OPINION ARTICLE
Medical collaboration as symbolic capital in the comprehensive training process
La colaboración médica como capital simbólico en el proceso de formación integral
Hilda Peña Guerrero 1 
, Jorge Lino Balseiro 1
, Eneyda Secada
Cárdenas
1 
, Mileidys Alonso
Gómez 1*
1 University of Medical Sciences of Matanzas. Faculty of Medical Sciences of Matanzas “Dr. Juan Guiteras Gener”, Matanzas. Cuba.
* Corresponding author: mileidysag1@gmail.com
Received: 12/11/2025
Accepted: 30/01/2026
How to cite this article: Peña-Guerrero H; Lino-Balseiro J; Secada-Cárdenas E; Alonso-Gómez M. Medical collaboration as symbolic capital in the comprehensive training process. MedEst. [Internet]. 2026 [cited access date]; 6:e474. Available in: https://revmedest.sld.cu/index.php/medest/article/view/474
ABSTRACT
The medical university contributes to the formation of the human capital needed by society, a task made all the more significant by its responsibility for humanistic education. At the same time, neoliberal globalization leads to the dehumanization of the most human of professions; new forms of cultural domination lead to a dehistoricization that leaves societies without symbolic capital. International medical collaboration has a global impact and is recognized for its contributions to teaching, healthcare, and research. Therefore, it is valid to analyze international medical collaboration as symbolic capital in the training process of medical professionals. The authors use the term "symbolic capital" to describe the contribution of international medical collaboration to the successful training of healthcare professionals. Utilizing the wealth of accumulated experience should result in personnel committed to the Cuban social project and its management model, which includes international outreach. International medical collaboration as symbolic capital is linked to the training process and results in a competent, well-rounded professional.
Keywords: Training Process; International Medical Collaboration; Symbolic Capital; Historical Memory.
RESUMEN
La universidad de ciencias médicas contribuye a la formación del capital humano que se necesita para la sociedad, encargo que se hace más notable por su responsabilidad en la formación humanista. En paralelo, la globalización neoliberal conduce a deshumanizar a la más humana de las profesiones, las nuevas formas de dominación cultural conducen a la deshistorización que dejan a los pueblos sin capital simbólico. La colaboración médica internacional es de impacto mundial y acumula el reconocimiento de este en la docencia, la asistencia y la investigación. Por ello es válido analizar la colaboración médica internacional como capital simbólico en el proceso de formación de los profesionales de las ciencias médicas. Los autores utilizan el término de capital simbólico para describir la contribución de la colaboración médica internacional al éxito de la formación del profesional de la salud. Emplear el caudal de experiencias acumuladas debe dar como resultado un personal comprometido con el proyecto social cubano y su modelo de gestión que incluye la proyección internacional. La colaboración médica internacional como capital simbólico se vincula al proceso de formación y da como resultado un profesional integral competente.
Palabras claves: Proceso de Formación; Colaboración Médica Internacional; Capital Simbólico; Memoria Histórica.
Education is a determining factor in shaping national identity, constructing the social ideal, and developing the human capital that society requires. This mission acquires a singular dimension in Cuban Medical Sciences universities, given their explicit responsibility for the humanistic training of health professionals. In parallel, on a global scale, a neoliberal model of capitalist development predominates which, by its intrinsic logic, tends toward the dehumanization even of the most human of professions.
The commodification of all dimensions of life challenges the spirituality of individuals, while new forms of cultural domination affect subjectivities and lead to processes of de-historicization. This phenomenon deprives peoples of their symbolic capital and plunges them into an ethical and axiological crisis, emptying them of ideas, values, and meanings.
Cuban collaborators have been direct witnesses to the symbolic war waged against international medical collaboration, which seeks to stigmatize it as a form of slavery or present it under a commodified image intended to mold subjectivities. This latter strategy acts as a façade to conquer popular imaginations and dethrone hard-earned prestige. Against this narrative, resistance emerges from the humanist imprint left on the world, where the Cuban medical collaborator is identified as the one who attends to the truly excluded: the enslaved, the colonized, the "nobodies."
