Abstract
BackgroundInterest and participation in global health activities among U.S. medical trainees has increased sharply in recent decades, yet the global health activities of physicians who have completed residency training remain understudied. Our objectives were to assess associations between individual characteristics and patterns of post-residency global health activities across the domains of health policy, education, and research.MethodsCross-sectional, mixed methods national survey of 521 physicians with formal training in clinical and health services research and policy leadership. Main measures were post-residency global health activity and characteristics of this activity (location, funding, products, and perceived synergy with domestic activities).ResultsMost respondents (73%) hold faculty appointments across 84 U.S. medical schools and a strong plurality (46%) are trained in internal medicine. Nearly half of all respondents (44%) reported some global health activity after residency; however, the majority of this group (73%) reported spending ≤10% of professional time on global health in the past year. Among those active in global health, the majority (78%) reported receiving some funding for their global health activities, and most (83%) reported at least one scholarly, educational, or other product resulting from this work. Many respondents perceived synergies between domestic and global health activities, with 85% agreeing with the statement that their global health activities had enhanced the quality of their domestic work and increased their level of involvement with vulnerable populations, health policy advocacy, or research on the social determinants of health. Despite these perceived synergies, qualitative data from in-depth interviews revealed personal and institutional barriers to sustained global health involvement, including work-family balance and a lack of specific avenues for career development in global health.ConclusionsPost-residency global health activity is common in this diverse, multi-specialty group of physicians. Although those with global health experience describe synergies with their domestic work, the lack of established career development pathways may limit the benefits of this synergy for individuals and their institutions.
Highlights
Interest in global health (GH) among physicians in training has steadily increased over the last three decades
U.S Academic Medical Centers (AMCs) [1,2], the National Institutes of Health (NIH) [3], U.S Government (USG) [4], and philanthropic foundations [5] have responded to this growing demand by investing in GH training
Characteristics of physicians with global health experience Overall, 44% of all respondents in our study reported having at least some GH experience either during or after their Robert Wood Johnson Foundation (RWJF) Clinical Scholar Program training
Summary
Interest in global health (GH) among physicians in training has steadily increased over the last three decades. [6] In 1978, 6% of U.S medical graduates reported experiences in GH, information about the post-training GH experiences of “typical” physicians engaged in clinical practice abroad could be used to maximize contributions of these physicians in clinical settings outside the U.S, our survey focuses on the GH experiences of U.S physicians with training in health education, research and policy for several reasons. Participation of physicians with training in these areas is complementary to clinical practice and crucial to drive systems change within key institutions such as NIH, USG, and AMCs. Data on the GH involvement of this group can help align priorities within these institutions, the aims of more traditionally GH-focused funders and stakeholders, and the GH interests of the broader U.S physician workforce [13,14]. Our objectives were to assess associations between individual characteristics and patterns of post-residency global health activities across the domains of health policy, education, and research
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