Latin American School of Medicine (Cuba)



Escuela Latinoamericana de Medicina (ELAM), formerly Escuela Latinoamericana de Ciencias Médicas (in Spanish; in English: Latin American School of Medicine (LASM), formerly Latin American School of Medical Sciences), is a major international medical school in Cuba and a prominent part of the Cuban healthcare system.

Established in 1999 and operated by the Cuban government, ELAM has been described as possibly being the largest medical school in the world by enrollment with approx. 10,000 or 12,000 students from 27 or 29 countries reported as enrolled in 2006/early 2007. All those enrolled are international students from outside Cuba and mainly come from Latin America and the Caribbean as well as Africa. The school also accepts students from the United States - 91 were reportedly enrolled as of January 2007. Tuition, accommodation and board are free, and a small stipend is provided for students.

A ELAM sister school operated by the Venezuela government and sited in Guri, Bolívar, Venezuela was scheduled to open in October 2006. The school is named Escuela Latinoamericana de Medicina A.P. Réverénd after French physician Alejandro Próspero Réverénd.

Campuses
The main campus of Cuba's ELAM is located northwest of the capital Havana and about 3.5 km from the Panamericana Highway. This 1.2 km² campus is built on the site of an old naval academy and overlooks the sea. It consists of 28 buildings with 80 classrooms, 37 laboratories, 5 amphitheaters, dormitories, an infirmary, and other facilities. The campus facilities were designed to support approx. 3,500 students with students beyond the second year of the medical program being based at other medical schools around Cuba. In December 2006, approx. 3,300 students were reportedly housed on the campus.

In 2005, it was announced that the Francophone Caribbean School of Medical Sciences in Santiago de Cuba - a second key campus - had been incorporated into ELAM.

Mission
ELAM's mission is dedicated to the training of general practitioners and primary healthcare providers for impoverished communities outside Cuba. The school is part of the international outreach through medical initiatives - which has previously included medical scholarships - that has been important to Cuban foreign policy since the 1960s.

It is preferred that ELAM students come from the poorest communities with the intent of returning to practice in those areas in their countries. Initially only enrolling students from Latin America and the Caribbean, the school has also become open to applicants from impoverished and/or medically underserved areas in the United States and Africa.

Preference is given to applicants who are financially needy and/or "people of color" who show the most commitment to working in their poor communities. ''

Final admissions decisions are made by a committee representing ELAM's faculty and the Cuban Ministry of Public Health.

Scholarship
The scholarship includes full tuition, dormitory housing, three meals per day at the campus cafeteria, textbooks in Spanish for all courses, school uniform, basic toiletries, bedding, and a small monthly stipend in Cuban pesos. The scholarship does not include travel expenses to and from school.

Admissions
To be considered for the US scholarship program at the Latin American School of Medicine must be US citizens (with a US passport), under the age of 30, with proficiency in college-level sciences, and a commitment to practice medicine in low-income and medically under-served communities in the US after graduation.

Curriculum

 * For a detailed English language ELAM curriculum plan, see the external links.

ELAM's pedagogical philosophy centers on intensive tutoring and advising. All courses are taught in Spanish.

The pre-medical program includes courses in health sciences, chemistry, biology, math, physics as well as a 12-week intensive course in the Spanish language. The medical program begins every September and is divided into 12 semesters. Students study at the ELAM campus for the first 2 years before completing their studies at one of Cuba's 21 other medical schools, including a 1 year rotating internship. The Cuban medical training model emphasizes primary healthcare, community medicine and hands-on internship experiences.

Students are required to pass examinations at appropriate points during their course of study. For US students, this includes the United States Medical Licensing Examination.