Cuban international medical collaboration has a worldwide impact and accumulates recognition in the fields of teaching, assistance, and research. Its value becomes tangible in lives saved, health problems resolved, and professionals trained; and it is revealed in the intangible through the production of symbols that globally identify Cuban health services.
Therefore, it is valid and necessary to analyze Cuban international medical collaboration as symbolic capital in the training process of medical science professionals.
On May 21, 1960, the first medical brigade was sent on an emergency basis to Chile following an earthquake. In 1963, the first permanent aid was established with the dispatch of a brigade to Algeria, composed of 55 collaborators who served for one year. This latter date is considered the formal beginning of Cuban international medical collaboration, an event that marks its historical origin. (1)
Since then, a solid tradition of international solidarity has been evident, and a system of actions has been deployed with the objective of providing aid in the health sector, considering that medical services constitute a strategic axis for achieving the national vision for 2030. (2)
The current socio-historical conditions in the Cuban university context of medical sciences require symbols that call for value-based training and contribute to the integral formation of the desired professional. International medical collaboration counts within its "army of white coats" a representative number of professionals who excel in the fulfillment of their duty and impact the new generations in training with their example.
The conscious assimilation of this example in training scenarios goes hand in hand with the chosen humanistic vocation and is in full coherence with the Marxist assertion that "Human nature is such that man can only achieve his perfection by working for the perfection of his contemporaries, for their well-being... one chooses a profession in which one can do the most for humanity; we will not be bowed down by burdens, for they are only common sacrifices; therefore we will not enjoy poor, limited, selfish joys, but our happiness will belong to millions, our works will live silently, forever, and our ashes will be bathed in the burning tears of men of integrity." (3)
The authors use the term symbolic capital to describe the contribution of international medical collaboration to the successful training of the health professional.
It is Pierre Bourdieu (4), a French sociologist, who incorporates the concept of symbolic capital into social analysis. Bourdieu conceives it as a fourth species of capital, composed of everything socially valuable, accumulable, reproducible, and convertible. Its content encompasses properties inherent to individuals, such as authority, prestige, reputation, fame, credit, notoriety, and honorability, understood as social energy in relations of meaning. This concept is based on the human need to justify existence and find a socially recognized reason for being.
Other authors enrich this conceptualization. París Pombo (5), for example, emphasizes the subjective dimension by considering that symbolic capital is constituted by all forms of social recognition and perception. Similarly, Flachsland (6) deepens Bourdieu's contributions (4), exploring the possibility of analyzing the intrinsic relationship between the objective and subjective dimensions of social facts.
In the Latin American context, the Brazilian theologian Frei Betto (7) recognizes Cuba's richness in symbolic capital, highlighting its originality and foundation in independence, freedom, cooperation, and solidarity. Betto poses a crucial question: What would happen if Cuba abandoned its symbolic capital? For this thinker, this capital represents ideological immunity and a sense of life, which achieves fullness when accompanied by an ethical sense.
For his part, the Cuban jurist and sociologist Julio César Guanche (8) links the concept directly with historical memory. This connection became evident at the II International Conference "With All and for the Good of All" held in 2016 (9), where the claim to preserve the symbolic capital of peoples was exposed. More recently, during the Patria Colloquium 2023 in Cuba, the term was used recurrently by Latin American journalists, demonstrating its currency in public debate. (10)
These antecedents motivate the rescue, from historical memory, of Cuban international medical collaboration as symbolic capital which, embodied by its "white coat heroes," has become living history.
The concept of symbolic capital facilitates the interdisciplinary analysis of educational problems. Although its origin is sociological, its application has extended to areas such as politics, philosophy, psychology, pedagogy, and the study of education itself.
