Abstract
BackgroundGlobal health interest has grown among medical students over the past 20 years, and most medical schools offer global health opportunities. Studies suggest that completing global health electives during medical school may increase the likelihood of working with underserved populations in a clinical or research capacity. This study aimed to assess the association of global electives in medical school on subsequently working in global health and with underserved populations in the United States (U.S.), additionally considering students’ interests and experiences prior to medical school. We also examined whether respondents perceived benefits gained from global electives.MethodsWe surveyed medical school graduates (classes of 2011-2015) from a large public medical school in the U.S. to describe current practice settings and previous global health experience. We evaluated work, volunteer, and educational experiences preceding medical school, socioeconomic status, race and ethnicity using American Medical College Application Service (AMCAS) data. We assessed the association between students’ backgrounds, completing global health electives in medical school and current work in global health or with underserved populations in the U.S.ResultsIn the 5 to 8 years post-graduation, 78% of 161 respondents reported work, research, or teaching with a focus on global or underserved U.S. populations. Completing a global health elective during medical school (p = 0.0002) or during residency (p = 0.06) were positively associated with currently working with underserved populations in the U.S. and pre-medical school experiences were marginally associated (p = 0.1). Adjusting for pre-medical school experiences, completing a global health elective during medical school was associated with a 22% greater prevalence of working with an underserved population. Perceived benefits from global electives included improved cultural awareness, language skills, public health and research skills, and ability to practice in technology-limited settings.ConclusionMedical school graduates who participated in global electives as students were more likely than their peers to pursue careers with underserved populations, independent of experiences prior to medical school. We hypothesize that by offering global health experiences, medical schools can enhance the interests and skills of graduates that will make them more likely and better prepared to work with underserved populations in the U.S. and abroad.
Highlights
Global health interest has grown among medical students over the past 20 years, and most medical schools offer global health opportunities
Medical school graduates who participated in global electives as students were more likely than their peers to pursue careers with underserved populations, independent of experiences prior to medical school
We hypothesize that by offering global health experiences, medical schools can enhance the interests and skills of graduates that will make them more likely and better prepared to work with underserved populations in the U.S and abroad
Summary
Global health interest has grown among medical students over the past 20 years, and most medical schools offer global health opportunities. Medical school experiences can play a formative role in student career decision making and can have substantial influence on future practice choices, both in terms of medical specialties pursued and populations served. These experiences may be realized through formal curricular components, clinical training sites, and elective opportunities, all of which can have a focus on underserved patient populations. Opportunities for medical students to learn skills important for working with underserved populations include clinical training in rural and urban settings; language immersion programs; migrant farmworker outreach; refugee health initiatives; and short-term global health experiences in low- and middle- income countries [10]. Students who attended a medical school with a strong social mission or grew up in a medically underserved setting are more likely to work with the underserved [11]
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