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Natural and Traditional Medicine in Cuba: Lessons For U.S. Medical Education

Appelbaum, Diane RN, FNP, MS; Kligler, Benjamin MD, MPH; Barrett, Bruce MD, PhD; Frenkel, Moshe MD; Guerrera, Mary P. MD; Kondwani, Kofi A. PhD; Lee, Bennett B. MD, MPH; Tattelman, Ellen MD

doi: 10.1097/01.ACM.0000246681.34207.a7
International Medical Education

The Institute of Medicine's (IOM's) Academy of Science has recommended that medical schools incorporate information on CAM (complementary and alternative medicine) into required medical school curricula so that graduates will be able to competently advise their patients in the use of CAM. The report states a need to study models of systems that integrate CAM and allopathic medicine. The authors present Cuba's health care system as one such model and describe how CAM (or natural and traditional medicine) is integrated into all levels of clinical care and medical education in Cuba. The authors examine the Cuban medical school curriculum in which students, residents, and practicing physicians are oriented in the two paradigms of CAM and allopathic medicine. Only health professionals are permitted to practice CAM in Cuba; therefore, Cuba's medical education curriculum incorporates not only teaching about CAM, but it also teaches basic CAM approaches and clinical skills. Both the theory and practice of CAM are integrated into courses throughout the six-year curriculum. Similarities and differences between the U.S. and Cuban approaches to CAM are examined, including issues of access and cost, and levels of acceptance by the medical profession and by the public at large in both countries. The authors conclude that there is potentially much to learn from the Cuban experience to inform U.S. medical educators and institutions in their endeavors to comply with the IOM recommendations and to incorporate CAM into medical school curricula.

Ms. Appelbaum is a certified nurse practitioner, adjunct faculty at Emory University Nell Hodgson Woodruff School of Nursing and the U.S. Director of Medical Education Cooperation with Cuba in Atlanta, Georgia.

Dr. Kligler is associate professor, Department of Family Medicine at Albert Einstein College of Medicine, and co-director of Fellowship Programs at the Beth Israel Center for Health and Healing in New York, New York.

Dr. Barrett is a family physician, anthropologist, and associate professor in the Department of Family Medicine at the University of Wisconsin Medical School, Madison, Wisconsin.

Dr. Frenkel is associate professor in family medicine in the University of Texas Medical Branch, and a key contributor to the UTMB CAM Project (An NIH R25 Grant) in Galveston, Texas.

Dr. Guerrera is associate professor in the Department of Family Medicine at the University of Connecticut School of Medicine and serves as the principal investigator for a Complementary and Alternative Medicine (EDCAM) project grant in Hartford, Connecticut.

Dr. Kondwani is assistant professor at Morehouse School of Medicine, Departments of Community Health and Preventive Medicine and Family Medicine, and course director for the Introduction to Complementary and Alternative Medicine elective in Atlanta, Georgia.

Dr. Lee is assistant professor of medicine, Division of General Medicine; Emory University School of Medicine in Atlanta, Georgia.

Dr. Tattelman is assistant professor of Family and Social Medicine at Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, and director of the Health in Medicine Project at the Residency Program in Social Medicine, Montefiore Medical Center, Bronx, New York.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Kligler, Beth Israel Center for Health and Healing, 245 Fifth Avenue, second floor, New York, NY 10016; telephone: (646) 935-2251; fax: (646) 935-2273; e-mail: (

© 2006 Association of American Medical Colleges