ObjectivesTo evaluate the feasibility of providing regular, live, text-based teaching to medical students and junior doctors in Somaliland using a dedicated case-based medical education website ().DesignReview of MedicineAfrica database for details of teaching sessions held in Somaliland from December 2008-October 2010 and evaluation of user experiences through focus groups.SettingKing's College Hospital, London, UK and Ahmoud University, Borama, Somaliland.ParticipantsFinal year medical students, newly graduated interns and second year interns at Ahmoud University, Borama, Somaliland.Main outcome measuresQualitative and quantitative user rating of online case-based tutorials in the context of pre-existing educational opportunities available to them.ResultsRegular online teaching sessions are received enthusiastically by students and junior doctors and are reported to improve their clinical practice.ConclusionsDespite technological limitations in Somaliland, a live text-based teaching service can be delivered effectively and streamlined with local curricula. This represents an alternative to traditional static teaching methodologies currently used in international medical education.

As more mission groups become involved with health care education, by starting medical and nursing schools, postgraduate training programs and paramedical professional training, there is a need to recruit expatriate faculty from high income countries to help start programs as there are few national health care education professionals available in the mission setting in most low- and middle-income countries. This paper outlines the current status and needs for academic faculty in health care education mission settings. A working group of medical educators met in conjunction with the Global Missions Health Conference in November 2015 and discussed the motivational factors which lead Christian academics to volunteer, both short- and long-term in mission settings. The group then looked at barriers to volunteering and made suggestions for future directions and best practices when mobilizing academics from high income countries.

One of the challenges facing international healthcare missionaries is that of maintaining up-to-date knowledge and staying current with professional certification. Since 1978, annual programs by the Christian Medical and Dental Associations have offered professional continuing education to thousands of US healthcare professionals serving as missionaries in the regions of Africa, Asia, and, in more recent years, globally. In addition, conference programming is designed to prepare, train, and support healthcare missionaries to, in turn, serve as educators in their places of ministry. The program is designed for both professional education and personal encouragement. Utilizing historical documents from program facilitation and interviews from those involved with its implementation, this paper describes the history, vision, and favorable quantitative growth and qualitative impact on participants. The program continues to grow as healthcare missionaries are educated near their places of service, while reinforcing their own roles as educators.

Critical thinking, an essential skill for the transformation of medical knowledge into practice, should be a key component of medical education, even in cross-cultural training situations.  Critical thinking is the use of purposeful, self-regulatory judgment which results in interpretation, analysis, evaluation, and inference as well as the explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations upon which that judgment was based.  Critical thinking is important because the healthcare workplace and the science on which healthcare is based continue to advance and evolve. Those who teach healthcare cross-culturally may experience challenges in teaching critical thinking to cross-cultural learners, challenges in the areas of language/communication, cultural differences, customary education approach, and educator factors. The challenges may be identified, addressed, and overcome.  Tangible means of implementing training in critical thinking include the use of questions and discussions during educational sessions as well as structured systems for reflecting on causes and treatment of medical conditions.

A response to Mark Crouch's article The Propper College.

The severe lack of human resources in the health care field in many countries has resulted in avid interest in global undergraduate medical education. Christian medical missionaries have, thus, a unique opportunity to contribute to transformative, holistic development through the training of future physicians for resource-limited settings. Starting a new medical school is, however, a complex process which requires significant resources and intellectual investment. This paper outlines some of the challenges encountered in faith-based individuals’ engagement in undergraduate medical education, as well as suggesting some practical solutions and recommendations.

Ethical issues frequently arise during the practice of clinical medicine and when providing medical education.  These issues become particularly challenging when practicing and teaching medicine cross-culturally.  In this case study, a structured approach to managing ethical challenges effectively was found to assist in overcoming a conflict about potentially removing a seemingly incompetent medical trainee from a residency program.  The step-wise approach includes identifying relevant stakeholders; agreeing on actual background facts; understanding the various goals and values involved in the situation; reviewing locally applicable ethical, professional and legal standards; acknowledging limitations in various options to resolve the issues; and analyzing risks and benefits of the various courses of action.

In the United States, there are a growing number of medical students participating in international health electives. These experiences have the potential to be mutually beneficial to both the host country and the student. However, there is a significant risk of unethical and damaging practices during these trips, including concerns for sending trainees without appropriate pre-travel preparation with inadequate accountability to local health care providers at a stage in their education that imposes an undue burden on the local health facilities. This article describes one first year medical student's experience in navigating common challenges faced in international health electives and offers practical advice enlightened by the literature on how to overcome them. We emphasize the need for students to ensure adequate pre-trip preparation, communicate their level of training clearly, practice cultural humility, ensure personal safety, and engage in projects needed by the host community.