Loss of international medical experiences: knowledge, attitudes and skills at risk

Corita R Grudzen,Eric Legome

doi:10.1186/1472-6920-7-47

Abstract

BackgroundDespite the great influence International Medical Experiences (IMs) can have on young physicians and their impact on patients and communities, they are not offered in all training programs and are at risk of being reduced in some due to stringent guidelines for funding of graduate medical education.DiscussionIMs provide unique experiences in clinical, epidemiologic, cultural, and political arenas. From an educational perspective, they broaden a physician's differential diagnostic skills and introduce clinical entities rarely seen in the U.S.Time spent in developing countries emphasizes the importance of community health and increases cultural and linguistic competence. Experience working with the underserved during an IM has been shown to increase interest in volunteerism, humanitarian efforts, and work with underserved populations both in the US and abroad. IMs also afford physicians the opportunity to learn about the delivery of health care abroad and are associated with an increase in primary care specialty choice.SummaryIt is time for the leaders in graduate medical education to prioritize international health opportunities. Leaders in academic medicine can press for changes in reimbursement patterns at the national level or special funds for international electives. Hospitals can set up separate accounts to help finance resident salaries and benefits while abroad. Individual departments must be flexible with resident schedules to allow elective time. Medical students and housestaff can organize and lobby larger organizations such as the American Medical Association (AMA), the American Association of Medical Colleges (AAMC), and specialty groups to make IMs universally accessible.

Highlights

Introduction to rare clinical diseasesImprovement in clinical skills Exposure to other health care delivery systems Primary care career choice Public health or health policy career choice Commitment to underserved populations or rural areas Increased cultural competence abroad
Students' idealism and desire to work with underserved populations has been shown to decline as they progress from preclinical training through residency [8]
Despite the great impact international medical electives can have on physicians and those they serve, they are limited in availability due to the nature of graduate medical education funding

Summary

Introduction

Introduction to rare clinical diseasesImprovement in clinical skills Exposure to other health care delivery systems Primary care career choice Public health or health policy career choice Commitment to underserved populations or rural areas Increased cultural competence abroad. Medical students who participate in international electives show an increased interest in volunteerism, humanitarian efforts, and work with underserved populations both in the US and abroad [9,10]. Dr Paul Farmer, a recipient of a MacArthur award [1], was inspired as a medical student and resident working in Haiti. He went on to establish a hospital in rural Haiti and co-founded an international non-profit organization that has pioneered humanitarian work on several continents. Dr Albert Schweitzer, the 1952 Nobel Peace Prize recipient, chose a medical career after missionary work in Africa Having obtained his medical degree, he founded his hospital at Lambaréné in (page number not for citation purposes). International medical work has undoubtedly inspired countless others to lives of service

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