Establishment
ELAM was first conceived - reportedly from an idea by President Fidel Castro himself - as part of Cuba's humanitarian and development aid response (known as the "Integral Health Plan for Central America and the Caribbean" ) to the devastation caused by Hurricane Georges and Hurricane Mitch in 1998, which affected several countries in Central America and the Caribbean, including Cuba. 500 full medical scholarships per year for the next decade were offered by the Cuban government to students from 4 countries - the Dominican Republic, Haiti, Honduras and Nicaragua - seriously affected by the hurricanes. In support of this plan, ELAM was opened in March 1999 and started its full medical program in September 1999 with approx. 1,900 student in its initial classes. On November 15, 1999, Castro officially inaugurated ELAM at as Havana hosted the 9th Ibero-American Summit (at this time, ELAM had 1,929 students from 18 countries).

The first class of 1,498 ELAM doctors graduated on August 20, 2005, together with 112 from other Cuban medical schools. 28 foreign countries of Latin America and the Caribbean, and including the United States were represented by the graduates. The ceremony was led by Castro and Venezuelan President Hugo Chávez. Also reportedly attending were Prime Minister Baldwin Spencer of Antigua & Barbuda, Prime Minister Roosevelt Skerrit of Dominica, Prime Minister Keith Mitchell of Grenada, President Martín Torrijos of Panama, Prime Minister Denzil Douglas of St. Kitts & Nevis and Prime Minister Ralph Gonsalves of St. Vincent & the Grenadines as well as high-ranking government representatives of The Bahamas, Barbados, Belize, the Dominican Republic, Ecuador, Grenada, Guatemala, Guyana, Jamaica, St. Lucia, Suriname and Trinidad & Tobago.

Cooperation with the United States
In June 2000, a US Congressional Black Caucus (CBC) delegation visited Cuba to meet with Castro. Representative Bennie Thompson (D-Miss.) mentioned to Castro that his district had a shortage of doctors, who responded by offering full scholarships for US nationals from Mississippi at ELAM. Later that same June, in a Washington, D.C. meeting with the CBC, the Cuban Minister of Public Health expanded the offer to all districts represented by the CBC. At a September 2000 speech event at Riverside Church, New York City, Castro publicly announced a further expanded offer which was reported as allowing several hundred places at ELAM for medical students from low-income communities from any part of the USA. Reports of the size of this offer varied in the US press - 250 or 500 places were suggested with perhaps half reserved for African-Americans and half for Hispanics and Native Americans. The ELAM offer to US students was classified as a "cultural exchange" program by the US State Department in order to avoid the restrictions of the U.S. embargo against Cuba. The first intake of US students into ELAM occurred in the Spring of 2001, with 10 enrolling into the pre-medical program.

In 2004, the legality of the presence of US students at ELAM was threatened by tightened restrictions against travel to Cuba by US nationals under the administration of President George W. Bush. A CBC campaign led by Representatives Barbara Lee (D-Calif.) and Charles Rangel (D-NY) with 27 other members of Congress persuaded Secretary of State Colin Powell to exempt ELAM from the tightened restrictions.

Applications from US citizens are administered through the New York City-based Interreligious Foundation for Community Organization (IFCO), headed by the noted human rights activist and critic of the U.S. embargo of Cuba, the Rev. Lucius Walker Jr.

Collaboration with Venezuela
In August 2005, Venezuelan President Hugo Chávez and Castro negotiated a healthcare agreement with Castro at a summit in Sandino which included the building of an ELAM equivalent in Venezuela. The agreement was part of the trade and cooperation alliance between Cuba and Venezuela known as Alternativa Bolivariana para las Américas (ALBA). Attending ELAM's first graduation ceremony in the same month, Chávez publicly announced the plan and claimed that 100,000 doctors could be trained through the Cuban and Venezuelan ELAMs over 10 years - or even 200,000 if other Latin American countries joined the collaboration. A Medical Education Cooperation With Cuba (MEDICC) report on the announcement valued the projected 100,000 trained doctors as potentially a US$20 to 30 billion contribution to the developing world and suggested that 30% of the places would be reserved for low-income applicants from Latin America and the Caribbean.