CARACAS -- She said she'd be wearing a short jean skirt and a red top. She said she'd be alone, somewhere near the second-floor cafeteria of a large supermarket where her colleagues, Cuban doctors like her, were unlikely to be: None of them can afford the $3 it costs to eat a plate of rice, a slab of meat and potato salad -- the dish of the day today -- washed down with a carton of mango juice.

The meeting is set for 2 p.m. And right on time, she walks in, barely glancing at the shelves stacked with products she is dying to try but can't. She is saving her money to escape to the United States.

''For me, this is nothing but a way out,'' said the doctor, an internist who is afraid to speak openly about her plans to defect and begged that her name not be used. ``I can't wait to get out of this place.''

Meet the Cuban doctor, the most widely deployed and effective ideological and diplomatic weapon in the almost 50 years since Fidel Castro seized control of the island. And, in the past few years, the most profitable export of the country's economy.

Although thousands of doctors have defected over the years, and others, like the doctor in the red top, are planning to do the same, more than 72,000 remain on the island and scattered all over the world, and more are in the pipeline.

Cuba churns out doctors like no other nation in the world -- it boasted one doctor for every 159 people in 2005, according to official Cuban estimates. By comparison, in 2000, the United States had about one doctor for every 414 citizens, according to the most recent figures on the World Health Organization's website.

But the doctor-to-citizen ratio in Cuba has decreased greatly because so many have been sent on international missions, a much coveted posting for doctors who make an average of $25 a month at home.

Despite the increasing risks of defection -- since 2006 the United States has made it easier than ever for Cuban doctors to abandon their posts by offering them U.S. visas from consulates wherever they defect -- Cuba seems to be relying more than ever on its vast health industry for income.

Julie M. Feinsilver, a Latin American scholar and author of Healing the Masses: Cuban Health Politics at Home and Abroad, maintains that Cuba is the only country that ``has developed doctors as an export commodity.''

''Fidel looked at it as a politician,'' Feinsilver said. 'Raúl is much more pragmatic; he's looking at it as a manager: `I have this huge industry. What makes sense? How should I use it?' ''

NEW VENTURES

In the past four months alone, Cuba has inaugurated the first of seven ophthalmology hospitals that it plans to open in Algeria, staffed only by Cubans; it opened the second of at least three centers of the same kind planned in China; and it has made a commitment to staff with Cuban doctors a hospital in Qatar, Spain's La Vanguardia newspaper reported in June.

And in July, Cuba's national magazine, Bohemia, reported on its online pages that the country earned about $350 million last year from the sale of medicines abroad, second only to nickel and surpassing more traditional exports such as tobacco, rum and sugar.

More than 31,000 Cuban health workers -- most of them doctors -- who toil in 71 countries brought in $2.3 billion last year, Feinsilver said, more than any other industry, including tourism.

Most of them are paid $150 to $375 a month, a small percentage of the cash or trade benefits the Cuban government pockets in exchange for their work, she added.

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