Global Health Careers Research Articles

The effectiveness of competency-based global health education programs for medical students.

This study aimed to develop a competency-based global health education (GHE) program for medical students and analyze its effectiveness. The study had a pretest-posttest control group design. The program was developed based on the eight global health competency domains for medical students and implemented for 18 hours over 6 weeks beginning in September 2023. The intervention and control groups comprised 34 students and 41 students, respectively. The analytical methods used were t-test, chi-square test, and analysis of covariance. Experience with global health activities and pretest scores were controlled as covariates to exclude the effects of participants' general characteristics and pretest scores. The intervention group had outscored the control group on interest in a global health career and the necessity of GHE and also showed significantly higher posttest scores on global competence, global citizenship, and global health competence. Students were generally satisfied with the GHE program. A global health competency-based GHE program effectively increases medical students' interest in global health careers, their understanding of the need for GHE, and their global competence, global citizenship, and global health competence. This study is expected to promote GHE program development and research.

Journal Editorial Board Membership: An Enduring Connection in a Peripatetic Career in Global Health.

Journal Editorial Board Membership: An Enduring Connection in a Peripatetic Career in Global Health.

The Glass Ceiling in Global Health: Perspectives of Female and Male Anesthesiologists.

Gender equity is essential for improving health outcomes globally. Despite comprising 75% of the global health workforce and dominating academic global health programs, women remain underrepresented in leadership positions in global health organizations. Our study aimed to identify potential gender differences in the beliefs and attitudes regarding barriers that women anesthesiologists encounter in pursuing careers and leadership roles in global health and to identify recommendations for improving gender equity in global health. We conducted a cross-sectional online survey focusing on career leadership opportunities and challenges uniquely faced by women clinicians in global health. We obtained permission from the World Federation of Societies of Anaesthesiologists to distribute our questionnaire to their leadership committee members during 2 months (May-July 2022). The questionnaire was distributed to 164 study participants with 67 individuals (44.8% female) based in 38 different countries completing the survey (response rate 40.9%). Overall, 47.8% of the participants aspired to a leadership position in global health and 58.2% agreed women face unique barriers to global health leadership (70.0% of women compared to 48.6% of men; P = .081). Female gender (odds ratio [OR], 19.22, P = .004) and divorced marital status (OR, 746.26, P = .004) were positively associated and African ethnicity (OR, 0.002, P = .017) was negatively associated with the perception of gender bias in their career growth. The main challenges included balancing work and family responsibilities, lack of female mentors or role models, gender-based discrimination, and limited opportunities for career advancement. Men acknowledged these challenges but reported personally experiencing them to a lesser extent, particularly concerning lack of opportunities (P = .005), inadequate pay (P = .000), and lack of training (P = .000). Gender disparities exist in the pursuit of global health careers. This study underscored that more women than men perceive barriers in pursuing leadership roles in global health and that men generally encounter these obstacles to a lesser extent. Female representation in leadership positions could be supported through evidence-informed policies that promote work-life balance, improve mentorship, offer equal opportunities for career advancement and adequate pay, and combat gender-based discrimination.

Beyond the surface: unraveling global health curriculum insights through interviews of learners and educators using the CIPP model.

Our study aimed to delve beyond a surface-level understanding and explore the various dimensions of the global health curriculum from the perspective of both learners and educators using the Context, Input, Process, and Product (CIPP) model. From 2020 to 2021, interviews were conducted with a total of 10 individuals, including five students who had taken at least one elective course and at least one elective research course, three teaching assistants (TA), and two faculty members who had taken more than four global health courses in multiple phases in the global health curriculum. Semi-structured interview questions based on the CIPP model were used and qualitative data were analyzed through content analysis. The study identified 12 sub-themes. Students held idealized views of global health careers and sought to bridge the gap through global health classes. They desired early exposure to global health courses, emphasizing both pre-medical and clinical phases. Challenges in adjusting course difficulty and recruiting faculty were identified, along with a preference for interactive teaching methods and offline discussions. The curriculum promoted reflection on medicine's essence, expanded career perspectives, and emphasized competencies like altruism, communication skills, and crisis management in the evolving global health landscape. This study showed that a comprehensive approach is possible from the perspective of learners and educators by identifying strengths, weaknesses, and the value of the curriculum's goals, plans, implementations, and results through the CIPP model. For optimal curriculum design, a sequential approach from basic to advanced courses is essential, promoting hands-on global health experiences for students.

