Evaluating the Experience of Visiting International Providers on Local Neurology Trainees in a Resource-Limited Setting (P4-8.007)

Abstract

<h3>Objective:</h3> Assess the impact of visiting international neurology attendings and trainees on local neurology trainees in Zambia. <h3>Background:</h3> Interest in global neurology is increasing among U.S. neurology residents. Global health electives improve clinical skills, commitment to underserved populations, and cost-effective decision-making practices among neurology trainees from high-income settings. However, existing literature focuses primarily on the experiences of Canadian and U.S. trainees, with formal research on the perspective of local neurology trainees lacking. <h3>Design/Methods:</h3> The Zambian neurology training program, which graduated its first class in 2018, frequently hosts visiting neurology attendings and residents from high-income settings. Current trainees and graduates of the program completed surveys and participated in focus groups to assess their experiences with visitors and the impact on their training. <h3>Results:</h3> 100% of current trainees (n=5) and program graduates (n=4) participated. All participants rated the experience of working with international visitors positively (56% rated 5/5 (most positive), 44% rated 4/5). Specific positive aspects included exposure to different teaching styles and clinical approaches, awareness of neurologic practice in different parts of the world, expertise in subspecialties less available locally, and expanded academic networking opportunities. Local trainees appreciated the clinical contribution to busy inpatient and outpatient services, the ability to compare themselves to an “international standard”, and the cultural exchange with visitors. Challenges of working with visitors included occasional discrepancies in expectations, prolonged patient encounters due to language barriers, incomplete understanding by visitors of cultural differences and resource limitations, and physical workspace constraints. <h3>Conclusions:</h3> Local trainees in Zambia reported an overall positive experience with visiting providers from high-income countries. Our results provide support for expanding global health electives and faculty opportunities in Zambia and, potentially, similar settings. Orientation sessions for visiting clinicians to review cultural differences, resource limitations, and training expectations may improve the experience for visitors and hosts alike. <b>Disclosure:</b> Dr. Salasky has nothing to disclose. Dr. DiBiase has nothing to disclose. The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from National Multiple Sclerosis Society. The institution of Dr. Saylor has received research support from American Academy of Neurology. The institution of Dr. Saylor has received research support from United States Department of State. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and Educational Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.