Medical Education in the United States: A Resource for the Third World?

Prologue: The Reagan administrations foreign policy inclines toward strong economic and military intervention in the affairs of other countries where such steps are perceived as important to the interests of the United States. Social assistance is viewed as less important in implementing the presidents foreign policy design. Such a policy, says Donald Nutter, is shortsighted because it neglects the value of America s medical preeminence, as recognized throughout the world. Nutter is a professor of medicine and executive associate dean at the Emory University School of Medicine. During the year 1978-1979, Nutter worked for then Senator Richard Schweiker (R-Pa.) as a Robert Wood Johnson Foundation health policy fellow. During his time on Capitol Hill, Nutter was struck by how little attention is paid to the importance of medical care and its delivery as a tool of foreign policy. Organized as it is along categorical lines, health and foreign policy rarely intersect in congressional committees, where most of the legislative work gets done. In the executive branch, the international health office of the Department of Health and Human Services is a tiny outpost. Nor is health an area of emphasis at the State Department. For many years, religious organizations have sent medical missionaries to developing countries. More recently, foreign medical graduates have been training in the United States, but they have often failed to return to the developing countries which invested in their education. The United States seems headed for a period of having more trained physicians than it can afford as well as a greater capacity to educate medical students than it needs. Why not, Nutter asks, marry the critical need that developing countries have for training doctors with Americas abundant capacity to train such professionals? The consequence, he suggests, would add a dimension to Americas foreign policy and alleviate, in part, the intensifying concern over a physician surplus in the United States.