Characteristics of Global Health Careers among Graduates of a Global Health Equity Residency Training Program in the United States.

The number of global health (GH) physician training programs in the United States has increased in the past decade. Few studies have explored the demographics of individuals in these programs, the impact of global health training on career development, and specific factors associated with whether graduates achieve a career in global health. We aimed to describe characteristics of program graduates and quantify which previously identified factors were associated with achieving a self-defined career in GH among a cohort of graduates from one GH post-graduate training program in a highly resourced academic medical center in the United States between 2003 and 2018. We conducted a cross-sectional survey and analyzed differences between participants who self-identified as having a career in GH compared to those who did not. Among 59 individuals invited to participate, 53 (89.9%) responded to the survey. Having a GH mentor was associated with having a career in GH (OR 10.3; p = 0.004). Those who had a GH career were more likely to have a clearly-defined career path (p = 0.03), have institutional support in their current job (p = 0.00006), be able to manage the split between their GH and non-GH work (p = 0.0001), find funding to achieve their objectives in GH (p = 0.01), invest in their personal and family life (p = 0.05), and split work abroad and domestically with few challenges (p = 0.01). We present sociodemographic and career characteristics for graduates from a GH training program in a highly resourced academic medical center in the United States. Mentorship, institutional support, funding, ability to balance GH with non-GH work, and time spent domestically or abroad are key factors associated with successful careers in GH. If institutional funding is allocated to strengthen these aspects of GH training, we anticipate more sustained GH career development.

No Roots, No Fruits: Marcel Tanner's Scholarly Contribution, Achievements in Capacity Building, and Impact in Global Health.

On 1 October 2022, Marcel Tanner celebrated his 70th birthday with his family and friends on the River Rhein in Basel. Trained in epidemiology (Ph.D.) and public health (MPH), Tanner devoted his entire working life to research, teaching, and capacity building. Indeed, he built up productive partnerships, fostered multinational consortia, served on numerous scientific and strategic advisory boards, and contributed measurably to improving people's health and well-being. We systematically searched the Web of Science Core Collection to identify Tanner's scholarly contribution and pursued an in-depth analysis of his scientific oeuvre including the main areas of research, pathogens, diseases, and health systems, and the geographical foci of his scholarly activities. Additionally, we examined Tanner's impact on personal and institutional capacity building in the arena of global health. We also invited a handful of colleagues to describe their experiences while working with Marcel Tanner. What transpires is a considerable breadth and depth of peer-reviewed publications in tropical medicine; epidemiology, environmental, and occupational health; parasitology; and infectious diseases. More than a third of the 622 peer-reviewed articles, the first piece published in 1978, focused on various aspects of the protozoan parasite Plasmodium and the disease it causes: malaria. Tanner trained, taught, and inspired generations of students, scientists, and practitioners all over the world. His unique ability to bring people and institutions together to work in partnership is at the heart of an impactful career in global health.

Remote online global health education among U.S. medical students during COVID-19 and beyond

BackgroundDue to the COVID-19 pandemic, the 2021 Harvard Medical School course Clinical Topics in Global Health was offered for the first time as a remote class. We sought to understand student and faculty perceptions of the elective and evaluate the perceived effectiveness of teaching global health using an online education platform.MethodsFollowing the course, students and faculty were invited to complete a combined total of three online surveys, which consisted of closed- and open-response questions assessing the strengths and challenges of online learning. Data analyses included traditional descriptive statistics, Net Promoter Score calculation, and inductive thematic analysis of qualitative data.ResultsThirty-two students and eighteen guest faculty (including four international faculty) participated in the course. Highly-rated course components included guest lecturers, practical skill sessions, polls, and case studies. The Net Promoter Score for the course was excellent at 92, and students reported a greater likelihood of pursuing a career in global health because of the course. While students and faculty highlighted limitations of the remote learning platform (lack of community and interactivity), they also commented on increased accessibility and faculty diversity. Most faculty and students recommended a hybrid model for future versions of the course and suggested strategies to address current limitations.ConclusionsA remote learning platform can effectively deliver global health education, both in the pandemic setting and beyond.

