The Cuban doctor Alexander Jesús Figueredo Izaguirre, residing in Houston, Texas, urged President Donald Trump and Secretary of State Marco Rubio on Friday to utilize the expertise of health professionals exiled in the United States to develop the new medical recruitment program announced for the Caribbean.
In an open letter published on Facebook, the physician celebrated the U.S. initiative of $61.5 million aimed at promoting the direct hiring of healthcare workers, but warned that there is an opportunity that Washington should not overlook: the Cuban doctors who already live in U.S. territory and have been unable to practice their profession again.
"The doctors are already here. We just need to be allowed to practice medicine," wrote Figueredo, who proposed that Caribbean governments could hire these professionals directly, with full salaries, transparent contracts, and without the involvement of Cuban authorities.
His statement provoked numerous reactions. Although he received messages of support and testimonies from professionals working in fields unrelated to his training, it also generated criticism regarding the necessity of validating medical degrees in the United States, political questioning, and even personal attacks.
"Where are they going to find those doctors?"
Figueredo's letter responds to the announcement of a U.S. program of 61.5 million dollars to aid Caribbean countries in directly hiring healthcare personnel, without the salaries going through state intermediaries.
The initiative, called ASPIRE (Strategic Alliance of the Americas for Independent Regional Health Excellence), was presented during the dialogue between the United States and Caribbean countries held in Washington.
The program aims to promote more autonomous regional health systems through transparent hiring practices and direct payments to workers.
Its funding still requires approval from the U.S. Congress, so the announced funds should not be considered disbursed.
Figueredo's proposal starts from a question directed at Trump and Rubio: "Where are you going to find those doctors?"
The doctor argues that part of the answer may be found among the Cuban professionals who emigrated to the United States after working for years in hospitals and international medical missions.
"Because here, in the United States, we are already here. We are thousands of Cuban doctors who crossed jungles and borders fleeing from the same regime that you want to take the business away from," he stated.
Figueredo described a reality that, according to his testimony, affects many colleagues: professionals with clinical experience who are currently working as cleaners, delivering packages, managing parking lots, or holding other jobs.
"I take my blood pressure at a clinic in Texas. In Cuba, I used to sign for the treatment. That is the real photo of the Cuban doctor in exile," he expressed.
The physician clarified that he does not intend to obtain a U.S. medical license through the letter.
His request is for the beneficiary countries of the program to be able to hire Cuban professionals residing in the United States, according to the conditions and requirements set by the relevant authorities.
"I'm not asking for a personal favor. I don't have a license in this country, and I'm not requesting one through this letter. I'm asking you not to leave the program half-finished: money without doctors can't heal anyone," he insisted.
An alternative to the medical missions controlled by Havana
Figueredo claims to have participated in Cuban medical missions and stated that direct hiring would allow professionals to receive their full salaries and work without the restrictions he criticizes in the system managed by the Government of Cuba.
"Let the Caribbean hire free doctors directly, with their full salary in their pocket, with a transparent contract and your supervision. No intermediaries in Havana. No 70% withholding. No passports kept in a drawer. No fear," he wrote.
The doctor stated that Caribbean countries could benefit from the experience of professionals who are already familiar with the region and its healthcare needs, but this time through individual labor agreements.
He also stated that this model would allow for a reduction in the revenue that the Cuban government generates from international medical services agreements.
The conditions of Cuban medical missions have been the subject of complaints from former participants and human rights organizations.
The 2024 Trafficking in Persons Report from the State Department documented coercive practices, restrictions on mobility, and wage withholding in Cuban worker export programs.
Havana, for its part, has rejected the accusations of exploitation and presents its medical brigades as international cooperation programs.
In September, U.S. officials heard the testimony of a former member of a Cuban medical mission and reiterated their opposition to agreements that, according to Washington, allow the Cuban state to profit economically from the work of healthcare professionals.
"Get to studying and validate your degree": the criticism of the proposal
Figueredo's post opened a debate about the real possibilities of Cuban-trained doctors returning to practice after emigrating.
Among the most critical reactions, several users recalled that the United States requires compliance with accreditation and licensing requirements to practice medicine, regardless of the country where the studies were completed.
"You must validate your medical degree as required by the country's law; all countries demand the same before you can practice medicine legally," wrote a commentator.
Another was more decisive and questioned the usefulness of sending letters to Washington: "Instead of wasting time writing useless letters that no one will ever read [...], focus on studying and validating your medical degree as many Cuban doctors have done since 1959 while also cleaning floors, washing dishes, and working at whatever jobs they could find."
