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> A NYC taxi medallion in 2010 cost around $600,000. Does that mean it was harder to be a NYC cab driver in 2010 than to get an MD at Mount Sinai? No. Taxi med

> A NYC taxi medallion in 2010 cost around $600,000. Does that mean it was harder to be a NYC cab driver in 2010 than to get an MD at Mount Sinai? No. Taxi medallion in NYC is an open market. You can just pick up a license if you have the means to buy it and operate legally. It is not the case in Cuba. Good luck going into the business and keeping the "right" to operate there. Meanwhile medical school is just an application you need to fill for those who couldn't get a job as a taxi driver or in a tourist resort. > I'm perfectly fine if your answer is "yes" - it just means that "harder" doesn't mean something like "years of hard study". I'm not going to comment on the "hard" part but perhaps working smarter and not harder would be better for them. Seems medical degrees from Cuba are recognized almost nowhere in the world. That speaks for the quality.

eesmith 5y ago
You mentioned earlier that "the capital to start" was part of what made being a taxi driver in Cuba "hard". $600,000 certainly sounds like rather a lot of capital in 2010. Are you now saying that acquiring that capital isn't hard, so only knowing who to bribe is the hard part? > Seems medical degrees from Cuba are recognized almost nowhere in the world I ... don't know what that means. If a Cuban MD visit the US, they aren't referred to as doctor?! Or do you mean they can't practice as an MD in US without some sort of re-qualification? In the US, a doctor can't move to another state and immediately start working as a doctor (though many states are members of a compact, which simplifies those transfers). As a check, I see https://medicalcredentialing.org/help-applying-medical-licensure-transferring-license/ https://medicalcredentialing.org/help-applying-medical-licen... says "Discussing options with the licensure board if an applicant’s application is deficient in some way (ex: a required course was not part of professional’s schooling)" So I wouldn't be surprised that an MD moving countries wouldn't be recognized without some sort of re-qualification. Or do you mean that the Cuban MD program is worthless, and students need to start from scratch if they, for example, want to be an MD in the US? That's clearly not correct. In a parallel thread I linked to https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-020-0450-9 https://human-resources-health.biomedcentral.com/articles/10... . Table 1 lists things like > Cape Verde had no medical school until 2015 and was dependent on international collaborations. Human resource secondary data were used to map the training of doctors. Cuba has trained almost half (189) of the doctors trained since 1975. > "Medical students from Equatorial Guinea Bata Medical School are taught by Cuban academics and go to Cuba to take their sixth academic year and graduate. So far, 208 doctors have graduated from the Bata school." and says "US citizens trained in Cuba have demonstrated success in examinations to work in the US health system". The citations include http://mediccreview.org/latin-american-medical-school-class-of-2015-exclusive-with-cuban-trained-us-graduates/ http://mediccreview.org/latin-american-medical-school-class-... , which has numbers: > A decade after the first US graduate received his diploma from ELAM, 113 have followed. While most (especially recent) grads are still finishing their USMLE exams, 40% of the total are already in residencies or have completed them: of these, 90% have chosen to practice in three main primary care specialties—family medicine (61%), internal medicine (23%) and pediatrics (6%). Of US graduates already practicing, 65% work in Health Professional Shortage Areas (HPSAs) and/or Medically Underserved Areas (MUAs). The success of these doctors also helps destigmatize the Cuban program; US foreign medical graduates are often viewed as substandard, the