Engaging youth in global health and social justice: a decade of experience teaching a high school summer course

ABSTRACT Background Education and training in global health and social justice is crucial to ensuring the next generation of health professionals are poised to tackle the pressing issues of our time. Objectives To develop and implement an intensive summer course on global health and social justice for high school students at the University of Southern California. Methods This paper reviews the course aims and curriculum, its implementation both onsite and online, and reports on student course evaluations and long-term student outcomes. Results Student satisfaction with the program was extremely high, which endured when the course went virtual during the COVID-19 pandemic. The most popular elements of the course included interactive, game-based activities and guest speakers. Many students reported that the course motivated them to pursue higher education and careers in global health or related fields. Conclusions More universities should consider offering summer programs or other extension programs targeting high school students in order to meet the increasing demand for global health education. Recommendations for implementing global health courses for younger learners include having an interdisciplinary focus with a range of topics and diverse perspectives; provision of scholarships to allow low-income students and students from abroad to participate; prioritizing the integration of active learning and experiential educational opportunities; and incorporating debriefing and reflection as integral parts of learning.

Medical students’ perceptions of global health at the University of Cape Town, South Africa: The gap between interest and education

Background. Global health competencies are an increasingly important part of medical training; however, there is currently no integrated formal global health curriculum at South African (SA) medical schools, and perceptions of medical students towards global health have not been reported. Objectives. To describe SA medical students’: (i) perceptions of global health; (ii) access to global health education (GHE); (iii) awareness of global surgery as a global health priority; and (iv) perceived relevance of select medical specialties to global health. Methods. Medical students at the University of Cape Town (UCT), SA, were invited to complete a 35-item survey over 2 months in 2018. The survey was designed on REDCap (Research Electronic Data Capture) and distributed by email. All responses were anonymised and self-reported. Results. Of 1 640 medical students, 245 (18%) completed the survey. Only 66 (27%) reported GHE in medical school, whereas 213 (87%) reported a career interest in global health. Childhood in a rural setting was a positive predictor of a career interest in global health, while lack of medical resources and infrastructure in resource-limited communities was the most commonly cited barrier to a career in global health. Most students identified family medicine and infectious diseases as the two most important specialties in global health delivery. The majority of students had limited insight into global surgery, which ranked low as a past and future global health priority. Conclusion. UCT medical students are interested in global health careers, but lack formalised GHE or global surgery education during their medical studies to support and encourage integrating global health into their future careers.

Training in Neurology: Resident Perception of the Utility and Applicability of Global Neurology Morning Reports.

Interest in global health is increasing among neurology residents. However, funding, time, and, recently, COVID-19 travel restrictions remain barriers to widespread participation. To meet this need, we instituted virtual global neurology morning reports with the objectives of (1) improving knowledge about neurologic diseases common in sub-Saharan Africa and (2) developing clinical reasoning skills through consideration of diagnostic and therapeutic limitations in resource-limited settings. Interactive case-based sessions were presented from Zambia via videoconference by a Johns Hopkins faculty member or Zambian neurology trainee. An anonymous cross-sectional survey was conducted among Johns Hopkins neurology residents. Of eligible participants, 69% (n = 30) completed the survey, 66% of whom were female, and 33% reported prior in-person global health experience. Although most participants did not anticipate a career in global health, the majority (85%) reported that exposure to global health was important. All but 1 participant (96%) reported satisfaction with the global neurology morning reports, with 100% reporting that they were useful to their clinical knowledge and 86% reporting that they were useful to their clinical practice. All respondents felt that morning reports should continue, and 69% ranked the educational value of the experience in the top quartile of the residency curriculum. Resident satisfaction with and perceived utility of global neurology morning reports were high, although the majority did not plan to pursue global neurology opportunities as part of their career. Remote learning opportunities may increase interest in global health among neurology residents.

