America symbolizes a fresh start for many immigrants, but for medical professionals, the message isn’t as positive.
It’s an early morning at Advance Care, an adult day care in Cape Coral, Florida. Ania Rodriguez, who owns and runs the place, greets an arriving client with a cry of “Mamito!”
Holding the woman’s face in both hands, she kisses her on each cheek, then takes a seat at the dominoes board with two older women clients. Her bright red manicure flashes as she mixes up tiles for a game.
Rodriguez started her career caring for people as a surgeon in 1991 in Matanzas, Cuba, 30 miles dead east of Havana.
She explains how she felt about her career: “In my case, I really like it. Because the compensation in Cuba for doctors is nothing. So the people who want to be a doctor, at least in Cuba, is because they like it.”
Although she loved her work and the prestige of being a respected surgeon, she found the political environment in Cuba untenable.
“I didn’t have the choice to be free,” she says. “There was no freedom. Now I can say anything I want to say.”
In 1999, Rodriguez won a visa lottery to relocate permanently to the United States. Her plan was to join her longtime boyfriend Michel—who’d come to Florida eight months before—and find work as a surgeon. But her dreams hit a stumbling block.
Regardless of the amount of experience they have in the nation they immigrated from, to work as a doctor, foreign medical graduates must show proof of graduation from a U.S.-approved medical school, pass a three-part licensing exam, and complete a minimum three-year graduate medical training known as a residency. The same is required of all U.S. grads.
Rodriguez says she passed the first of those exams, but then got bogged down in what she found to be a daunting and confusing process. To compound matters, by that time, she had had a baby, and was working to put food on the table in a new country. All in all, Rodriguez says, it was just too much, so she stopped pursuing the license.
Leonel Cordova, a Cuban-born pediatrician and emergency medicine doctor practicing in Miami, did manage to pass the boards and get licensed.
“Since I was 12 years old, I realized that that way of life—the Communist government—I didn’t want to live that way,” he says.
Cordova and his wife, a dentist, came to the U.S. in 2000 after being granted political asylum. Back then, he saw firsthand how many of his fellow Cuban doctors struggled to recertify, so he and some colleagues arranged an informational meeting for them. They expected about 200 people—2,000 showed up. He remembers having to close the doors against the crowds.
“There were a lot of people outside, all of them Cuban physicians that had absolutely nothing to do at this moment with the medical field,” he says. “They were willing to do whatever it takes. That was really a shame.”
Cordova does not want to see Cuban doctors get special treatment. He believes everyone should meet the same standards, but part of him can’t help but think a compromise may be a good idea.
“I think we are missing a lot of opportunity with the Cuban physicians,” he says. “They should have a different status and be able to work like the nurse practitioners and physician’s assistants. Because those are really people who know what they are doing.”
A troubling policy
The pipeline of doctors arriving from Cuba each year has only increased since 2006. That’s the year the U.S. Departments of State and Homeland Security implemented the Cuban Medical Professional Parole Program. It allows Cuban medical personnel who are working internationally to be fast-tracked for US citizenship.
Not only does the CMPPP serve as a brain drain on the Cuban economy, it’s also a black eye to a nation that prides itself on its doctors. To date, more than 7,000 healthcare professionals have been approved since the program’s inception.
John Kirk, professor of Latin American Studies at Dalhousie University in Halifax, Nova Scotia, and author of Healthcare Without Borders: Understanding Medical Internationalism, is not a fan of the program.
“In many ways, it’s a con trick,” he says. “First of all, to embarrass the Cuban government and secondly to get medical personnel to come to the U.S., but there’s very little infrastructure to help the doctors, nurses and technicians, once they get there.”
Statistics show how difficult it can be for many foreign medical graduates to meet the U.S. requirements to practice medicine. About 94 percent of U.S. medical school grads were placed in residencies in 2015. But the total percentage of graduates of overseas medical schools placed in U.S. residencies hovers just around 50 percent.
And those the program brings to the U.S. may have an even higher hurdle. Not only is there a language gap, but Cuba watchers say since the fall of the Soviet Union in 1991, the island’s textbooks and medical techniques have not been updated.
Meanwhile, back at Advance Care, former surgeon Ania Rodriguez is busy growing her successful enterprise and making a good living for her family in another facet of the healthcare industry. She employs about 38 people and has plans to expand soon.
“I have money in my pocket because I am working,” Rodriguez says. “For me, I don’t know for the rest of the people, but for me, I am in the best country in the world.”
But even with all this, she hasn’t given up her dream to get back into the operating room someday.
“I need to have the knife in my hand doing surgery to be really happy,” she says.