The developing world is faced with a high burden of infectious disease and insufficient
physicians to address these problems. The alternative model of medical training that
characterizes Cuban social medicine has been credited with the major successes of
Cuba’s health system, but the possibility of applying this model to other developing
countries has not been well studied. In Timor-Leste, physicians newly trained in Cuba in
social medicine are returning to practice in the individual patient-focused health care
system of Timor-Leste. Although the 1,000 newly graduated physicians expected to
enter the Timorese national health system in the coming few years will help fill the
current gap in human resources in health, the different approach to health problems
afforded by their social medicine training may also present novel challenges.
Methods
The study design employed mixed methods, administering a quantitative questionnaire
and performing qualitative semi-structured interviews with all 18 members of the first
class of Timorese graduates of the Latin America School of Medicine in Cuba as well as
with key informants in the Timorese medical community.
Results
Recent graduates demonstrated a social medicine directed approach to conceptualizing
and addressing health issues, including strong public health skills with an emphasis on
societal-level determinants of health. In addition, all respondents referred to a
humanistic motivation to practice medicine, a service-oriented work ethos and a desire
to work from within the community.
Conclusions
The integration of social medicine-trained physicians into the Timorese medical system
may produce physicians who put a greater focus on societal-level, public health
interventions and who share a humanistic ideology to practice medicine. That approach
is relevant for the health problems of Timor-Leste and may in addition provide some
resistance to brain drain.