The various definitions of the concept agree in indicating an accumulation—both objective and subjective—of socially recognized ways of thinking, being, and doing. These ways give meaning to existence, identify histories and socially appreciated goods, and encompass honors that possess a profound meaning and an inspirational capacity for others.
This concept also allows for the analysis of the spirituality that develops in the process of Cuban international medical collaboration. In this context, new attitudinal paradigms, values, and elements of the affective sphere are revealed, integrated into individual and collective histories. Symbolic capital contains the acquired honors that, when accumulated, give meaning to life and the chosen profession, functioning as sources of national and international prestige. Together, these elements constitute a social energy, a motivation, and a set of articulated knowledges in the model of medical science professional that Cuba and the world need.
Symbolic capital is, ultimately, constituted by cognitive human experiences and behaviors. It is one of the most complex concepts, used as a heuristic instrument to articulate the objective and subjective dimensions of social phenomena. It brings together scientific virtues, expressed both in the professional's attitude and quality of life, as well as in a constellation of virtues that transcends the national space to project itself internationally.
From all of the above, the authors define symbolic capital as the accumulation of socially valid meanings, expressed in recognition, life stories that reflect identity, and senses that distinguish the work of international medical collaboration.
Ban Ki-moon, former Secretary-General of the United Nations, during his visit to Cuba in January 2014, stated that the common factor he found in the world's most neglected areas was the presence of Cuban doctors and native health professionals trained on the island. He warned that many of the health service leaders he met in developing countries had studied in Cuba, incorporating the lessons learned into their own public health systems. The diplomat summarized the Cuban medical presence by stating: "They are always the first to arrive and the last to leave, and they always stay after the crisis. Cuba has a lot to teach the whole world with its public health system, a model for many countries." (11)
This international valuation dignifies Cuban medical collaboration and distinguishes its vocation of service alongside patients, without distinctions of any kind, which evidences its profound human dimension. Furthermore, it explicitly recognizes that medical training in Cuban universities contributes to a social doctor model, whose practice is distinguished by a paradigmatic humanism.
The university of medical sciences in Cuba has the mission of training health specialists for Cuba and the world. Its educational model integrates humanistic education, solidarity, and social responsibility, assuming the Martían precept that "Homeland is humanity." In this way, it strengthens the value of internationalism as a guiding principle of the Cuban Revolution, endorsed in the 2019 Constitution. (12)
The "Study Plan E" defines integral formation as an inescapable paradigm for future doctors, establishing the references to follow: the personal example in teaching and the scientific and patriotic components, supported by the experiences acquired during the provision of services both inside and outside the country. (13)
Consequently, it is imperative to train an integral professional capable of understanding and transforming their social environment. Training must result in graduates with a solid political development, based on the Ideology of the Cuban Revolution; endowed with a broad scientific, ethical, legal, humanistic, economic, and environmental culture; committed and prepared to defend the socialist Homeland and the just causes of humanity with their own arguments; and, finally, competent for excellent professional performance and the exercise of virtuous citizenship. (13)
From the inquiries into the category of *formation*, the conception prevails that it constitutes a process characterized as simultaneously social and individual, multifactorial, multicontextual, complex, mediational, permanent, relational, multilateral, unfinished, and multidimensional. It is configured throughout life and is built based on knowledge, practices, values, customs, regulations, experiences, and lived experiences. Not only the individual in training participates in it, but all the people with whom they relate. (14)
The effectiveness of this formative process can be evaluated through the prism of Cuban international medical collaboration, where it is expressed in the consolidation of values and the accumulation of learning at the cognitive, scientific, and ethical levels.
The context of international collaboration entails a spirituality that is built in the social practice of struggle for justice. This practice generates a more fraternal and universal vision, forging a social identity manifested in the professional's attitude. In this way, the values developed during medical training are objectified. Humanism stands as a basic component, as ideals are consolidated in historical-social practice. The basis of moral education, therefore, must be the homeland, also understood as humanity.
