Didactics and Curriculum Development: Conferences, speakers, presentations, and other didactic components of the training program need to be catered towards preparing residents for international work. Residents might have varying degrees of global health knowledge and international experience and the didactic component of the program needs be designed with this in mind. Often times more graduated discussions are beneficial to introducing the topic of global health and international medicine to those who have little background on the subject. When looking for individuals who can teach on global health, it is sometimes helpful to look to the surrounding community for those outside the medicine department. Local schools of public health, other health professionals, experts in public policy and social sciences can be assets in helping to broaden the resident’s global health knowledge. However, while the “what” that is addressed by factual competencies demanded in global health education, exposure to career opportunities within the realm of global health work is also important in order for the resident to also gain an understanding of “how” global health works. See Table 1 in full article for
Resources for Faculty and Curriculum Development in Global Health
Peer Education: Often times one of the best educational resources are the residents and medical students themselves. Take advantage of the skills the trainees might already possess such as prior global health experience, or previous international medicine practice and incorporate them into the formal didactic programs with student-led seminars and journal clubs. Faculty members can help facilitate these activities by formulating a list of relevant journal club topics and articles that can be annually updated. Peer education helps the trainees enhance their factual knowledge as they learn teamwork, networking, and problem solving skills necessary for a work in the global health arena.
Experiential Learning in the International Setting: Implicit in incorporating global health into a residency training program is medical or health training experience in an international setting. Programs for experiential learning internationally are varied in nature and are unique to the goals of the program. Some programs allow residents to participate in clinical rotations at their site, while others rely on the residents to organize the actual clinical rotations in its entirety. Other times residents will chose to participate in non-clinical global health opportunities. Community health centers with already established international programs can incorporate their residents and medical students into their programs abroad (as long as it is within the context of their curricular requirements). Other resources to help residents locate international opportunities are the International Health Opportunities Database maintained by the Global
Programs
Health Education Consortium, Students for Global Health, Child and Family Health International, and Doctors for Global Health.
Experiential Learning in the Domestic Setting: With increasing globalization, it has become easier to integrate global and domestic educational activities for trainees. This is especially true for residents at community health centers. Although resources in developing countries are usually significantly less than those available in the United States, the medically underserved populations community health centers serve domestically, encounter similar barriers as patients abroad such as low literacy rates, poor transportation, and limited financial resources. Helping residents see the correlation between domestic and international medically underserved populations can help to justify and fund global health activities.
Preparation and Debriefing: When designing a global health program in community health center residencies, it is necessary to take into consideration how you will prepare the residents and medical students for their actual work abroad. Their initial preparation levels will be varied, but preparation should be tailored accordingly. Debriefing should include a formal mechanism for program evaluation, as well as practical training such as to how to keep the doctor healthy while abroad.
Mentoring: Providing strong mentorships for trainees is an essential part of any successful residency program. Ideally the mentors would have extensive training in global health. However, programs short on mentors with global health expertise should take advantage of existing global health networks in the community. Programs can also look to annual and regional organizations that host meetings on global health, schools of public health and/or international affairs, and local non-profit organizations to provide guidance to residents. See
Table 2 in full article for lists some of these organizations.
Research and Scholarly Activities: Community based research is a good way for residents to learn about how to assess the needs of a population at the community level using limited resources, while gaining experience in understanding the effectiveness of various interventions at meeting those needs. Supervisors should be involved in the research process from the beginning to ensure feasibility of design given time and logistical constraints, and also that the research is of a beneficial nature to the community. Mentors should provide careful oversight throughout the entire process and provide guidance on research ethics and how to design research projects with proper participation that provide previously unavailable resources to the community.
Program Evaluation: In order for a residency program to be sustainable and continue to receive funding, an evaluation process must be a part of the program. How the evaluation measures success can vary depending on what outcomes are most indicative to explaining how well the main goals established in the beginning of the program were achieved. For example, program success might be measured by patient and staff satisfaction, increase in cultural competency levels, capacity building within host country or community, changes in specified outcomes, etc. Whatever the means for measuring success are, it is important to design an evaluation process
Programs
Information for this section consists of summaries and excerpts taken from “Going Global: Considerations for Introducing Global Health Into Family Medicine Training Programs” by Jessica Evert, MD; Andrew Bazemore, MD,
from the outset and be consistent throughout the program’s duration in collecting date for the chosen indicators of the program’s success. Some health centers find issuing surveys before and after the program to be the easiest way to evaluate progress. Health centers with the resources to do so might choose to also track health indicators of the population served, and the progress of the trainees throughout the entire duration of the program.