The criticism raises an important distinction: having a medical degree issued in Cuba does not automatically authorize one to practice as a doctor in the United States.
Professionals trained abroad must fulfill certification, evaluation, and clinical training procedures, in addition to the licensing requirements of the state where they intend to work.
However, Figueredo's proposal does not call for the elimination of those U.S. requirements. His stance is that Caribbean countries should be able to hire exiled Cuban professionals through direct agreements and under the applicable regulations in the destination countries.
Another reaction suggested precisely that alternative: "Why don't you write to the Health Secretary of a Caribbean country and offer your resume? They might consider it."
There were also those who pointed out that the revalidation process can be difficult and costly, but not impossible. One commentator recalled that many foreign doctors have managed to complete the process after years of study and sacrifice.
The criticisms were not limited to professional requirements. Some comments questioned Washington's motivations and the role of Cuban doctors in the political conflict between the two countries.
"The problem is not the well-being of doctors; the problem is harming the Cuban government," stated a user.
Another claimed that the U.S. initiative fundamentally serves political objectives: “They are not interested in Cuban doctors; it is more of a political issue than a social one.”
A third reaction expressed doubts about the guarantees that professionals hired through the new program would receive and questioned the trust placed in the Trump administration.
Other messages were directly hostile towards Figueredo for having emigrated and criticized the Cuban regime.
“Keep cleaning floors. Didn’t you want the north? Well, tough luck,” wrote one of the participants.
Another described him as a "traitor" and criticized him for having studied medicine in Cuba before leaving for the United States.
In response to one of the attacks, focused on his writing style, the doctor said:
"Look, my friend: what matters is not my writing, but the idea. There are thousands of doctors trained in Cuba doing other jobs in this country. Spelling doesn’t heal patients; doctors do. Have a good day."
In another response, Figueredo defended his career and rejected the notion that his academic background compels him to support the Cuban government.
"I trained in Cuba and served on missions. I left on my own accord and here I work humbly. If you have arguments against the proposal, I'm listening," he stated.
Doctors, caregivers, and workers from other sectors: the testimonies
In response to the criticism, numerous users shared personal or family experiences that support the concerns expressed by Figueredo.
A woman reported that her daughter is a Cuban doctor who is currently taking care of patients in the United States, but she is not practicing as a doctor.
Another person claimed to know a doctor who makes a living doing maintenance work in homes, while a commentator mentioned that a Cuban professional in their circle works delivering for a restaurant.
“My specialist niece works as a shelf stocker at a Walmart,” another user pointed out.
A doctor also participated, claiming to have more than 30 years of experience and having worked for nine years on a mission in Venezuela before emigrating.
"Yes, I know one: myself," he wrote in response to Figueredo's question about Cuban professionals who are currently doing other jobs.
A woman described an especially long journey: she claimed that she has been in the United States for 12 years, invested thousands of dollars in certifications and additional studies, but has not found the job opportunities she expected in the healthcare sector.
"I fought a lot until I got tired," she expressed, after explaining that she ended up working as a caregiver and in other jobs.
Among the comments, there were also individuals who defended the right of resident doctors in Cuba to receive better working conditions, as well as those who questioned whether the exiled professionals would necessarily be willing to relocate to remote areas of the Caribbean, where Cuban brigades have provided services for decades.
The problem of Cuban doctors who cannot practice in the United States
The difficulties in returning to the medical profession in the United States are not new.
In May 2026, more than 300 Cuban doctors were identified in a state of migratory uncertainty that hindered their access to employment and professional advancement, according to a report by Telemundo 51.
The group was part of a network of approximately 1,500 foreign doctors who had organized to address the recertification requirements and other barriers to practicing in the United States.
Some had entered through immigration mechanisms such as humanitarian parole, CBP One, or I-220A documents, and were facing additional difficulties related to their legal status.
In July 2024, another Cuban doctor publicly requested a job opportunity in the U.S. healthcare sector, despite having professional experience and a credential as a medical assistant.
Figueredo himself has previously shared his adaptation process in the United States.
In September 2022, shortly after emigrating, he reported that he had earned 200 dollars doing a move while preparing to work in the healthcare sector.
Months later, he shared his first professional advancements in Houston and his intention to continue studying in order to practice Medicine.
In March 2025, he publicly addressed his situation in the United States again, where he was working at a clinic and was continuing to prepare to validate his qualifications.
The new agenda revisits that concern but transforms it into a proposal directed at Washington: to leverage the experience of exiled Cuban doctors to address the healthcare needs of the Caribbean through direct contracts.
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