You mentioned earlier that "the capital to start" was part of what made being a taxi driver in Cuba "hard".

$600,000 certainly sounds like rather a lot of capital in 2010. Are you now saying that acquiring that capital isn't hard, so only knowing who to bribe is the hard part?

> Seems medical degrees from Cuba are recognized almost nowhere in the world

I ... don't know what that means. If a Cuban MD visit the US, they aren't referred to as doctor?!

Or do you mean they can't practice as an MD in US without some sort of re-qualification?

In the US, a doctor can't move to another state and immediately start working as a doctor (though many states are members of a compact, which simplifies those transfers). As a check, I see https://medicalcredentialing.org/help-applying-medical-licen... says "Discussing options with the licensure board if an applicant’s application is deficient in some way (ex: a required course was not part of professional’s schooling)"

So I wouldn't be surprised that an MD moving countries wouldn't be recognized without some sort of re-qualification.

Or do you mean that the Cuban MD program is worthless, and students need to start from scratch if they, for example, want to be an MD in the US?

That's clearly not correct. In a parallel thread I linked to https://human-resources-health.biomedcentral.com/articles/10... . Table 1 lists things like

> Cape Verde had no medical school until 2015 and was dependent on international collaborations. Human resource secondary data were used to map the training of doctors. Cuba has trained almost half (189) of the doctors trained since 1975.

> "Medical students from Equatorial Guinea Bata Medical School are taught by Cuban academics and go to Cuba to take their sixth academic year and graduate. So far, 208 doctors have graduated from the Bata school."

and says "US citizens trained in Cuba have demonstrated success in examinations to work in the US health system". The citations include http://mediccreview.org/latin-american-medical-school-class-... , which has numbers:

> A decade after the first US graduate received his diploma from ELAM, 113 have followed. While most (especially recent) grads are still finishing their USMLE exams, 40% of the total are already in residencies or have completed them: of these, 90% have chosen to practice in three main primary care specialties—family medicine (61%), internal medicine (23%) and pediatrics (6%). Of US graduates already practicing, 65% work in Health Professional Shortage Areas (HPSAs) and/or Medically Underserved Areas (MUAs). The success of these doctors also helps destigmatize the Cuban program; US foreign medical graduates are often viewed as substandard, the assumption being that they studied abroad because they couldn’t get accepted anywhere else. But often, as in the case of ELAM-trained doctors, US medical education poses a financial, not intellectual, barrier to their training.

So, the US appears to recognize medical degrees from Cuba like it recognizes degrees from other countries.

To be absolutely clear, that first paper describes how Cuban-trained students "are perceived to have inadequate skills", while also pointing out "RSA’s long heritage of British medical education traditions and academic excellence, selection of the brightest students and its strong emphasis on specialisation have not helped in developing primary health care."

Doctors who have been trained in hospital and speciality services might indeed consider someone trained in primary care for the poor and disadvantaged as being under-trained. But if you need MDs for primary care for the poor and disadvantage then perhaps specialist training is the wrong thing.