Preliminary findings from the survey cited here (but not the specific material reported herein) were presented at the Global Health Education Consortium Annual Meeting in San Francisco, California, 9 March 2005.
Global choices: international health and medical student residency preferences
Article first published online: 20 OCT 2009
© Blackwell Publishing Ltd 2009
Volume 43, Issue 11, pages 1079–1080, November 2009
How to Cite
Bazemore, A. and Diller, P. (2009), Global choices: international health and medical student residency preferences. Medical Education, 43: 1079–1080. doi: 10.1111/j.1365-2923.2009.03515.x
- Issue published online: 20 OCT 2009
- Article first published online: 20 OCT 2009
Editor – As globalisation and increasing migration blur borders, medical students are demonstrating an increasing interest in global health, a trend to which primary care graduate medical education (GME) programmes are responding.1,2 Although global health programmes have been reported to have many benefits for trainees, little is known about the benefits they offer to GME programmes.2–4 We performed a cross-sectional survey of medical student attendees at the 2004 American Academy of Family Physicians (AAFP) National Conference of Family Medicine Residents and Medical Students in Kansas City, Missouri, a natural confluence of students interested in primary care from across the country, to measure the self-reported impact on students of the offer of global health training on student recruitment to a particular residency training programme. The study protocol was approved by the University of Cincinnati Institutional Review Board.
Of 82 medical student respondents (over 80% of those approached), 91% felt that training in global health should be offered by all family medicine residency programmes and 81% noted that a residency offering international health opportunities would be more or much more appealing than one that did not.
Interest in primary care specialties among US seniors has waned since 1997, in parallel with the growth in their participation in global health.5,6 To be successful, these GME programmes need to have appealing curricula that are attractive to applicants.2 This work adds to growing evidence that students interested in primary care value international health opportunities during residency.
Curricula cannot and should not be judged solely on the basis of their popularity, but the provision of education in global health may offer additional appeal to policymakers and reformers of medical education. Central to the new administration’s plans for major health policy reform are efforts to increase access to primary care in areas of greatest need, to which the US Congress has responded with bills to expand GME positions for primary care disciplines. Of great concern to educators and policymakers alike is the issue of how to fill existing GME positions in primary care amidst declining interest among US seniors, much less the additional slots being considered by Congress.7,8
In response to these concerns, primary care GME innovation and reform are underway. These innovations are designed to prepare graduates for new models of primary care service delivery in the patient-centred medical home9 and recognise the need to integrate novel curricula that are attractive to learners. Simultaneous expansion of opportunities for training in global health can help programmes undergoing transformation to broaden their community medicine and public health curricula, understand team-based and low-resource care, address service learning, and adapt to an increasingly global community.1–3
These and other demonstrated benefits, such as the fostering of idealism, improving of cultural competency and provision of career choices in underserved settings, are mostly derived from studies of medical students, but are likely to extend to the primary care GME setting.3–5,10 Our recent findings provide early evidence of their power as attractants to primary care.2 They also point to the need for additional research to identify and evaluate meaningful curricula capable of reversing the decline in interest in primary care in the USA and to measure their associations with desirable policy outcomes such as service in the most vulnerable communities.
- 4International health training in family practice residency programmes. Fam Med 1998;30 (1):29–33., .
- 8Special and Geographic Distribution of the Physician Workforce: What Influences Medical Student and Resident Choices? Washington, DC: Josiah Macy Jr Foundation, Robert Graham Center 2009., , , , , et al.
- 9Robert Graham Center. The Patient-Centered Medical Home: History, Seven Core Features, Evidence and Transformational Change. Washington, DC: Robert Graham Center 2007.