Cuba is a small middle-income Caribbean country with excellent public services, notably in education and health. Both health and education are free and universal for all inhabitants. Free education has resulted in Cuba having one of the highest number of medical doctors per head of population (84.8 per 10 000).1 Despite having a large number of doctors, Cuba is training over 60000 medical students, with 8–10 000 students anticipating graduating each year.1 This includes the 8000 overseas students training at the Latin American School of Medicine. Universal healthcare and an excellent primary healthcare system have ensured that health indices are excellent in Cuba, comparable with high-income countries. For example, child mortality is lower in Cuba than in the USA.2 It is also lower than in all other countries in Latin America and the Caribbean.