Wenyuan Zhou, a second-year medical student who is also earning a master’s degree in public health, planned and completed a unique summer internship that combines her passions for preventive medicine and global health: She traveled to Havana, Cuba, to discover how prevention is integrated into every aspect of the Cuban healthcare system.
For four weeks, Zhou received intensive one-on-one lectures from faculty members at Escuela Latinoamericana de Medicina (ELAM) — a major medical school in Cuba, largely free, that is dedicated to training physicians from around the world to practice in underserved areas. Her courses were focused on understanding Cuba’s national health care system, especially elements involving prevention and primary care.
Beyond the lectures, Zhou also shadowed physicians in family health clinics, interviewed healthcare professionals about their experiences, visited Cuban health institutes, and sat in on medical school classes dedicated to health promotion. Following her time at ELAM, she also completed a one-week internship at a local pediatric hospital.
Zhou, who spent a year teaching preschool in Guatemala before entering medical school, completed the internship as part of the field experience component of her master’s degree.
Read a Q&A with Wenyuan Zhou
Why did you decide to complete an internship in Cuba?
I had been interested in Cuba for a really long time. I had heard a lot of great things about its health system; it’s really focused on disease prevention and health promotion, and I’m very interested in that.
I also knew it had some challenges, because they don’t have access to a lot of advanced medicine and technology. And yet they’re still able to achieve great health results — with infant and maternal mortality rates similar to developed Western countries — and that really appealed to me.
As an undergrad, I was involved in the organization Global Brigades, and we saw a documentary about how Cuban doctors practice in some of the poorest areas of the world. Many of these doctors actually graduate from ELAM, so that’s how I became really interested in the school.
How did you organize the trip?
I knew we had a really great Center for Global Health here, so as soon as I started at Feinberg in August I made an appointment with Dan Young, the deputy director of the Center. I then cold emailed a bunch of faculty at ELAM asking about an internship, kept following up, and eventually heard back from the dean of the school. I was the first intern they had ever had at the school.
How did the Cuban healthcare system compare to the U.S.?
Many people think of Cuba as stuck in the past, but that’s not really true — it has its challenges in terms of availability of resources, but that’s not to say that it’s behind in terms of the practice of medicine.
Clinically, medicine is practiced very similarly in the two countries. The physical exam and the way you take a patient’s history are the same — but there are differences in what they focus on. For example, they care more about the social determinants of health, so they’ll ask about things like education level and home life. They also have to rely more on the physical and the history to diagnose, because there’s often a lack of resources, in terms of extra labs and imaging.
In April, I attended a Social Medicine Conference and one of the quotes from the speakers really stood out to me: “Every system is perfectly designed to get the results that it gets.” I really saw that in practice in Cuba.
The Cuban healthcare system is designed to get good results in prevention and in promotion of health — so those are the results that it gets. Whereas if you look at the American system, it’s not designed to focus on prevention, but rather treatment and in-patient care, and those are the results that we get.
What else did you take away from your experience?
I think in general, the more you learn about different perspectives and different ways of doing things, the better you become at what you do. Feinberg is one of the best medical schools in the country, and we have all these great resources, but it’s important to remember that there’s not necessarily only one way of doing things.
It also keeps me humble and reminds me that the physical and history will take you very far, and to not always rely on technology. Feinberg actually does a really good job of emphasizing that to us as well: The history and the physical should give you your diagnosis, and extra tests and imaging should only confirm that. But seeing that really in practice in Cuba was nice.
How else are you involved in global health on campus?
I’m on the Student Committee on Global Health. The committee is comprised of students from all four years, and we meet to discuss different projects and where we want to see global health go.
Right now, we’re focused on RefugeeOne, which is an organization that supports refugees, and we’re working to set up medical volunteering. We want to have medical students accompany refugees to their healthcare appointments to help them navigate the system and feel more comfortable.
What are your future plans for medical school and residency?
One of the reasons I liked Feinberg so much is because it has such a strong global health program. Every student has guaranteed funding for two trips — and I’m already thinking about where I want to go next.
I’d like to go to China, where I was born, to learn how medicine is practiced there. I’m also really interested in an organization called Partners in Health, an NGO that tries to build health systems in developing countries. With my Spanish skills, I think it would be most useful to go to one of their sites in Peru or Mexico.
I’m very interested in pediatrics and I’d like my future practice — wherever and whatever it ends up being — to focus on education, prevention, health promotion and reducing health disparities.
Even if I don’t necessarily live abroad, I want global health to be part of my career in the future. I want to work with underserved populations, so just in general, having an understanding of different cultures — and being able to communicate with a different patient population — is going to be really helpful going forward.
Zhou’s internship was funded through the Center for Global Health.