By Dr. Jessica Evert
Executive Director, CFHI
As trainees are more and more senior (think resident physicians compared to pre-health undergraduate students), the questions around the content of their global health training, particularly in clinical settings, are more complex. As residents or young faculty we have more clinical skills and expertise, but does that mean we should use international opportunities to focus on clinical care? Is clinical care as a primary focus of global health activities a sustainable endeavor? What happens when we leave and our clinical skills leave with us? As Michelle Morse pointed out in 2014, residents undertaking global health training and service activities requires a new mind-set (read her great commentary: http://www.pih.org/blog/dr.-michelle-morse-a-new-mindset-for-global-health-training). Its no longer acceptable or desirable for resident physicians from High-Income Countries to use large volume patient opportunities in Low and Middle Income Countries to bolster their clinical encounters or surgical case requirements. We have to do better. Even though residents are still in ‘training’ they have skills that can contribute to the capacity of resource-limited health settings, and often these capacities have little to do with directly providing clinical care to patients.
A new article in the Journal of General Internal Medicine walks residency programs through a thought process on how to create opportunities for residents to engage in global health. The approach is based on four fundamental questions.
Who are you teaching?
How are you teaching?
What are the goals of your Global Health program?
What are your resources?
The last question is an important one. While many programs aspire to build a wide breadth of opportunities in global health for trainees and faculty, the administrative support can be lacking. For programs with limited resources, it is suggested that partnering with an organization, such as Child Family Health International, as an ‘extender’ of the personnel, relationships, quality improvement, and curriculum necessary to provide thoughtful and impactful global health education and engagement. Residency programs grappling with the opportunities and challenges presented by Global Health are well served by this new publication and the thought process it outlines. Here’s to developing the fundamentals and collaboration necessary for safe and impactful global health training and service!