Cuba seems like such an amazingly bad choice just now; between likely major political instability in the fairly near future, and the fact that their vaunted medical system is pretty much a farce. I'd be happier to hear "Mexico", even.
Does he plan to practice somewhere other than here, and figures getting trained there would make it easier? Or is there some reason to avoid training here when you intend to practice here?
1. Cuba's medical education is world-famous: excellent, and free, and the obligation is that you have to go work in underserved populations for a while (which is Frank's briar patch). I don't know why you say their medical system is a farce: they struggle along, because they are poor and they have some awkward structures, but in terms of health care delivery to the whole population, they do so well that they export doctors. And. again, the medical school there is the jewel of the Spanish-speaking world.(Tangent: while my stepmother was working in Africa, she said the Cuban doctors were extremely popular everywhere they went)2. He has some Spanish, and there's a built-in intensive Spanish course. 3. As Frank says, Mexico, though it has good medical schools also, is "on fire" (his words): a state of open civil war in several states, and lesser chaos in other states. In comparison, Cuba looks really peaceful. On the plus side for Mexico, there are also serve-the-poor components to its programs. A transition is coming up for Cuba, but it looks to me like there's a good chance it will not be horrific, just nerve-wracking. We'll see. Anyway, he's also looking at universities in Europe and Canada.
He's talking about maybe not coming back (except to renew his passport and visit, maybe), but nobody's silly enough to hold him to ideas he's throwing around.
It's a weird thing for me, really. I've never had an empty nest for more than a few days at a time, and I've only been off the North American continent twice. So seeing my firstborn contemplating a life in the big world is just -- unsettling. I'm proud of the fact that he's thinking about it in terms of being helpful someplace, but gee. It'll be strange.
I know, that's getting repetitive, but when I think about it I automatically think (ohmygodjustafewmoreyears). I'm freaking out now b/c your kid is going to go away, far away, for medical school and Puppy goes to college in like, oh, six years.
I know there's some disagreement about the actual state of healthcare in Cuba. The people I've talked to who want there in person make it sound fairly dire (and mostly they're people who are *trying* to make it sound good). The doctor/patient ratio seems to be *excellent*, the basic preventive work very good, for whatever reason they seem to have less of an AIDS disaster (not sure that's a medical outcome though). The changes in infant mortality over time are troubling, and questions on how the policy on aborting high-risk pregnancies impacts those stats are interesting (my emotional reaction is that they should be, but I'm not I think up to overriding the parents' decision, but then who pays for care if it's really expensive?)
If you happen to know (or if you care enough to read it), do you feel the Wikipedia article http://en.wikipedia.org/wiki/Healthcare_in_Cuba is reasonably "neutral point of view"?
Correspondence in the New England Journal of Medicine seems to show considerable difference of opinion about the training system, too. There's also a long interesting article in the Washington Post largely about an American woman named Melissa who's studying there, which has little bad to say about the training as I read it (but lots about the living conditions of course). I'm guessing you (and he) have found these obvious things already, I'm just noodling about info sources and conflicting data sort-of in general.
Anyway, more good doctors are generally a good thing, and it mostly seems to be a pretty darned fulfilling career, if you survive the training sane.
Certainly emigrating to a different country is a *really* big deal. All of us have ancestors who did, of course (at least so long as Africa as the source of H. Sap. holds up).
The changes in infant mortality over time are troubling The CIA factbook gives Cuba's infant mortality rate in 2005 as 6.33 per thousand. The US has 6.50 per thousand in the same year (that is to say, a slightly worse rate, though not significantly).
If I try to find a country with a similar wealth, I run into difficulties, because the countries I can find with similar PPP (http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28PPP%29) (which appears to be a GDP adjusted to make it more comparable across countries) are pretty dire, except for Slovenia and Oman: war-torn Serbia, Cameroon, Turkmenistan, Nepal, Kenya . . . only Slovenia has a better infant mortality rate than Cuba. Serbia has the next best of this group after Cuba at 12.89, more than twice the rate. Oman, which Wikipedia refers to as "a major success story for economic growth," has a rate of 19.51, more than three times that of Cuba.
So what's the troubling change here? Are you troubled because it's been getting better, is much better than you could expect for the economic condition of the country, and compares quite well to the US?
