Stories of Cuban medical accomplishments often note that half of the country's 6,000 doctors had left by 1963. But just as professionals were forsaking their homeland en masse for the comforts of Miami, 3,000 doctors chose to stay. Why did they remain? More important, the number of patients per doctor now doubled, how did they face the daunting task of transforming medicine? In addition to treating patients, their goals included expanding medical care to rural regions; increasing medical education to replace doctors who had left; making care preventive, community-oriented, and focused on tropical diseases; and redesigning a fractured and non-cohesive health system.… The consciousness of the 3,000 who stayed became the "material force" in the production of Cuban health care, as much a material force as the manufacture of pharmaceuticals or the construction of hospitals.