School and the experience of a US student working in a Barrio Adentro clinic in rural Venezuela.
This Portal contains numerous postings about Cuba and the ELAM school. Readers should note that Cuba still has several hundred full scholarships for US students to attend the 6 year medical school in Havana.
posted by Matt Anderson, MD
1 Comment January 11th, 2009 by Matthew Anderson
The schedule for the 11th year of the Social Medicine Course organized by students at Albert Einstein College of Medicine has just been announced. The course, supported by the AECOM Division of Education, is designed to teach “Essentials of medical practice not taught in medical school.”
January 14: Integrating Prenatal Care with the Diagnosis and Clinical Management of HIV and Syphilis: A Latin American and Caribbean Initiative, Dr. Arachu Castro, PhD, MPH. (Presented as part of the student-organized “Sex Week”)
Arachu Castro, PhD, MPH is a medical anthropologist trained in public health, working primarily in Latin America and the Caribbean on infectious disease (HIV/AIDS, TB, dengue) and sexual and reproductive health. She is Assistant Professor in the Dept. of Global Health & Social Medicine at Harvard Medical School, Project Manager for Mexico and Guatemala at the well-renowned NGO, Partners In Health, and Medical Anthropologist at the Division of Social Medicine and Health Inequalities at Brigham and Women’s Hospital in Boston, MA.
Her talk will present an update on the Latin America and Caribbean Prenatal Testing Initiative for HIV and Syphilis, which she directs in collaboration with UNICEF, UNAIDS, the Pan American Health Organization (PAHO) ? an Initiative currently including Brazil, Colombia, Cuba, Dominican Republic, Nicaragua, Paraguay, Peru, and Uruguay, to identify barriers to testing for HIV and syphilis and scale up screening of HIV, syphilis, and other STDs during pregnancy in Latin America and the Caribbean.
January 21: Liberation Medicine, Lanny Smith, MPH, DTM&H, FACP (will start at 7PM) This talk has been rescheduled to May 12.
January 28: Social Medicine 101, Matt Anderson, MD, MSc
Dr. Anderson is a family physician working in the Department of Family & Social Medicine at Montefiore Hospital/AECOM. He runs the Social Medicine Portal (www.socialmedicine.org) and co-edits an bilingual, online academic journal Social Medicine (www.socialmedicine.info). In this talk he will discuss the core concepts of social medicine and how they have been developed and put into practice over the past 300 years.
February 4: Health Literacy, Jennifer Adams, MD & Fatima Ashraf, Mayor’s Office
February 11. Harm Reduction in the Bronx: Hepatitis & IV Drug Users, Donald Davis, VHIP
VHIP is the Viral Hepatitis Intervention Program, a government-funded harm reduction program geared towards education and prevention of viral hepatitis in the Bronx community. It is primarily run by NYHRE (New York Harm Reduction and Education) and AECOM faculty (Dr. Alain Littwin and Dr. Melissa Stein of the Department of Medicine.) Students are closely supervised by AECOM faculty, Irene Soloway and NYHRE supervisor Donald Davis, as they assist in giving vaccinations and phlebotomy, as well as providing health education and counseling to program clients. http://www.aecommunity.com/vhip/Welcome.html
Donald Davis is the VHIP Coordinator at New York Harm Reduction Educators. He has been in the field of HIV and Harm Reduction for over ten years, having presented at numerous Hepatitis C conferences at the local, state and national level. He works with Irene Soloway, a Physician Assistant at Albert Einstein College of Medicine’s Division of Substance Abuse, in overseeing and supervising students in provide testing, vaccination and referral services to active drug users and supervise AECOM medical students at one of the NYRE syringe exchange outreach sites in Hunts Point.
The talk will introduce the concept of harms reduction with a focus on hepatitis C and how community-based screenings have affected the current situation. New York City has a higher prevalence of hepatitis C than the entire United States overall. Hepatitis C is also the most commonly reported type of viral hepatitis in NYC. Donald will address some of the issues that might be related to such a high prevalence, including incarceration, socioeconomic factors, HIV/AIDS, immigration and migration, drug and alcohol use, and hepatitis B. This talk will also cover how interventions, such as testing, vaccinations, referral services, and needle exchange programs have made an impact on hepatitis C rates as well as future interventions that can be implemented at the local community level.
February 18: Gun Violence, Jackie Hilly, NYAGV
What should the medical community know about gun violence prevention? This presentation will explore the legislative initiatives on gun violence, the public health approach to gun violence, and youth development models.
