MEDICC Rev. 2008 Oct;10(4):5-9. doi: 10.37757/MR2008.V10.N4.2.
Profound changes are under way in Cuban medical education. Some aspects of this transformation represent radical shifts, others a deepening of processes already in motion. Together, these changes reflect a progressive sense of urgency over the last four decades to: 1) scale up physician training to meet the needs of the whole population; 2) recruit and train scientifically prepared and socially committed students; and 3) match competencies, knowledge base, and scope of responsibilities to the concrete health needs of people in Cuba and other countries where these future physicians may serve. These three goals have guided successive innovations in Cuban medical education since the early 1960s, when the University of Havana Medical School was left with only 23 of its 161 professors - the rest either emigrating or in disagreement with academic and health care reforms designed to guarantee the right to health care. From a fee-for-service model catering mainly to individual patients, health care was being transformed into a universal public health system. This required decentralization of medical services - first to the rural areas of the country, which had essentially gone without - followed by development of a nationwide primary health care network. Thus, from the beginning, there was an urgent need to train many more physicians and to train physicians prepared for, and committed to, this new vision.
古巴医学教育正在发生深刻变革。这种转变的某些方面代表了根本性的转变，而另一些方面则深化了已经在进行的进程。这些变化共同反映了过去四十年中，人们越来越紧迫地意识到需要：1）扩大医生培训规模，以满足整个人口的需求；2）招募和培养具有科学素养和社会责任感的学生；3）使能力、知识基础和职责范围与古巴人民和这些未来医生可能服务的其他国家的具体健康需求相匹配。自 20 世纪 60 年代初以来，这三个目标一直指导着古巴医学教育的不断创新，当时哈瓦那大学医学院只剩下 161 名教授中的 23 名——其余的要么移民，要么不同意旨在保障医疗保健权利的学术和医疗改革。从主要为个别患者提供服务的按服务收费模式，医疗保健正在转变为全民公共卫生系统。这需要医疗服务的去中心化——首先是在该国基本上没有医疗服务的农村地区，然后是发展全国性的初级卫生保健网络。因此，从一开始，就迫切需要培训更多的医生，并培养有准备和致力于这一新愿景的医生。
