Global Health Training for Residents

Abstract

To the Editor: We agree with Drain and colleagues1 that global health training should become an integral part of residency training and be tailored for each specialty. In such training, we maintain that particular emphasis should be given to tropical medicine, which encompasses those diseases that are most often encountered in underdeveloped countries. But because tropical medicine is a vast discipline, residency programs cannot include it as a whole in their curricula. Therefore, we propose that programs concentrate on those diseases that cause the most burden, as defined by the Global Network for Neglected Tropical Diseases: ascariasis, trichuriasis, hookworm infection, schistosomiasis, lymphatic filariasis, trachoma, onchocerciasis, leishmaniasis, Chagas disease, leprosy, human African trypanosomiasis, dracunculiasis, and Mycobacterium ulcerans infection (Buruli ulcer). Together, these infections pose a high burden on society.2 Much has to be done to raise medical educators’ awareness of the need to teach about tropical medicine. For example, the American Board of Internal Medicine infectious diseases board exam does not include the topic of tropical medicine as such, and information on parasites makes up only 4% of the content.3 And the European Union of Medical Specialties Board of Infectious Diseases training curriculum4 recommends tropical medicine training as an option, not a requirement.5 But the teaching of tropical medicine should no longer be optional or regarded as an “interesting” elective; the increase in globalization makes it imperative for this topic to be incorporated into the mainstream of residency education. Francisco M. Pherez, MD Internal medicine and infectious disease specialist in private practice, St. Louis, Missouri. Polly K. David, MD Internal medicine and infectious disease specialist in private practice, St. Louis, Missouri.