The role of a pharmacy residency program in global health: Establishing pediatric clinical pharmacy services in a Malawian hospital

To describe the establishment of pediatric clinical pharmacy services in a Malawian hospital as part of a pharmacy residency program's engagement in global health. While pharmacy is expanding its role in global health through the introduction of international advanced pharmacy practice experience (APPE) rotations at US schools of pharmacy, international experiences for pharmacy residents are currently very limited. Such programs are advantageous for pharmacists planning for a career in public or global health, and there is also great opportunity for clinical pharmacists to work with international partners for professional development and to help advance pharmacy practice. The University of North Carolina at Chapel Hill Eshelman School of Pharmacy recently expanded its international APPE rotation in Malawi into the postgraduate training space through creation of a pediatric pharmacy residency training program, with the specific aim of working with partners in Malawi to introduce pediatric pharmacy services at Kamuzu Central Hospital. As this was the first time there was a pharmacist involved in patient care on the pediatric wards, the focus for the participating pharmacy resident was on establishing a positive relationship with the medical team through providing high-quality collaborative patient care for the pediatric population. In addition to working to establish pediatric clinical pharmacy services, the resident further contributed to sustainable improvements in pediatric patient care by identifying areas for quality improvement. We discuss several considerations for the successful implementation of international experiences and their impact on participating residents. Pharmacy has an opportunity to build on the success of international APPE rotations and expand postgraduate offerings. Through collaboration with other institutions already involved in global health and identifying international rotation sites, residency programs across the country can create similarly beneficial global health experiences for their pharmacy residents.

Creating a platform to enable collaborative learning in One Health: The Joint Initiative for Teaching and Learning on Global Health Challenges and One Health experience

The “Joint Initiative for Teaching and Learning on Global Health Challenges and One Health” targets education and training in Global Health Challenges and One Health, focusing on surpassing issues that affect One Health training programs. The present work describes the planning, implementation, and challenges to develop an international educational initiative among six partner institutions from four different countries, to build a collaborative teaching and learning environment. The course applies collaborative online international learning principles and is addressed to graduate students of universities from Brazil, Germany, Mozambique, and Kosovo. A pilot curriculum was developed with modules on intercultural competence, interprofessional and collaborative practice in One Health; One Health; healthcare, surveillance, and One Health; bioethics in One Health and careers in Global Health. The course combines synchronous and asynchronous activities developed in groups by mixing students from different institutions and countries. Forty-four experts from 22 institutions of the Americas, Africa, Europe, and Asia collaborated with the course content. Some challenges to implementing the course were the different criteria to assign credits across institutions, the lack of bibliographic material across all partners, limited overlap hours and periods for synchronous activities, and short semester overlap across institutions. Despite the challenges for implementation, the entire process of planning and delivering the course involves intense international collaboration, contributing to the curriculum internationalization, benefiting all institutions involved, promoting exchange even in the challenging scenario of the pandemic of coronavirus disease 2019 (COVID-19).

Expanding Opportunities for American Descendants of Slavery to Build a More Inclusive and Diverse Global Health Workforce.

ABSTRACTHistorically, the terms African American and Black have been used interchangeably to describe any person with African ancestry living in the United States. However, Black Americans are not a monolith, and legitimate differences exist between those with generational roots in the United States and either African or Caribbean immigrants. American descendants of slavery (ADOS) are underrepresented in many fields, but I have noticed during my decades long career in global health that they are acutely absent in this field. Here, I offer seven recommendations to improve recruitment, retention, and advancement of ADOS in the global health field. Immediate implementation of these recommendations will not only bring diverse perspectives and immense capacity to the field but also allow ADOS an opportunity to engage in compelling and meaningful work and to collaborate with those from their ancestral homelands.

