THE PREEMINENCE OF PRIMARY-CARE WITHIN CUBAN PREDOCTORAL MEDICAL-EDUCATION

As a result of a massive public health system and state-of-the-art tertiary medical care services, Cuba's health profile now indicates a high incidence of chronic noncommunicable diseases; Cuban health authorities concluded that this required a community-based primary care solution. In the early 1980s the Ministry of Health (MINSAP) implemented a national family medicine program with the goal of providing one ''Medico de la Familia'' (family physician) for every 700 persons. To attain and ensure the sustainability of this primary care model, MINSAP reformed the medical education curriculum. The reform strategies created a primary care ''specialty'' and provided a broad-based interdisciplinary approach to primary care training. The reforms place primary care in a prominent position within the predoctoral medical education curriculum. Cuba's approach is an innovation for a country that attained impressive medical advances through a specialized high-technology medical system.