The Role of Social Medicine in Filling the Gap in Human Resources in Health: The Cuba - Timor-Leste Health Program

Abstract

Objectives 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. Key Words Social medicine, human resources, brain drain, Cuba, medical training.