assumption being that they studied abroad because they couldn’t get accepted anywhere else. But often, as in the case of ELAM-trained doctors, US medical education poses a financial, not intellectual, barrier to their training. So, the US appears to recognize medical degrees from Cuba like it recognizes degrees from other countries. To be absolutely clear, that first paper describes how Cuban-trained students "are perceived to have inadequate skills", while also pointing out "RSA’s long heritage of British medical education traditions and academic excellence, selection of the brightest students and its strong emphasis on specialisation have not helped in developing primary health care." Doctors who have been trained in hospital and speciality services might indeed consider someone trained in primary care for the poor and disadvantaged as being under-trained. But if you need MDs for primary care for the poor and disadvantage then perhaps specialist training is the wrong thing.
- 908B64B197 5y ago
  > You mentioned earlier that "the capital to start" was part of what made being a taxi driver in Cuba "hard". $600,000 certainly sounds like rather a lot of capital in 2010. Are you now saying that acquiring that capital isn't hard, so only knowing who to bribe is the hard part? Raising money in NYC is not the same as in Cuba. First of all, in NYC you need USD and that's what the market will loan you. You can use your house as colateral, finance it through other means or rent the license from an owner. It's a scummy business and I'm glad Uber disrupted it, but there were several legal ways of doing so. In Cuba, you'll need USD as well (the "official" currency is worthless) but it's illegal to carry it and the local warlord won't let you exchange it for a fair price. You need black market connections and potentially help from abroad to even have the slimmest chance at getting some real currencies. > I ... don't know what that means. If a Cuban MD visit the US, they aren't referred to as doctor?! This is America, they can refer to themselves how they want. Signing a prescription with their name and MD however would be a felony. > So, the US appears to recognize medical degrees from Cuba like it recognizes degrees from other countries. But earlier > "US citizens trained in Cuba have demonstrated success in examinations to work in the US health system" It's unclear how much classes they had to re-take before being able to pass the exam. The article won't say (of course).
  - eesmith 5y ago
    So I take it that getting $600,000 in the US is not hard? What world do you live it? Apparently one where you expect taxi drivers to 1) own a house instead of rent, and 2) have enough collateral in the house. I certainly couldn't get that sort of loan. > Signing a prescription with their name and MD however would be a felony. Like I said, if an MD moves to another state and does the same thing (that is, doesn't get a medical license in the state) then it's also a felony. Does that make the MD program from other states bad? No. > It's unclear how much classes ... It's also unclear how many classes a German MD (or one from India, Russia, Japan, or any other non-US program) would need to take to be an MD in the US. You haven't pointed to anything to back your statements. I have. Here you go - https://www.ama-assn.org/education/international-medical-education/practicing-medicine-us-international-medical-graduate https://www.ama-assn.org/education/international-medical-edu... : ] "After ECFMG certification, physicians who wish to practice medicine in the United States must complete an accredited residency training program in the United States or Canada. This process will take at least 3 years. The physician will have to complete a residency program regardless of the training he or she has received overseas." By your categorization, NO medical degrees from outside the US and Canada are recognized in the US. I guess we can conclude "That speaks for the quality" of ALL overseas medical programs, not just Cuba's.

