A doctor in Cuba becomes a nurse in the United States

When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors.

One example includes doctors from Cuba. According to this story in The New York Times, “6,000 medical professionals, many of them physicians, have left Cuba in the last six years.” Cuban doctors, who often earn $25 per month, find it significantly more lucrative to practice as nurses in the United States. In one example cited in the article, a former Cuban doctor became a hospice nurse Stateside, earning “more than $100,000 a year, [sending] his two children to private schools and [vacationing] with his family in France and Spain.”

What a deal.

One a related note, international medical professionals make up a significant part of the United States health care workforce. 25 percent of American doctors are trained overseas, and furthermore, according to a spokesperson from the American Medical Association, “We rely very heavily on them because they take positions that are in underserved areas and go into primary care. Without them our country would be in dire straits, especially minority populations and the poor.”

Indeed, there is little doubt that the already overburdened American primary care workforce would collapse without the support from international medical graduates.

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  • Beck

    This is sad because it is proof positive our doctors are overpaid and it appears just another Corporation suffering from greed. If a Cuban doctor becomes a nurse here and makes enough for trips to France and private schools for his kids something is very wrong.

    • http://www.kevinmd.com Kevin

      According to the article, as a nurse, he is able to take trips/afford private schools etc., but your conclusion is that American doctors are overpaid?

      Kevin

  • John

    Beck: Regardless of his background, he met the qualifications to become a nurse in the USA. What is “very wrong” about a nurse making enough for trips to France and providing private schools for his/her kids?

  • Cospo

    @Beck – Highly trained advanced degree nurses with specific skills in certain circumstances have the opportunity to make such large amounts of money. Out of this must come not only the living expenses for themselves and their families but overhead for all professional licenses, equipment, continuing education, and way over-priced malpractice insurance and other fees in order to practice. It’s the same for physicians who have even more added overhead such as employees, office equipment, etc. etc. for which to pay. Other highly trained professionals make similar salaries : engineers, attorneys, architects, designers, etc. Why do some people pick on the professions dedicated to help them in matters pertaining to their very lives and quality thereof and begrudge them compensation for their services? Admittedly, there may be some physicians who give the appearance of priorities geared only toward “the good life” that is the envy of so many, but I can assure you they are very few compared to those who are truly devoted to their patients’ well-being. Yes, many of them make a good living in order to provide for the well-being also of their families. Why should they be begrudged? There are also many who actually bring home a lot less than you might think once they’ve covered all their overhead.

    @Kevin – I’ve known a RARE few of physicians in the U.S. who have become disgruntled/discouraged with the fractured system of healthcare. Some, not having enough time to spend on their patients along with all the other crap physicians are subjected to these days, have opted out of medicine and actually turned to nursing. Every one of these instances turned out to be a shock to me and to others of their friends. But in nearly every case they found greater job satisfaction with less of a hassle. I’ve had one physician tell me that had he more fully realized what medicine in this country often entails in the terms of administrative BS etc., he’d have become a plumber. *sigh* What a sad comment on the present sate of affairs.

  • http://askanmd.blogspot.com/ Doctor D

    It is sad that we are importing our primary doctors. The doctors that are supposed to have ties to communities and long-term relationships with patients end up being the ones with difficult accents and cultural barriers causing misunderstandings. We import doctors from countries that need them more than we do, because all the American med students want to grow up to be dermatologists. Sad!

  • anon

    Nurses with specialized skills and willing to work the tough shifts, nights, weekends, yeah, they can do quite well financially.

    More power to them.

    I would imagine anyone who made it through medical school anywhere, could be an excellent nurse with just a little orientation to whatever day-to-day idiosyncracies we have here, compared to where they came from.

    Also means, if that Cuban doc can do it, so could an American nurse.

    Doctor D – I agree. Last time I checked, the biggest determinant of getting doctors to practice in rural areas is, training in the same rural areas, and most important, being from that area in the first place.

  • Mary

    I ‘ve worked as a hospice nurse in many capacities for many years. The CEO of the program does not come close to making 100,000 year, never mind a nurse.

  • andrew

    I’m glad that IMGs help out with the physician shortage in this country, but I’m sure that they lead to shortages in their home countries. This brain drain of physicians leaving this homes to come here and become doctors or nurses isn’t a long term solution.

  • http://groups.yahoo.com/group/CubaNews/ Walter Lippmann

    US law gives Cubans advantages which no one else from any other country on earth gets. Under the Cuban Adjustment Act, for one example, any Cuban from anywhere on earth who manages to set foot on US soil is guaranteed to be able to stay.