February 25: Physicians and the Pharmaceutical Industry, Joseph Ross, MD, MSH
Dr Ross will discuss the many ways physicians and the pharmaceutical industry interact and work together. He will describe how common these interactions are, and what their implications.
March 4: National Health Insurance for the US: Has Its Time Come? Oliver Fein, MD
This presentation includes a history of health insurance in the United States; a review of health care macroeconomics – where we spend our health care dollars and how we raise the revenue to pay for those expenses; an outline of the five fundamental problems facing the U.S. health care system; and, a description of single payer national health insurance and how it addresses those fundamental problems.
March 11: Environmental Justice and Climate Change Health Effects, Perry Sheffield, MD
March 17 (Tuesday): Women’s Health is a Family Value: A History of Reproductive Health Policies in the US, Carol Roye, EdD, RN, CPNP
Carol Roye is a Professor of Nursing at Hunter College in New York City and a practicing pediatric nurse practitioner in the Washington Heights neighborhood of New York. Dr. Roye’s research focuses on reproductive health issues pertinent to adolescents, including teen pregnancy prevention and working with mothers of pregnant and parenting teens to improve outcomes for their daughters. She is currently at work on a book which examines the genesis of current, unfavorable reproductive health policies and the adverse impact they have on child health in the U.S. and overseas.
March 18: Interactive Session: Novel Health Care & Sustainable Living, Frank and Bonnie Gifford, MD [This session has been postponed]
Bonnie and Frank Gifford run EntropyPawsed, a nature linked low energy living demonstration site located in the mountains of West Virginia. Their vision is to endeavor to develop a strong positive vision of the future and the personal qualities of strength, courage, wisdom, and perseverance necessary to make a positive vision reality. The Entropy Pawsed mission is to offer educational opportunities demonstrating simplicity in living with a deep ecology perspective so that we may leave a reasonable world for all children of future generations. An Einstein student, Michelle, who has studied with them, has organized a unique experience for students of the Social Medicine Course: and interactive distance-learning session, where we will practice the low-energy ideals and communicate “live via satellite” style and discuss how to incorporate sustainable practices into our future careers. http://entropypawsed.org/default.aspx
March 25: The Asian American Diabetes Epidemic, Perry Pong, MD
Despite having a lower body weight, Asian Americans are more likely than Caucasians to have diabetes. Diabetes is a rapidly growing health challenge among Asians and Pacific Islanders who have immigrated to the United States, affecting about 10 percent of Asian Americans; about 90 to 95 percent of Asians with diabetes have type 2 diabetes. Come learn about how this devastating disease has hit a seldom-discussed ethnic group – Asian Americans – and the active research that is underway to stop this epidemic.
April 1: Separate and Unequal: Medical Apartheid in NYC, Neil Calman MD & Nisha Agarwal, JD
Bronx Health REACH, established in 1999, includes 40 community and faith-based organizations dedicated to eliminating racial and ethnic health disparities in health outcomes. In addition to its advocacy efforts, the group sponsors community health promotion and disease prevention programs, with support from the Centers for Disease Control and the NYS Department of Health. REACH is a project of the Institute for Family Health, a nonprofit organization that operates health centers and trains health professionals to work in urban, medically underserved communities in New York State. New York Lawyers for the Public Interest (NYLPI) is a nonprofit civil rights law firm that strives for social justice. NYLPI has worked with the Coalition on this issue for several years.
April 22: Health Consequences of Immigration Detention, Homer Venters, MD
Over 300,000 people are detained each year in the United States by Immigration & Customs Enforcement (ICE). These detainees are held in a wide variety of public and private jails, prisons and contract facilities but face the common problem of inadequate medical care. ICE is under no legal mandate to provide an acceptable standard of medical care, or to track and report adverse medical events for detainees. In addition, the health plan that governs much of the medical care received by detainees is inadequate and unethical. Analysis of this health plan, as well as the circumstances around a number of detainee deaths, reveals a system lacking medical sufficiency
April 29: War and Public Health, Victor Sidel, MD
May 6: Integrative and Botanical Medicine, Roberta Lee, MD
TUESDAY, May 12th: “Liberation Medicine,” Lanny Smith, MD, MPH, DTM&H, FACP
Talks (unless noted otherwise above) will take place on Wednesday evenings from 5:30 to 6:30 PM in the Forchheimer 5th floor lecture room. Dinner is provided.
Commentary:
The social medicine course, now in its 11th year, is one of the highlights of the activism by the students at AECOM. There are over a dozen student groups at Einstein involved in questions of social justice. They work together as part of the Einstein Umbrella. One of the members of the umbrella is the ECHO clinic, a free clinic established by AECOM students in 1999. This model has been followed at a number of other NYC medical schools (see our posting on Free and Low Cost Health Care in NYC).
