-DATE-
19870314
-YEAR-
1987
-DOCUMENT_TYPE-
SPEECH
-AUTHOR-
F. CASTRO
-HEADLINE-
MEDICAL SCIENCES INSTITUTE
-PLACE-
CAMAGUEY
-SOURCE-
HAVANA TV SVC
-REPORT_NBR-
FBIS
-REPORT_DATE-
19870316
-TEXT-
CASTRO SPEECH AT MEDICAL SCIENCES INSTITUTE

FL1141800 Havana Television Service in Spanish 0100 GMT 14 Mar 87

[Speech by President Fidel Castro at Higher Institute of Medical Sciences
in Camaguey, date not given -- recorded]

[Text] Commander in Chief Fidel Castro has toured installations in Florida
municipality of his third day in Camaguey Province. As part of his tour,
Fidel visited the Camaguey School of Medical Sciences, where he received a
report on the progress of that higher educational center, and the Carlos J
Finlay detachment. He also visited the main areas of the school. While
there, he spoke with a variety of students attending the Higher Institute
of Medical Sciences.

[Begin Castro recording] You know that there were 6,000 doctors in Cuba and
3,000 left. Many of them were not capable of going to the mountains or to
the country to render services. Three thousand doctors were left and our
health program began with these remaining doctors.

Throughout these years, there has been an effort...[change thought] I
remember that the Institute of Basic Sciences was organized in 1962 in
Giron. There was an effort to enroll as many people as possible in the
medical institute. There were not many; they were few. The number of people
with degrees were few. There was a time when it was necessary to divide the
students. Several studied technology, several studied medicine.

Nevertheless, we slowly began increasing the number of doctors and with the
efforts carried out through the years, especially over the last few years,
we now have 25,000 doctors but we will continue graduating almost 3,000
doctors a year. Each year we will graduate as many doctors as we had left
at the beginning of the revolution and in 1989 we will be graduating more a
year than were left at the beginning of the revolution. By 1990 we expect
to be graduating 4,000 medical students a year. The idea of the detachment
arose during that time, among the declaration of the idea [words
indistinct] a historian should gather his data more accurately. The idea of
the detachment was one of many measures and it was put into practice.

Thanks to the efforts developed by the revolution in the education field,
we are able to count on dozens of thousands of graduates with degrees each
year. We have advanced so much in that field that we have had nursing
students enroll with a ninth grade education, who are 15 or 16 years old.
There were little girls who went to nursing school with their dolls.
[laughter] They had to study and they were still playing with dolls. That
is an old problem but we have arrived at the privileged situation of
enrolling girls and boys with a 12th grade education in the nursing field.

Previously they studied for 2 years. Now they study for 3 years. They will
have... [changes thought] they will receive degrees, they will study for 3
years, they will be prepared for enrolling in courses to receive a higher
degree in the medical sciences and this will guarantee the quality of their
[?technical] personnel.

The idea of the detachment created other measures. They sent [words
indistinct] most-advanced medical professors in the world, best
universities, they gathered technical books and programs, and with all
this, we developed our new plan. This process has been adapted to first and
second year students but we now have a new program, which I understand is
excellent and includes much medical practice. It begins with exposure to
medicine and the polyclinics and it creates the ideal conditions for
training doctors.

Also, the detachment was... [changes thought] we had selected the
detachment. There was a rigorous selection process that has not had any
exceptions. It focused on the academic records, vocation, and
political-moral attitude of the youths because medicine is not just any
career. It requires much seriousness, dedication, and integrity, as well as
special moral conditions. A doctor is not working with things. He is
working with people, who trust him with their life and health, as well as
that of their families and that is why there is more emphasis on selecting,
on choosing students for this detachment than there is for other university
students.

The program of integral general medicine was developed. It is an excellent,
strong program. It was decided to combine the work of integral general
practitioners with a specialty. Thanks to them, all our future doctors will
be specialists. All of them. They will also have the considerations that
come with being a specialist, the salaries, incomes will reflect their
expertise. But something else in the future... [changes thought] we are
still training pediatricians, obstetricians, internists, and others. For
the interns, their direct residency... [changes thought] however, the
direct residency in the future will only be available for orthopedic
surgery, general surgery and other fields of specialization that require
manual dexterity. All other specialized fields will first have to be
specialists in integral general medicine.

For several more years, the students will have to be interns. In the
future, when we have enough specialists in certain areas... [changes
thought] because we need them in the polyclinics. We need professors in the
family doctor field and we need them in the polyclinic now. After 1991 or
1992, when, many doctors have specialized in integral general medicine, the
future cardiologists, obstetricians, pediatricians, internists, and other
specialists will emerge as doctors with a second speciality. For example,
if they have two specialities, they will be in another category and their
income, of course, would appropriately reflect what they have done, even
though the compensation may not be much.

I imagine that a doctor, who works for 4 or 5 years and then becomes a
specialist, such as a pediatrician, will have a vast knowledge of all the
conditions of the citizenry. We see the actual individual at the hospital
but everything else about the individual is abstract. He is a citizen. No
one knows where he lives, how he lives, his family means, or his
profession, material conditions, or his environment, which greatly affects
a person's health. That knowledge is learned by the doctor in practicing
general medicine and in his studies, and I am sure that he will undoubtedly
be one of the many doctors who will have worked under circumstances that
-END-