Global Health Training in Graduate Medical Education

Globalization is influencing all sectors of society, including health and wellness. The preceding quote by Shaywitz and Ausiello reflects a growing body of literature which demonstrates the desire of residency applicants to engage in global health education during their post-graduate training. In order to meet this demand, medical residencies are grappling with the challenges of establishing and expanding global health programming. Since the 1st edition of this guide book, many programs have incorporated new and expanded global health education opportunities, however many challenges remain. Many residencies and institutions experience unique challenges based on size, level of administrative support, resources, and other factors. International and field-based experiences during training are accompanied by ethical questions and dilemmas about sustainability and impact. As programs seek to incorporate clinical training in new and unfamiliar settings, they must be aware of the many intended and unintended consequences of involvement by medical trainees from outside the host community. These are critical considerations as we prepare the next generation of a healthcare workforce to care for the communities of the world. As a sign of the advancing interest in global health education, many primary care and specialty societies have established international subcommittees and seminars, such as the annual International Family Medicine Development Workshop and the Section on International Child Health of the American Academy of Pediatrics. Larger, multidisciplinary organizations serve to link educators, clinicians and researchers in the effort to improve communication, training, educational resources, and service in communities around the world. Such is the mission of the Global Health Education Consortium (GHEC), which sponsors this text. Concurrent growth and specialization is happening within the academic sector. A new sister organization, Consortium of Universities in Global Health (CUGH) is a membership organization for universities who seek to develop a multi-disciplinary approach across universities to improve global health research, education, and service. Outside of the academic setting, the past decade has also witnessed an increase in the number of non-profit organizations dedicated to global health exposure for future physicians, which include Child and Family Health International, Doctors for Global Health, and Community for Children are a few examples. Many non-profit and non-governmental organizations devoted to improving global health access have also produced educational resources to help both training physicians in highly resourced nations, as well as health care workers in under-resourced communities – these include Doctors without Borders/Médecins sans Frontiéres, and the Bill and Melinda Gates Foundation among many others. This remains an exciting time for global health program development. As with any program introduction or expansion, the challenges are manifold. This guidebook attempts to navigate the maze of global health education, provide examples of global health residency training, and identify resources for developing and improving programs, while defining competencies for residents and examining ethical dilemmas of these efforts.