This posting will be periodically updated as we get information from the course organizers about the details of each of the talks.
For information on similar courses in US medical schools, consult Public Citizen’s listing of health activism courses.
This posting was updated on 2/5/2009 to incorporate information about the talks.
Posted by Matt Anderson, MD
Add a comment January 2nd, 2009 by Matthew Anderson
This report by US medical student Joanna Mae Souers offers her perspective on the recent Medical Education Conference in Havana.
November 30th 2008, commenced the 4-day conference, “Medical Education for the 21st Century: Teaching for Health Equity,” at the National Hotel of Cuba. The conference brought together health professionals, educators, administrators and researchers from around the world to exchange the latest in socially “accountable” health education.
The opening night included an inaugural address by Dr. Roberto Gonzalez, the Vice Minister of Public Health in Cuba, and a lecture by Dr. Charles Boelen, an international consultant on health care and ex-coordinator of the World Health Organization’s (WHO) Program for Human Resources.
The turnout was impressive with 230 presenters from 29 different countries including Cuba, the Philippines, the United States, Canada, Belgium, Honduras, Chile, Ethiopia, Columbia, Iran, Egypt, Ecuador, Argentina, South Africa, Mexico, Brazil, Spain, Great Britain, Greece, Germany, Ecuador, Belgium, Switzerland, Puerto Rico, Hungary, Tanzania, Australia, Pakistan, and New Zealand.
I was amazed that 54 of the 230 presenters came from the United States, representing a plethora of institutions including the American Association of Medical Colleges (AAMC), UCSF-UC Berkley, Albert Einstein College of Medicine, Boston University, The Jay Weiss Center for Social Medicine and Health Equity of the Leonard Miller School of Medicine, George Washington University, the University of Wisconsin, and the list goes on.
As representative students of the Latin American School of Medicine (ELAM), we were very pleased to be invited as guests of the non-profit organization, MEDICC (Medical Education Cooperation with Cuba). MEDICC, one of the many sponsors, has worked closely with Cuba over the years to bring awareness to the international community the highly qualified human resources they have developed to meet the needs of the Cuban people and others around the world.
It was a wonderful opportunity for students to meet and share their experience with health care educators from around the world. Educators were mostly impressed with the student’s humanistic ideals and their well-established set stride ahead of the curve on Social Health Care.
Most of the U.S. students chose the Latin American School of Medicine not only as their first choice, but they chose it as their only choice for the program’s social, humanistic and altruistic ideals embedded in its history and carried out in its curriculum.
As a student of the Latin American School of Medicine, I am proud to represent Cuba’s thought provoking, innovative ways of approaching health education in the 21st Century. It was amazing to see so many people come together to share their ideas and show an interest in our experience. I hope that people will be further inspired to mark their experience with positive thinking and practical change.
Joanna Mae Souers
Escuela LatinoAmericana de Medicina
Carretera Panamericana
KM 3,5
Santa Fe, Playa
Ciudad de la Habana, CUBA
CP 19108
jsouers@gmail.com <mailto:jsouers@gmail.com>
Add a comment December 30th, 2008 by Matthew Anderson
Over last week’s holiday break, we had a chance to meet with Joanna Mae Souers, an American student at the Escuela Latino America de Medicine (ELAM, Latin American Medical School) in Havana, Cuba. Ms. Souers, a graduate of Cornell, is currently in her second year of studies. She is the recipient of one of 500 full scholarships offered by the Cuban government for US students. For more about this program, please check previous postings on the Portal or an article describing the program written in our online journal.
Ms. Souers shared with us two reports that the US students have prepared about their work. This is the first:
On October 30th ELAM students, alumni, school and government officials were present for the Opening Ceremony for the First International Alumni Conference of Project ELAM here in Havana, Cuba. Dr. Jose Miguel Barruelos Millar, Fidel Castro’s personal doctor during the Revolution and one of ELAM’s founders, was among the speakers. Over the course of the conference, students, alumni and professors attended lectures, presentations and roundtable discussion on various themes, including human rights, student movements, indigenous movements, gender issues, alumni relations and healthcare brigades.
Students and alumni, discussing healthcare brigades, debated and defined the future formation, participation and integration of projects such as the Brigada Estudantil de Salud (Student Brigade for Healthcare, BES) and the Federación Internacional de Salud (International Federation of Health, FIS).