    Others who are not from Cuba and who come without permission are deported, but Cubans all get to stay. Why? To help de-stabilize Cuba and encourage their talented and well-trained people to leave the island.

    Did you know that the United States government even has a special program to encourage Cuban doctors to defect and come to the United States?

    Here’s the US document encouraging this:
    http://www.uscis.gov/files/pressrelease/CubanMedPrf091906.pdf

  • Reality Rounds

    Maybe I am just an oversensitive nurse, but it rubs me the wrong way when a NYT article profiles these poor Cuban doctors who come to the US only to become “factory workers, gas attendants, or……..nurses.” Thanks for lumping my profession in with shift workers, no offense to shift workers. I hate the whole feel of “settling to become a nurse” like somehow we are second best.
    http://realityrounds.com/2009/08/05/im-good-enough-smart-enough-and-doggone-it-people-like-me/

  • http://tarl.net/tarl Tarl Neustaedter

    Be aware – a medical degree outside the U.S. is a good deal less painful and expensive to obtain. Medical degrees in most of the world (in particular Latin America) are an undergraduate degree. I recall in Mexico it was not uncommon for doctors to start practice in their early 20′s.

    Whether that makes them more or less effective, I won’t comment, but it’s certainly one reason why other countries have less trouble finding people to be primary care physicians.

  • Doc99

    @Kevin
    The influx of so many FMG’s to shore up an overburdened healthcare infrastructure is more than a little unsettling. The UK ‘s recent travails, eg Glasgow, should be a wake-up call.

  • LastoftheZucchiniFlowers

    First – IF the Cuban docs wish to practice medicine here – they should do what all FMGs who wish to practice here do. Take AND PASS the FMG examsIf I am not mistaken – India’s medical training begins immediately after high school. There is no undergraduate ‘college’ as we know it here which explains the extreme youth of so many East Asian physicians. I have known many and each one was intellectually sound with fierce clinical funds. They’ve been young, and highly focused on their work and caring for their families. How is this a bad thing? They might be insular, but who wants to deal with indictments of cultural inadequacy and heavy accents. What a bunch of phonies we have become in the US. When it comes to OUR medical care. I believe that we’ve become frankly schizophrenic in our assessments: if it is OUR personal care or that of OUR families we expect AND DEMAND million dollar w/u (whether medically indicated or not). In addition but we want the most famous (and booked 1 year out ) surgeon in the state to do our elective surgery ON OUR schedule! If we don’t get everything we want – we fly into a fit of pique. And God forbid if we are assigned to a ‘foreign’ doctor by our crappy insurance plans (which emerged from our incessant whining about the older, fee for service policies our parents had). I admire most of the FMGs. They must take and pass the rigors of the FMG exams and those are in English, not their native language. They’ve learned another language and yes, have accents. So what? My position has always been that anyone speaking English with an accent is fluent in one more language than I AM. . Then we begin to trash physicians with whose cultural gaps disturb us. GROW UP! It’s ridiculous how physicians are expected to be our parents, guardians, counselors, hand-holders and simpatico enablers of crappy constitutional habits ALL IN A 15 MINUTE ‘encounter’ whose ‘quota’ go up every quarter as though we’re selling widgets!!!! It’s all about us and the sky’s the limit – But let another person from another culture sit next to us in the ER or Dr’s office and right away we want to talk cost containment. Please. Ladies and Gentlemen – you CANNOT have it both ways.

    PS – I would like to know WHERE that Cuban doc practices ‘nursing’ and how many of that $100/year consists of overtime and shift differential??? Something stinks about his story………..I know many fabulous clinican nurses and all are UNDERPAID for the work they do. Is this Cuban doc working as a CRNP? That would be the only way his salary makes sense.

  • James R Piotrowski , PA-C,MS

    dear Kevin:
    I sat on the FL BOM PA Committee when the state of Florida gave Cuban doctors the opportunity to be come Physician Assistants . I personally interviewed 2000 of the applicants . They all had a great story of escape from Cuba but their education and training were substandard by our standards. Therefore the Cuban state held their diplomas most of these individuals really could not prove who they were, an MD vs a Mechanic.
    The various colleges in Miami have opened their doors to for those to change their educational status as this physician has changed to be a hospice nurse his training as a physician will make him one of the best is nurses in hospice care
    But of the large numbers of FMG’s who remain unlicensed Is still a problem.

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