RESUMEN
BACKGROUND: In terms of the Nelson Mandela Fidel Castro Medical Collaboration programme, an agreement between the governments of South Africa and Cuba, cohorts of South African students receive their initial five years medical training at a Cuban university before returning to South Africa for a six to twelve months orientation before integration into the local final year class. It is common for these students to experience academic difficulty on their return. Frequently this is viewed merely as a matter of a knowledge deficit. DISCUSSION: We argue that the problem arises from a fundamental divergence in the outcomes of the Cuban and South African medical curricula, each of which is designed with a particular healthcare system in mind. Using the discrepancy theory of identity proposed by Higgins in 1987, we discuss the challenges experienced by the returning Nelson Mandela Fidel Castro Medical Collaboration students in terms of a potential crisis of identity and suggest interventions which may prove valuable in promoting academic success and successful integration. CONCLUSIONS: Though providing additional training to address the gap in skills and knowledge in returning students is an important part of their successful reintegration, this could be insufficient on its own and must be complemented by a range of measures designed to ameliorate the discrepancies in identity which arise from the transition from one educational model to another.