Since the First Student Congress of Project ELAM in 2001, students have organized chapters of BES to participate in community service projects during their summer vacations. Stemming back even further, FIS was defined in 1999 to be the association of Project ELAM graduates working for medical brigades worldwide. Students and alumni have agreed to strengthen relations between BES and FIS by working together in the collaboration of such projects.
On November 1st, alumni and students of FIS/BES, respectively, presented to the ELAM community on the outcome, social impact and scientific results of their work. On this day, Joanna Mae Souers, graduate of Cornell University, 2nd year medical student, and BES representative for the U.S. Delegation, presented the U.S. BES proposal for 2009.
The US delegation is currently in the process of organizing and forming brigades to work in communities during the coming months of July and August. It is our goal to organize students working in brigades to collaborate with doctors, local professionals and community leaders, in order to learn more about their communities, the problems that plague them and the potential solutions that could improve U.S. healthcare and strengthen these students as future healthcare providers.
The overall impact of the conference was quite astounding, as it successfully brought students and alumni together from all over the world to show their support for one another. It was a true milestone for Project ELAM. We hope that in the upcoming conferences we get representation from the US physicians that have recently graduated from the Project ELAM.
If you have any questions or are interested in supporting this line of work you are welcome to contact Ramon Alejandro Bernal or Joanna Mae Souers, representatives of the U.S. Delegation.
Contact information:
Escuela Latinoamericana de Medicina
Carretera Panamericana Km 3 ½
Santa Fé, Playa
Ciudad Habana, Cuba
C.P. 19108
Email: Ramon Alejandro Bernal alex238209@yahoo.com
Joanna Mae Souers jsouers@gmail.com <mailto:jsouers@gmail.com>
posted by Matt Anderson, MD
1 Comment December 10th, 2008 by Matthew Anderson
Students represent their country at ELAM
Last week, Havana’s Hotel Nacional was the setting for the Medical Education for the 21st Century conference (see our posting of May 11, 2008). Among the groups participating in this conference were PAHO, ALAMES, the Global Health Education Consortium (GHEC), MEDICC and the Cuban Ministry of Public Health.
There were a fair number of US citizens at the conference and we are fortunate that US Pediatrician David Keller (of UMass Medical School) has posted a day-by-day description of the conference (along with a few pictures) on his blog Rosie D and Me. He notes: “The conference is fabulous and oversubscribed (> 700 attendees), but the facility is not perfectly designed for such a number. So it is sometimes a little crowded; they didn’t make arrangements for such a number to tour hospitals and the medical school, and I was unable to get my name on the proper list to have that opportunity. Still, the atmosphere is electric. People from all over the world (I heard 22 countries, but I have no official word on who is here) are gathered to discuss the complexity of integrating social medicine (for want of a better word) into the lexicon of medical education. Each country faces challenges consistent with the way in which their health care system is designed.”
Another participant in the conference, my colleague Sherenne Simon, has posted photos of Cuba and the conference on Picasa.
One of the benefits of having US attendees in Havana was that they go to meet with the US students studying at the Latin American School of Medicine (see our posting Studying Medicine in Cuba: The Experience of Two US Students). Figuring out how to support these students in their transition back to the United States is a challenge. Medical education in Cuba is quite different from the US. However, as a group, the ELAM (Escuela Latinoamericana de Medicina) students seem highly motivated (who else would spend six years living as scholarship student in Cuba?), speak Spanish, and have a commitment to work in under-served areas on their return to the US. In some ways, they are ideal residency candidates for a US health care system that struggles to provide clinicians to many underserved communities.
One of the ELAM students provided us with a link to letters that student Ramon Alejandro Bernal has been sending back to his hometown Seattle. These are available at the website of Western Washington PNHP. ELAM has its own publication, Panorama: Cuba y Salud available at www.panorama.sld.cu. Articles have abstracts in English.
Any readers that might be interested in helping the US ELAM students out, can contact me. Their main interest is in finding clinical placements in the US during their summer breaks.
Finally, the keynote address was given by Dr. Charles Boelen, of the WHO’s Human Resources for Health Department: Entitled “Social Accountability: Medical Education’s Boldest Challenge” Dr. Boelen notes: “Until recently, the prevailing assumption was that community orientation and posting, along with problem-based learning, were adequate for medical schools to serve social needs. But now, this notion of social accountability has emerged, meriting attention worldwide, even within traditional medical circles. This concept urges medical schools to go beyond pedagogical innovations and search for optimal integration of their graduates into health systems.” This paper was published in the most recent edition of MEDICC Review which has several excellent articles on international experience in Teaching for Health Equity.
posted by: Matt Anderson, MD
