Transcript
AN INTENSIVE POSTGRADUATE COURSE IN MEDICINE
FOR CUBAN PHYSICIANS IN EXILE
Presented by
The University of Miami, School of Medicine, Miami, Florida
I. INTRODUCTION
As a result of the obviously Communistic philosophy of the present Government of Cuba, many thousands of Cubans who are unalterably opposed to Communism have been forced to flee from that country. Most of them have lost all of their material possessions. The largest single group of Cubans in exile exists in the Greater Miami area. There are nearly 300 Cuban physicians in this community today. Most of these physicians have their families with them and they have no means of providing them with the necessities of life. Among these physicians are at least 10 full Professors from the school of Medicine of the University of Havana. They are men who have recognized international stature in their areas of medicine. Professor Vincente Pardo-Castello is the recent past President of the American Academy of Dermatology; Professor Jose Centurion, Chairman of the Department of Medicine, of the University of Havana, is the Governor for Cuba of the American College of Physicians; Professor Fernando Milanese is a member of the American Association of Gastroenterology: Professor Jose Lastra is a member of the American College of Surgeons; and Professor Hector Roccamora is President of the Cuban Society of Obstetrics and Gynecology.
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The University of Miami School of Medicine has given each of these men an appointment as Visiting Professor in their specialty. We believe that these men should be supported by fellowships and we are turning to the national societies, such as the American College of Surgeons and the American College of Physicians, for help in producing fellowships for them at the level of approximately $6,000 a year for their own members who are here in exiles and have been appointed to our Faculty. These men have been provided a suite of offices in the Medical School Building, and we have hired bilingual secretaries for them. Working with them, we have formulated an intensive postgraduate course covering all of the clinical disciplines of medicine and the basic sciences that are particularly pertinent to clinical medicine. In addition, we have created a corps of tutors who speak Spanish as well as English. Each tutor will have 10 Cuban physicians assigned to him and will conduct tutorial sessions as needed.
II. METHOD OF APPROACH
In order to design the best possible educational experience for these Cuban physicians in exile, we will give all of them extensive comprehensive examinations in internal medicine and surgery, in English and in Spanish. The examinations which will be used for this purpose are examinations which were prepared by the National Board of Medical Examiner and administered last year to the Medical Students of the University of Valle, Cali, Colombia and the University of Puerto Rico. These examinations were also given in English to most of the Seniors in American Medical Schools last year. By the
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use of those two examinations we will be able to determine the influence of lack of familiarity with the English language on the ability of each individual to demonstrate the extent of his knowledge of medicine in such an examination. In addition to those two examinations, all of the physicians will take a comprehensive objective examination consisting of 600 questions covering internal medicine, pediatrics, surgery, obstetrics and gynecology, public health and preventive medicine, and Psychiatry. In addition, 20% of the questions will cover selected areas of the various basic sciences of the first two years of the usual medical school curriculum. The results of these examinations will be machine graded in the offices of the National Board of Medical Examiners. The performance of each individual student will be analyzed in detail by medical discipline, i.e., medicine, surgery, etc. and by areas of information. I.e., cardiovascular system, central nervous system, gastrointestinal system, etc.
There will also be an analysis of the major areas of weakness in essential general medical knowledge of the group. On the basis of this analysis, a curriculum of didactic lectures will be planned and presented three evenings a week with simultaneous translation from English into Spanish available for each member of the audience. The curriculum will be designed and the lectures presented as a joint endeavor by members of the Faculty of the University of Havana and the University of Miami Schools of Medicine.
Each of the Cuban physicians who participate in this program will also be assigned to a tutorial group in which one bilingual
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instructor will work intimately as needed with 10 physician-students. Each tutor will have a detailed analysis of the weaknesses and strengths of medical knowledge of each of his students and he will design his tutorial group to meet each individual’s needs. At the end of three months the entire group will be re-examined in the same way, and the results will be analyzed in detail as before, to determine the effectiveness of this educational process. Early in April all of the students will take the National Qualifying Examination for Graduates of Foreign Medical Schools, administered by the Educational Council for Foreign Medical Graduates. Those physicians who pass this examination will be eligible for employment as physicians in many different parts of this country and they will be eligible for consideration for examination for licensure to practice medicine in many states. They will also have demonstrated that they have sufficient medical knowledge and knowledge of the English language to function effectively as physicians in the care of patients in this society.
It is anticipated that if the situation that presently exists in Cuba is unchanged or worse in April many of these physicians will be relocated in this country. If, or when, conditions are such that they can return to Cuba, this educational experience will help them to do a better job in their own country.
When the results of the National Qualifying Examination of the Educational Council for Foreign Medical Graduates are available to us, a second curriculum will be presented for any physician who has failed to pass the examination and for others who wish to take it. The
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results of that examination will be analyzed in detail and made available to us for that purpose. We will then have an analysis of the specific educational needs of each individual who fails to pass the examination. These results will determine the content of the second didactic curriculum and will guide the further conduct of tutorial sessions. We will also have an accurate objective measure of the effectiveness or weaknesses of our teaching effort and of each of our lecturers and tutors.
III. SIGNIFICANCE OF THIS RESEARCH AND TESTING
The significance of this endeavor for the physicians from Cuba who are here in exile is obvious. Their response to it has been most enthusiastic. They have indicated their eagerness to participate and their sincere gratitude for the educational opportunity that is being made available to them. We believe that the significance of this endeavor extends considerably beyond the immediate and urgent problem of the Cuban physician in exile. We hope to demonstrate how an intensive, carefully designed postgraduate course, based on specific measurements of individual needs, can be utilized to prepare physicians from other countries to function as physicians in this society and to enable physicians from other countries, particularly the developing nations (the so-called undeveloped countries) can be prepared to benefit maximally from the vast opportunities for continuing education in medicine that are available in this country.
There is , today, a tremendous need for this country to make available to physicians from other parts of the world the opportunity
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for continued study in medicine. The examination prepared by the Educational Council for Foreign Medical Graduates could deny this opportunity to as many as 9 out of 10 of the physicians who want to come here for further study from many countries of the world. This examination is serving a vitally important function in preventing a reduction in the standard of medical care in this country which would result from a great influx of graduates of the foreign medical schools, whose knowledge of medicine is so inadequate that they can not take responsibility for patient care, which is an essential part of postgraduate education in medicine.
The Educational Council for Foreign Medical Graduates Examination is also serving a second vitally important function in that it is protecting physicians from other countries from investing their time and money in coming to this country seeking to further their education when they are not prepared to profit from the educational opportunities which are available here. We hope to demonstrate how intensive postgraduate courses can be designed to prepare such students to come to this country for postgraduate education in medicine so they will receive the maximum benefit from the time they spend here.
IV. REQUIREMENT FOR FINANCIAL ASSISTANCE
The minimum budget required to provide these postgraduate courses and to conduct their research in educational methodology is shown on the attached sheet.
Because of the urgency of this program and became of the magnitude of the opportunity for research in educational methodology
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that is made available to us in this community, the University has committed its limited resources so that this work can be started. One foundation, which has asked to be un-named, has provided $5,000.00 for use as needed to initiate this program and the Chairman of the Educational Council for Foreign Medical Graduates has agreed to provide us with $5,000.00 to help us initiate this endeavor.
This request is submitted for additional financial support to enable us to meet the minimum costs required to continue until the First of June. We ask that it be considered as an urgent request, but we want it to be considered on the basis of its scientific merit and not on the basis of its emotional appeal.
Ralph Jones, Jr., M.D.
Chairman, Department of Medicine
University of Miami
School of Medicine
RJ/pm
ATT.
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