Icahn School of Medicine at Mount Sinai.

Icahn School of Medicine at Mount Sinai.

Academic careers in global pulmonary and critical care medicine.

The burden of respiratory and critical illness is high worldwide, yet specialist care is underrepresented in low- and middle-income countries (LMICs) [1]. For many areas of medicine, the past decade has witnessed tremendous growth in global health opportunities for trainees; however, these opportunities tend to be restricted to individual institutions and geographic regions and academic global pulmonary and critical care medicine (PCCM) remains a relatively novel concept [2]. Consequently, PCCM fellows and junior faculty at institutions with limited global health mentorship have little guidance in building successful global health careers.

Melting Ice and Malaria

A line from the WHO report on climate change struck me particularly – ‘Roman aristocrats retreated to hill resorts each summer to avoid malaria’. Hoping to pursue a career in Tropical Medicine and Global Health, the climate crisis is one of my primary concerns for the future of global health – will there come a time when we spend our summer holidays hiding in the Pennines from infections at ground level? Being a medical student in London during the climate strikes it was inspiring to see people protest government inaction around preventing climate change - it is certain that climate change is having a measurable impact on global health and that it is time that we encourage awareness and act against it.

Academic careers in global pulmonary and critical care medicine: perspectives from experts in the field

Academic global pulmonary/critical care medicine (PCCM) remains a relatively novel concept not fully embraced by all training programs, so PCCM early-career professionals may have little guidance in building successful careers in this field. To highlight various approaches used by current PCCM faculty to incorporate global health into their academic careers, speakers from a global health careers mini symposia held at the 2017 and 2018 American Thoracic Society International Conferences were invited to submit perspectives reflecting on academic PCCM and global health. The collection of essays was collated into a single manuscript. Eight current global PCCM faculty from diverse geographic and professional backgrounds provide experiential guidance for early-career professionals interested in global academic PCCM. Trainees and junior faculty interested in academic global PCCM will find innumerable obstacles to developing this non-traditional career pathway, but there exist diverse pathways to success.

Road map for capacity building and development for biomedical sciences in Kenya.

There is an effort to develop a critical mass of biomedical researchers in low middle-income countries by funding organizations and academic institutions in high-income countries. This involves providing short- and/or long-term training. Short-term training encompasses acquiring competencies in any or a combination of fieldwork, proposal/grant writing, laboratory techniques, data management, statistical approaches for data analyses and dissemination of research findings. Long-term training involves acquisition of an array of competencies that results into an award of a Master’s or PhD degree or acceptance into post-doctoral training programs. The author is motivated to write this article to create awareness on this capacity building effort and more importantly provide much needed guidance to potential graduate students considering pursuing long-term training careers in biomedical sciences and global health from Kenya.

Report from WPA: Limited resources, cultural sensitivity, and expanding the workforce

As the shortage of mental health care providers comes into focus against a growing need for mental health care worldwide, and the community of individuals pursuing careers in global health broadens, the question emerges: What are the ethics of practicing internationally in a field like psychiatry, which seems inextricably linked with cultural norms, language, sociopolitical events, and the ability to cultivate long‐term therapeutic relationships? I took the opportunity to attend the 18th annual World Psychiatric Association's (WPA's) World Congress of Psychiatry (WCP) in Mexico City in an attempt to learn more.

Evolution of a Stand-Alone Undergraduate Public Health Program and the Inclusion of a Peace Corps Prep Certificate Program

For over a decade there has been a growing interest in undergraduate public health degree programs and global health careers. To this end, colleges and universities across the United States are training undergraduate students to meet these demands. In 2014, the Council on Education for Public Health began to accredit stand-alone, undergraduate public health programs. This article highlights the steps followed by one university to obtain Council accreditation. Additionally, the authors describe how the university’s Peace Corps Prep Certificate Program has been intertwined with the Public Health Studies curriculum to offer public health students a unique opportunity to fulfill both degree and program requirements, while receiving specialized training in global health.