Pre-Departure Training for Global Health Electives at US Medical Schools

Abstract

Pre-departure training (PDT) has been suggested as a tool to address the ethical, safety, and educational issues associated with global health electives. In 2013, due in part to increasing popularity of global health electives, the Liaison Committee on Medical Education (LCME) mandated that medical schools provide PDT as a means to address the unique safety and ethical challenges of these experiences. The purpose of this study was to characterize the prevalence, structure, and content of PDT for global health electives currently offered at US medical schools. An online survey was distributed to the director of the global health office or the dean of student affairs at all LCME-accredited US medical schools. Follow-up phone calls assured a high completion rate. Descriptive statistics were used for analysis. Seventy three percent (104/143) of medical schools responded. Among respondents, 96% (100/104) offered global health electives, and 88% (91/104) had PDT. Eighty-one percent (74/91) of PDT programs were mandatory, but only 59% (54/91) had formal curricula. Personal and travel safety, cultural competency, and ethics were the most commonly covered topics though offerings were highly variable. Though most US medical schools offer PDT, the structure and format of the programs vary widely. Despite broad acknowledgement of the value of PDT, institutional financial support is minimal. At the national level, resources need to be directed toward developing standardized objectives and curricula for medical student PDT.