eesmith 5y ago

You mentioned earlier that "the capital to start" was part of what made being a taxi driver in Cuba "hard". $600,000 certainly sounds like rather a lot of capital in 2010. Are you now saying that acquiring that capital isn't hard, so only knowing who to bribe is the hard part? > Seems medical degrees from Cuba are recognized almost nowhere in the world I ... don't know what that means. If a Cuban MD visit the US, they aren't referred to as doctor?! Or do you mean they can't practice as an MD in US without some sort of re-qualification? In the US, a doctor can't move to another state and immediately start working as a doctor (though many states are members of a compact, which simplifies those transfers). As a check, I see https://medicalcredentialing.org/help-applying-medical-licensure-transferring-license/ https://medicalcredentialing.org/help-applying-medical-licen... says "Discussing options with the licensure board if an applicant’s application is deficient in some way (ex: a required course was not part of professional’s schooling)" So I wouldn't be surprised that an MD moving countries wouldn't be recognized without some sort of re-qualification. Or do you mean that the Cuban MD program is worthless, and students need to start from scratch if they, for example, want to be an MD in the US? That's clearly not correct. In a parallel thread I linked to https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-020-0450-9 https://human-resources-health.biomedcentral.com/articles/10... . Table 1 lists things like > Cape Verde had no medical school until 2015 and was dependent on international collaborations. Human resource secondary data were used to map the training of doctors. Cuba has trained almost half (189) of the doctors trained since 1975. > "Medical students from Equatorial Guinea Bata Medical School are taught by Cuban academics and go to Cuba to take their sixth academic year and graduate. So far, 208 doctors have graduated from the Bata school." and says "US citizens trained in Cuba have demonstrated success in examinations to work in the US health system". The citations include http://mediccreview.org/latin-american-medical-school-class-of-2015-exclusive-with-cuban-trained-us-graduates/ http://mediccreview.org/latin-american-medical-school-class-... , which has numbers: > A decade after the first US graduate received his diploma from ELAM, 113 have followed. While most (especially recent) grads are still finishing their USMLE exams, 40% of the total are already in residencies or have completed them: of these, 90% have chosen to practice in three main primary care specialties—family medicine (61%), internal medicine (23%) and pediatrics (6%). Of US graduates already practicing, 65% work in Health Professional Shortage Areas (HPSAs) and/or Medically Underserved Areas (MUAs). The success of these doctors also helps destigmatize the Cuban program; US foreign medical graduates are often viewed as substandard, the assumption being that they studied abroad because they couldn’t get accepted anywhere else. But often, as in the case of ELAM-trained doctors, US medical education poses a financial, not intellectual, barrier to their training. So, the US appears to recognize medical degrees from Cuba like it recognizes degrees from other countries. To be absolutely clear, that first paper describes how Cuban-trained students "are perceived to have inadequate skills", while also pointing out "RSA’s long heritage of British medical education traditions and academic excellence, selection of the brightest students and its strong emphasis on specialisation have not helped in developing primary health care." Doctors who have been trained in hospital and speciality services might indeed consider someone trained in primary care for the poor and disadvantaged as being under-trained. But if you need MDs for primary care for the poor and disadvantage then perhaps specialist training is the wrong thing.

908B64B197 5y ago
> You mentioned earlier that "the capital to start" was part of what made being a taxi driver in Cuba "hard". $600,000 certainly sounds like rather a lot of capital in 2010. Are you now saying that acquiring that capital isn't hard, so only knowing who to bribe is the hard part? Raising money in NYC is not the same as in Cuba. First of all, in NYC you need USD and that's what the market will loan you. You can use your house as colateral, finance it through other means or rent the license from an owner. It's a scummy business and I'm glad Uber disrupted it, but there were several legal ways of doing so. In Cuba, you'll need USD as well (the "official" currency is worthless) but it's illegal to carry it and the local warlord won't let you exchange it for a fair price. You need black market connections and potentially help from abroad to even have the slimmest chance at getting some real currencies. > I ... don't know what that means. If a Cuban MD visit the US, they aren't referred to as doctor?! This is America, they can refer to themselves how they want. Signing a prescription with their name and MD however would be a felony. > So, the US appears to recognize medical degrees from Cuba like it recognizes degrees from other countries. But earlier > "US citizens trained in Cuba have demonstrated success in examinations to work in the US health system" It's unclear how much classes they had to re-take before being able to pass the exam. The article won't say (of course).
- eesmith 5y ago
  So I take it that getting $600,000 in the US is not hard? What world do you live it? Apparently one where you expect taxi drivers to 1) own a house instead of rent, and 2) have enough collateral in the house. I certainly couldn't get that sort of loan. > Signing a prescription with their name and MD however would be a felony. Like I said, if an MD moves to another state and does the same thing (that is, doesn't get a medical license in the state) then it's also a felony. Does that make the MD program from other states bad? No. > It's unclear how much classes ... It's also unclear how many classes a German MD (or one from India, Russia, Japan, or any other non-US program) would need to take to be an MD in the US. You haven't pointed to anything to back your statements. I have. Here you go - https://www.ama-assn.org/education/international-medical-education/practicing-medicine-us-international-medical-graduate https://www.ama-assn.org/education/international-medical-edu... : ] "After ECFMG certification, physicians who wish to practice medicine in the United States must complete an accredited residency training program in the United States or Canada. This process will take at least 3 years. The physician will have to complete a residency program regardless of the training he or she has received overseas." By your categorization, NO medical degrees from outside the US and Canada are recognized in the US. I guess we can conclude "That speaks for the quality" of ALL overseas medical programs, not just Cuba's.