The environment of Cuban international medical collaboration is saturated with symbols linked to the worldview of the world, the profession, and the doctor one is or aspires to be; symbols connected with what one loves and which reaches deeply into sensitivity. (15) The history of this collaboration over six decades, in all its forms and across the world, constitutes a pedagogical-didactic resource of extraordinary importance for the integral training of the health professional in Cuba. Its value is not limited to the humanistic aspect—perhaps the most significant—but also extends to the technical, allowing the linking of humanistic education with the concrete practice of humanism in the medical sciences.
Therefore, it is necessary to use international medical collaboration as symbolic capital in the training process, recognizing the collaborating professor as the living core of this capital. His or her example approaches as a paradigm the "existential time" of the students, who will discover and make it their own during their own formative process. Harnessing the entire wealth of experiences accumulated over this time must become a strategic necessity to train personnel committed to the Cuban social project and its international projection. Medical collaboration has been, from its beginnings, one of the most eloquent calling cards of this project, as it speaks directly to its humanist and internationalist character.
Despite the campaigns of discredit and constant pressures to which this collaboration—and its professionals—have been subjected, the majority have overcome the siege. In them, the principles and values acquired during their training predominate.
Both the formative process and the collaboration contribute to the formation of a professional ideal. (16) This abstraction is formed under the influence of a complex series of conditioning factors generated in the interaction between the subject and reality. The ideal of the collaborator is a historical-cultural product, a reality present in Cuban social consciousness and in the symbolic world. The efficacy of its conceptualization depends directly on the ability of the constructed concept to capture the essence of this reality in an articulated and coherent manner, explaining its genesis, current relevance, and future projection with a practical value that facilitates acceptance, conviction, and mobilization.
The history of Cuban medical collaboration, as a pedagogical resource, is fundamental in the humanistic training of health personnel, especially due to its direct contribution to symbolic capital. To form the desired profile, it is valid to use all available resources: from anecdotes and audiovisual materials to the physical presence of those who have participated, protagónically or not, in the most diverse situations and places. Personal experience told firsthand is an irreplaceable pedagogical resource; nothing influences and moves the behavior of others as much as personal example.
The rich history accumulated over decades of collaboration, often under complex and adverse conditions, highlights the most significant human values embodied in those attitudes and performances. Some acquire special relevance: solidarity, humanism, responsibility, patriotism, and internationalism.
Recognition of the collaborators contributes to the sustainability of the teaching staff by ennobling the individuals. It develops expectations in the students, consolidates the vocation to the extent that they leave a mark on the training, highlights the local within the national mandate, and generates socially necessary content that is transferred from generation to generation.
Part of this symbolic capital are those professionals whose curriculum bears the name of multiple countries and patients; those who have solved health problems in difficult places, have generated well-being for millions, and continue, from the homeland, to invest in the training of new generations. They distinguish themselves as dedicated and self-recognized professionals, ensuring both a national and professional identity.
Cuban international medical collaboration is a concrete historical process and, therefore, changing. The training process, for its part, configures an achievable ideal to the extent that it broadens the vision of existence on the planet. It uses symbolic capital as a paradigm and value, is nourished by humanism and life stories in new contexts. Its articulation with the training process inspires as a gnoseological ideal and, through new mediations, becomes social energy and a source of motivation, where the force of example results in an integral and competent professional.
They are heroes of medicine who constitute symbolic capital. They contribute with their example to the training of new professionals and daily give life to the words of Fidel Castro: "they gain in experiences, prestige, human quality; because that doctor who goes, who is there for a year, a year and a half, two years, who knows all those realities of the world, who faces serious problems, is undoubtedly also a professional, a specialist called to perform later with more efficiency, because the practice of internationalism does not mean that only with it do we help others, but by practicing internationalism we also help ourselves." (17)
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CONFLICT OF INTEREST
The authors declare no conflicts of interest.
FUNDING SOURCES
The authors received no funding for the development of this article.