Updated

Eight Americans who graduated from a Cuban medical school say they will put the education paid for by Fidel Castro's communist government to use in hospitals back home.

Four New Yorkers, three Californians and a Minnesotan, all from minority backgrounds, have studied in Havana since April 2001, forming the first class of American graduates from the Latin American School of Medicine.

One other American previously graduated from the school after transferring from a U.S. university, but the six women and two men graduating Tuesday were the first Americans to complete the entire six-year program since Castro offered the free medical training to U.S. students. The offer followed a meeting a delegation from the U.S. Congressional Black Caucus.

The students said that much of what they learned in Cuba matched the curriculum at American medical schools, but that instructors here placed a special emphasis on preventative care.

"I will be heading back to the United States with a great advantage over the American students who have stayed there," said Wing Wu, from Minneapolis, Minnesota.

"I've learned that medicine is not a business, it's social, it's humane," said Toussaint Reynolds, a graduate from Massapequa, New York. "I will be a better doctor in the United States for it."

The 80-year-old Castro has not been seen in public since last July 31, when he announced that emergency intestinal surgery was forcing him to step down in favor of his younger brother Raul, the 76-year-old defense minister.

Vice President Carlos Lage and other top Cuban leaders attended a graduation ceremony Tuesday evening at Havana's Karl Marx theater.

Wearing white robes, the Americans were among more than 2,100 students from about 25 countries who received diplomas. More than 10,000 students now attend the Latin American School, which opened in 1999 to provide free medical training to foreign students from disadvantaged families.

Washington's 45-year-old embargo prohibits most Americans from traveling to Cuba and chokes off nearly all trade between the countries. But the U.S. State Department has not opposed the medical school program, saying American policy hopes to encourage contact between ordinary Cubans and Americans.

U.S. authorities have suggested that it is unclear whether Americans who receive Cuban medical training can meet licensing requirements in the United States. The graduates will have to pass two exams to apply for residency at American hospitals, then eventually pass a third.

But the U.S. transfer student who graduated from the Cuban school recently began his residency at a New York City hospital. His experience gave hope to Tuesday's graduating class.

"Do I think there will be prejudices against us when we go back to the States and are looking for residences? Yes, it's inevitable," said Kenya Bingham, from Alameda, Calif. "I think there will be just due to the simple fact that there are political differences between the two countries."

The students held a news conference with the Rev. Lucius Walker, leader of the U.S. nonprofit Pastors for Peace. He has worked closely with the graduates. He said about 100 other Americans are currently enrolled at the Latin American School, and another 18 are starting next month.

Michael Moore's hit documentary "Sicko"' praised Cuba's universal health care system, featuring scenes where the filmmaker brought ailing Sept. 11 rescue workers to the island for treatment.

Graduate Carmen Landau, 30, of Oakland, Calif., noted in an e-mail that chronic shortages of medicine and equipment in Cuba — much of it caused by the embargo — make health care here far more complicated than Moore's documentary suggested.

"This is a highly flawed system," Landau wrote. "After six years here I could go on and on regarding things that I think should be different."

But she also praised "Sicko," saying "it may be what we need to reform a system that is broken in the United States."