Embedding international medical student electives within a 30-year partnership: the Ghana-Michigan collaboration

Abstract

Background: Global health experiences are an increasingly popular component of medical student curricula. There is little research on the impact of international medical electives embedded within long-standing, sustainable partnerships. Our research explores the University of Michigan medical student elective experience in Ghana within the context of the Ghana-Michigan collaborative. Methods: Study participants are University of Michigan medical students who completed an international elective in Ghana between March 2006 and June 2017. Post-elective reports were completed by students, including a description of the experience, highlights, disappointments, and the impact of the experience on interest in future international work and future practice of medicine. A retrospective thematic analysis of reports was carried out using NVivo 12 (QSR International, Melbourne, Australia). Results: A total of 57 reports were analyzed. Benefits of the elective experience included building cross-cultural relationships, exposure to different healthcare environments, hands-on clinical and surgical experience, and exposure to different patient populations. Ninety-five percent of students planned to engage in additional international work in the future. Students felt that the long-standing bidirectional exchange allowed them to build cross-cultural relationships and be incorporated as a trusted part of the local clinical team. The partnership modeled collaboration, and many students found inspiration for the direction of their own careers. Conclusions: Embedding clinical rotations within a well-established, sustained partnerships provides valuable experiences for trainees by modeling reciprocity, program management by local physicians, and cultural humilityall of which can help prepare learners to ethically engage in balanced, long-term partnerships in the future.

Gynecologic Oncology Sub-Specialty Training in Ghana: A Model for Sustainable Impact on Gynecologic Cancer Care in Sub-Saharan Africa

“…To date, 246 OBGYN resident physicians have been trained, of which 236 (95.9%) certified specialists have remained in-country ( 24 , 37 – 39 ). Subsequently, the University of Michigan has continued long-standing relationships with Ghanaian medical schools ( 40 – 42 ) and has been committed to an ongoing exchange of faculty and trainees ( 43 ). Building upon the successful OBGYN residency programs, the GCPS developed subspecialty training programs to further improve clinical care and promote research in certain specialized areas.…”

A Scoping Review of the Ethical Impacts of International Medical Electives on Local Students and Patient Care

“…Overview of the selected studies Travel destinations were mostly based in Sub-Saharan Africa (including Malawi [17,18], Zimbabwe [17], Zambia [18], Uganda [2,19,20] Tanzania [18,20], Botswana [21,22], Ghana [23,24], Benin [25], Kenya [17,26] and South Africa [19,26,27]), but also included other LMICs such as Solomon Islands [8,28,29] and India [2,17,22,26]. Students described in the studies mostly came from the USA (including Michigan [24] and Pennsylvania [21]), the UK (including London [17], Oxford [30], and Birmingham [31]), and Canada [2,22,26,32].…”

“…For the purpose of this analysis, rather than being grouped by the type of journal article, the papers were grouped by the "perspective" on which they were based. The rst group was publications based on interviews and re ections of students returning from electives (14 papers) [8, [17][18][19][20]22,24,26,27,29,[31][32][33][34]. The second group consisted of publications written by members of host institutions in LMICs, or based on interviews with them (5 papers) [2,25,28,35,36].…”

“…One-sided bene ts in partnership Some papers discussed the need for establishing bidirectional travel programmes as opposed to unilateral ones [2,24], and identi ed administrative, nancial and language barriers which can prevent students from LMICs from travelling to a HIC) [38]. The importance of exchange of teaching and ideas between the institutions was also discussed [21,30,42].…”

Could global surgery overcome a decline in surgical cases?

“…There should be a formal Memorandum of Understanding between HIC and LMIC, which emphasizes mutual benefits with longitudinal tracking of case logs [ 14 ]. There are successful electives such as between the University of Michigan Medical School and institutions in Ghana for over 30 years, which can serve as models [ 15 ].…”