- Politics and Social Issues
Mexican Doctors Have to Serve the Community Before Becoming Fully Qualified
Mexico's Doctors and Nurses: Pride and Compassion
Not All Doctors Get a License to Steal
Becoming a doctor in Mexico is a vastly different journey than that of his peers in the USA and the UK. It often appears in North America that receiving a medical degree is like being given a license to steal. And with doctor’s salaries doubling in the last couple of years in Britain, UK doctors here are being tarred with the same brush. We can trace much of this largess back to the insurance companies who are charging draconian amounts for malpractice insurance, (and thence our beloved super-crooks, the banks), and the courts, especially in the US, which are awarding huge settlements. Nor can we forget the lawyers who are like bloated ticks engorging themselves on the purses of the afflicted or their insurers. But none of this is the subject of this hub article.
The route to becoming a qualified GP or specialist is a lot different - and in my mind, superior - “south of the border.”
In Mexico, it takes just as much study and work as it does anywhere else and there’s a lot less guarantee you’ll instantly find a position. Also, there’s not oodles of money around and no NHS with its bottomless pockets to throw money at doctors, hospitals and clinics.
In the United States, a high school graduate goes on to four years college, after which he attends another four years medical school followed by one year as an intern.
In the UK, the situation is more blurred as the student needs good high school or baccalaureate grades; goes on to a university which offers a medical course, then progresses through a system taking from 5 to 9 years to become fully qualified.
In Mexico, the prospective doctor takes classes geared towards the medical profession as early as in prep- school - the 10th through the 12th grade. From there, he or she goes directly into Medical College at the age of 18. As in the USA, the apprentice then completes four years studies and one year of internship. But then his journey differs considerably from the sleekly groomed and haughty fat cats in the US and the UK.
Aspiring doctors in Mexico are then required to go and live in an often remote village without a doctor, in the rural sector of Mexico. There, the budding doctor must complete a minimum of one year, after which he takes his final medical exams with the wealth of experience gained in general medicine among the rural poor. He becomes a fully-fledged doctor, arguably better qualified to meet the myriad problems of the sick, than his US and UK counterpart. If he decides to specialize at this juncture, he faces another four years training in areas, such as surgery and his elected specialization. About 35% of aspiring specialists fail their board exams the first time around. Although the education is essentially free, it’s a long haul unless some help is available from families, which does mean many that specialize come from the wealthier sector of the community.
It’s interesting to note that not a few doctors who have become almost an institution in the rural villages over their year’s service, take their exams and return to the village with their family to practice, as even after becoming fully qualified, there is no guarantee of work back home. About 50% of young doctors accept a position in the country’s vast IMSS (Social Security Department). There, they make around $2,500 US per month (about £1500) - about the same as a top executive secretary in Mexico - less than the average wage in the UK! And a fraction of the nurses salaries in the USA . The result of this is that more doctors in Mexico are in the field because they are dedicated professionals; moved far more by the desire to serve their fellows than the dictates of Mammon.
It amuses me how many Gringos and Brits (if there is a distinction) tout their own system and condemn that of Mexico without really knowing anything about it.
First of all, the British NHS may be the one of the best systems of socialized medicine in the world, but like a star facing super-nova, it seems about to implode by sheer size and bureaucratic inefficiency, as well as the inability to afford to chuck more billions at it (all that has kept it going for the last 5 years).
America’s situation is even worse, with only the rich being able to afford decent health maintenance; the poor to obtain free care, and the middle-classes (as ever) being squashed by the huge financial burden.
Meanwhile, Mexico does a lot better than muddle-on. I have never seen a patient being turned away from a IMSS clinic or hospital regardless of their ability to pay. There is a yearly fee to use the health service there, but it is affordable by just about anyone. For about 10,000 pesos or less per year, a family can have State medical insurance, which covers them for anything except dentistry (which, basically, is very cheap anyway…lots of dentists; few fee-paying clients - and it is subsidized). This is less that $1000 dollars US a year (go on then, about £500 give or take UK money). That’s for full coverage, folks; how much does your private plan cost you in the States?
The doctors and nurses here are unfailingly courteous, professional and, above all, compassionate. Yes, there are long lines in the city hospitals and you may have to wait an hour or more. But when you get to see the doc, you don’t feel he has an internal stop-watch running as you do in the target-oriented UK; and neither will you be getting a bill that strains the upper limit on your Gold Amex, either.
Doctors reaching GP status in Mexico and deciding to hang out their shingle and go it alone will have to adopt the “what the traffic will bear” philosophy regarding their charges. His alternative, a-la-UK-dentists, is to only treat the well-heeled, or, as many do, to have many irons in the fire including a spot in the IMSS a few times a week, consultancies in other private practices or clinics as well as the one in his own surgery. Mexican doctors work very hard for little financial reward, compared to their peers in the First World. But they may well sleep better at night
Barry Coffman, youngest son of Mexican, Liz Coffman and her North American husband, Nelson Coffman, was just six years old when he awoke one day with a headache and a slight temperature. Liz kept him back from school and gave him a small aspirin and put him back to bed. Some hours later, she noticed he was very flushed and when she took his temperature she was alarmed to see it was 102 F. The doctor was called (they make house calls in “backward” Mexico), as soon as he examined Barry, he called an ambulance right away as his temperature was then 104F and the child was fractious and becoming delirious.
He was checked into a private room at the IMSS hospital in Cuernavaca where he was soon diagnosed with meningitis and what was to be a 3-week battle for Barry’s life began.
The disease was the viral type, which is very hard to treat and the doctors sought to find an anti-viral that would stop the infection. Meanwhile, Barry slipped into a coma and things looked grim. A cot bed was provided for one of the parents who were with their son 24/7 as he slipped in and out of a coma and his condition worsened. The whole ward became interested in the little “Guerro” (blondie); the Mexican nurses were in constant attendance, providing anything the parents or doctors called for. The doctors called about every hour to see the results of the latest series of drugs. Bit by bit, the battle against this awful disease was won and Barry’s temperature went down. But his temperature had been so high for so long - was there any brain damage?
The truth is that today Barry is a husky young man of 19, he is good at sports and has done well at college. There is some loss of mental function which manifests itself in a shyness and a slight slowness, which only adds to the charm of this young man, who owes his life to the devotion, compassion and care of the Mexican Social Security System.
For all the attention, the bill came to…zero. It was included in the family membership Nelson paid of about $400 dollars per year for the four of them, (back then, it’s not a lot more today).
I know all this to be a fact because, as a close friend of the family, I was there, too, marvelling at these wonderful Mexicans who put people before money every time.