Doctors in Exile

In the last year before Castro, Cuba had 6,600 physicians; since then, 2,000 doctors have fled Cuba, and 1,500 of them are in the U.S. A fortnight ago, in a Miami auditorium, the "Faculty in Exile" of the University of Havana's once highly rated School of Medicine graduated 152 exiled doctors who had taken its refresher course in medicine and qualifying courses in English. After that, the doctors took the tough screening examination set up by the U.S. Educational Council for Foreign Medical Graduates; about 80% are expected to pass. Since most states make U.S. citizenship a prerequisite, the Cubans still cannot get licenses to practice privately. But there is a big and insistent demand for them in doctor-starved public hospitals. So Castro's loss is a U.S. gain.

Miami's efforts to fit refugee Cuban doctors into U.S. medicine, to restore their self-respect and to make use of their skills, originated in an unfortunate incident a little more than a year ago. A difficult emergency operation in one of Miami's public hospitals came at the end of a long, hard day, and nerves were frayed as the surgeons hurried to get out of the operating room. Even so, a surgeon trained in Cuba was shocked to hear a colleague bark at a male scrub nurse: "Get out of my way, you Cuban nigger!" The surgical nurse was an exile who had been a professor of obstetrics and gynecology at the University of Havana.

Slash the Red Tape. The story got to Dr. Ralph Jones Jr., chairman of the University of Miami's Department of Medicine. An expert at slashing red tape, "Buck" Jones moved fast. "By noon of next day," he says, "we had found nearly a third of the Havana medical faculty--working as nurses and orderlies, or opening lobsters in restaurants, or running cars at the beach hotels." By that night, in a gallant gesture, Dr. Jones put all the Cuban medical teachers on salary as visiting professors at his own school.

Obviously, he could not do the same for the hundreds of other Cuban doctors --many of them with some U.S. medical training--living around Miami. So with a core group of Cubans from the Havana University staff (all but half a dozen of the 155 pre-Castro professors and assistants have fled), Buck Jones set up the Faculty in Exile. With U.S. volunteers joining in as tutors, the Cubans were offered a total of 80 hours a week free in graduate medical courses, plus English.

By last week, 700 of the 900 who took the faculty's courses had passed the Educational Council exams.

Psychiatric Training. Almost to a man, the doctors say that they left Cuba because they could not stomach the loss of freedom under Castro--for themselves as physicians, for their children as future citizens. Castro's policies have made a mockery of medicine. To head one reputable clinic, the regime nominated a janitor. In a major clinic it installed the barber as administrator, with the switchboard operator as his assistant. Says one displaced doctor: "Practice is terrible.

The only medicine you have is penicillin --no other antibiotics, no hormones. If you need another medicine, you may have to phone dozens of pharmacies to get it."*

One who quickly made good in the U.S.

is Dr. Sergio Leiseca, 40, who had several years of U.S. training in pre-Castro days.

He soon won a research berth in Miami, now has one at Tulane University with a grant that enables him to combine his specialty (blood-vessel surgery) with cancer research. But the Veterans Administration is the major employer of the Cubans, with the U.S. Public Health Service and state mental hospitals next. Says Dr. Alfredo Hernandez-Vila, 35, who has settled at Osawatomie State Hospital in Kansas: "I am going to stay in the U.S.

until I complete my training in psychiatry. Of course I would like ultimately to return to Cuba. I think that after Castro is finished--and he will be, one day--there will be a great need for psychiatry there."

* Medicines are exempted from the U.S. embargo on trade with Cuba, but--partly because of a dollar shortage--Cuba holds down imports.

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