The transitional experiences of South African medical students returning from Cuba

Abstract

The opportunity of studying abroad has many benefits related to long-term career and personal growth. A few months ago, South African medical students who were on the Nelson Mandela Fidel Castro Medical Collaboration (NMFCMC) programme returned home to complete their qualification at local medical institutions for eighteen months. The overall aim of the programme is to alleviate the critical shortage of the medical workforce in the South African rural settings. As returnees, students find it difficult to adjust to South African clinical settings to complete their qualification. It is common for returnees to experience adjustment problems and potential identity crisis, and these affect their academic performance. Their failure to do well in this programme results in the prolongation of their training. Their challenges include adjusting to the academic and social context in South Africa, as they go through re-entry shock. In addition, students must unlearn Spanish as a language of instruction at the Cuban facilities. With little knowledge of the extent of the students’ prior academic experiences in Cuba, local academics often find it difficult to help students reintegrate. The literature explains how such students find it difficult to cope without adequate support for readjustment. Twenty-two medical students from three South African medical institutions participated in this study. This interpretive qualitative study was guided by Schlossberg transition theory, which is embedded in a virtual metaphor approach, allowing participants to take photographs and write narratives about themselves, and then take part in one-on-one interviews. This study was aimed at understanding how South African medical students experience and manage transition upon returning from Cuba, by answering the following four research questions: How do South African medical students perceive their experience in Cuba in relation to their re-entry process? What kind of challenges do South African medical students experience on their return from Cuba? What kind of support do South African medical students receive to enhance transition on their return from Cuba? What coping strategies do South African medical students adopt on their return from Cuba? The findings revealed that students are faced with transition challenges related to language, social and academic integration. Receiving local institutions are found to be ill-prepared for the students’ return. Students have double language-switching from English to Spanish and back to English. Students find it difficult to integrate socially and academically because of the treatment they receive from locally trained students and academic staff. There is consistency between the study findings and literature in that students receive insufficient support and hence struggle to cope and manage the transition. Based on the findings, the study recommends that institutions adopt facilitated collaborative learning between the locally trained students and Cuban trained students which will assist in the promotion of social development and lead to a better language and academic integration for the returning students. Other recommendations include pre-departure orientation for students and the inclusion of learning support materials from the medical institutions.