The article was kind of a hash, I thought -- it repeated the same sentences about infant mortality and abortion several times, to the point where I thought I must be reading it badly. I'd rather have seen more facts about health care delivery: doctors per capita, doctors per capita by urban v. rural, well child visits and vaccinations, mortality rates for indicator conditions (perinatal maternal mortality, for example, or nosocomial infections). To quote somebody saying "This hospital is dirty" is mildly interesting, but I don't know what to make of it. "Dissident surgeon" covers a lot of ground, and I don't know whether the guy's a Semmelweiss or a nutcase or what.
There's no such thing as a neutral point of view. To be useful to me, an article doesn't have to be neutral, or to share my worldview (which for the record does not entail worshipping Cuba, which is as we all know a place with a sketchy government and not nearly enough democracy). But it does have to give me material I can chew on and decide its meaning for myself.
The high abortion rate is a good thing, I think. Damn straight it contributes to a low infant mortality. It's much, much better to elect to abort than it is to wait and let the child die a painful and ugly death outside the womb. Not to mention the wear and tear on the mother. Go Cuba.
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timeasmymeasure
no subject
Does he plan to practice somewhere other than here, and figures getting trained there would make it easier? Or is there some reason to avoid training here when you intend to practice here?
no subject
He's talking about maybe not coming back (except to renew his passport and visit, maybe), but nobody's silly enough to hold him to ideas he's throwing around.
It's a weird thing for me, really. I've never had an empty nest for more than a few days at a time, and I've only been off the North American continent twice. So seeing my firstborn contemplating a life in the big world is just -- unsettling. I'm proud of the fact that he's thinking about it in terms of being helpful someplace, but gee. It'll be strange.
no subject
Wow!
I know, that's getting repetitive, but when I think about it I automatically think (ohmygodjustafewmoreyears). I'm freaking out now b/c your kid is going to go away, far away, for medical school and Puppy goes to college in like, oh, six years.
Egad.
That's, like, tomorrow.
no subject
If you happen to know (or if you care enough to read it), do you feel the Wikipedia article http://en.wikipedia.org/wiki/Healthcare_in_Cuba is reasonably "neutral point of view"?
Correspondence in the New England Journal of Medicine seems to show considerable difference of opinion about the training system, too. There's also a long interesting article in the Washington Post largely about an American woman named Melissa who's studying there, which has little bad to say about the training as I read it (but lots about the living conditions of course). I'm guessing you (and he) have found these obvious things already, I'm just noodling about info sources and conflicting data sort-of in general.
Anyway, more good doctors are generally a good thing, and it mostly seems to be a pretty darned fulfilling career, if you survive the training sane.
Certainly emigrating to a different country is a *really* big deal. All of us have ancestors who did, of course (at least so long as Africa as the source of H. Sap. holds up).
no subject
The CIA factbook gives Cuba's infant mortality rate in 2005 as 6.33 per thousand. The US has 6.50 per thousand in the same year (that is to say, a slightly worse rate, though not significantly).
If I try to find a country with a similar wealth, I run into difficulties, because the countries I can find with similar PPP (http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28PPP%29) (which appears to be a GDP adjusted to make it more comparable across countries) are pretty dire, except for Slovenia and Oman: war-torn Serbia, Cameroon, Turkmenistan, Nepal, Kenya . . . only Slovenia has a better infant mortality rate than Cuba. Serbia has the next best of this group after Cuba at 12.89, more than twice the rate. Oman, which Wikipedia refers to as "a major success story for economic growth," has a rate of 19.51, more than three times that of Cuba.
So what's the troubling change here? Are you troubled because it's been getting better, is much better than you could expect for the economic condition of the country, and compares quite well to the US?
The article was kind of a hash, I thought -- it repeated the same sentences about infant mortality and abortion several times, to the point where I thought I must be reading it badly. I'd rather have seen more facts about health care delivery: doctors per capita, doctors per capita by urban v. rural, well child visits and vaccinations, mortality rates for indicator conditions (perinatal maternal mortality, for example, or nosocomial infections). To quote somebody saying "This hospital is dirty" is mildly interesting, but I don't know what to make of it. "Dissident surgeon" covers a lot of ground, and I don't know whether the guy's a Semmelweiss or a nutcase or what.
There's no such thing as a neutral point of view. To be useful to me, an article doesn't have to be neutral, or to share my worldview (which for the record does not entail worshipping Cuba, which is as we all know a place with a sketchy government and not nearly enough democracy). But it does have to give me material I can chew on and decide its meaning for myself.
The high abortion rate is a good thing, I think. Damn straight it contributes to a low infant mortality. It's much, much better to elect to abort than it is to wait and let the child die a painful and ugly death outside the womb. Not to mention the wear and tear on the mother. Go Cuba.