Cuban Doctors' Dilemma

Raimundo Lopez, a Havana physician, was more interested in practicing medicine than politics. But once Fidel Castro came to power in Cuba, Lopez found himself unable to separate the two. When he refused to join the Communist Party, he lost his job at Havana's Calixto Garcia Hospital. His position was further undermined when his wife's brother was killed as he sought asylum at a foreign embassy. Finally Lopez applied for permission to leave Cuba, was allowed to emigrate in 1969, and after an eight-month stopover in Mexico, arrived in the U.S. in 1970.

Lopez, now 52, is just one of more than 2,000 physicians who have fled the country since Castro's takeover. Most of them, like Lopez, came to the U.S., where they were free to do almost anything--except be doctors. Stymied by state licensing laws affecting foreigners who are not trained in the U.S., many able Cuban physicians had to take jobs as waiters, elevator operators or, if they could overcome language barriers and prejudice, medical technicians. There is a way out of the Cuban doctors' dilemma, however, and Lopez, like many of his countrymen before him, is trying to pursue it. He will soon take an examination established for all doctors trained abroad--and already has an offer to practice his profession in Oklahoma if he passes.

What enabled Lopez to prepare for the tough national exams is a University of Miami program that was established in 1961 especially for Cuban physicians. The twelve-week program is essentially a refresher course for those who have already practiced medicine in their own countries. Students are given six hours of medical instruction daily, bringing them up to date on the latest developments in preventive medicine, surgery, pediatrics, obstetrics and gynecology, and basic sciences. The course also provides six hours of English instruction weekly; the exams are phrased only in English.

Directed by Dr. Rafael Penalver, who is himself an exile and a graduate, the Miami program has been expanded to include doctors from 19 other Latin American, as well as a dozen European and Asian countries. In at least one case, the students were able to apply their training immediately to benefit their homeland. Nine Nicaraguan physicians were enrolled in the course at the time of the earthquake that devastated Managua in 1972. As soon as they completed their training, the university provided $30,000 to help them set up a special relief project to aid the quake victims.

But the program has had the greatest impact in the U.S. At least 2,166 Cubans, including pediatric cardiologist and Nobel Prize Nominee Augustin Castellanos, have taken the course. Half have passed the exams and gone on to practice their professions, helping to alleviate the shortage of physicians across the nation.

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