Evidence of Reciprocity in Reports on International Partnerships

Abstract

The increase in global health opportunities in medical education has been accompanied by calls for ethical and reciprocal institutional partnerships. The Working Group on Ethics Guidelines in Global Health Training (WEIGHT) guidelines were developed in 2010 and are widely accepted by the global health community. We reviewed 43 articles on international partnerships from 1970 to 2010 for eight principles of reciprocity derived from the WEIGHT guidelines. The results showed that, while few articles reflected all principles, there was a trend to increasing consideration of the international partner’s local needs, pre-departure cultural training, and collaborative authorship. However, learner supervision and consideration of local cost/benefit ratios decreased over the same time period. Partnerships with only one international partner or with institutional partners in Africa had lower reciprocity scores than those with two or more partners and institutional partners in Asia and South America. We recommend that a new focus on ethics in global health partnerships leads to the inclusion of the principles of reciprocity in model program descriptions in order to enable and encourage ethical, sustainable, and mutually beneficial institutional partnerships.

On Becoming a Global Citizen: Transformative Learning Through Global Health Experiences

“…Medical training programs designing global health experiences for their trainees are encouraged to establish international partnerships, built on mutuality and reciprocity, 17,26–28 and regularly engage trainees and committed faculty supervisors in shared international experiences with ample opportunities for reflection together.…”

Fostering Reciprocity in Global Health Partnerships Through a Structured, Hands-On Experience for Visiting Postgraduate Medical Trainees

“…9 For global health partnerships to be considered equitable, reciprocal learning opportunities for faculty and trainees from the resource-limited institution can be made available in the resource-rich institution. [10][11][12][13][14][15] Such opportunities may help to facilitate the sustainable development of national educational and research capacity. [16][17][18][19] The Working Group on Ethics Guidelines for Global Health Training (WEIGHT) group guidelines for global health training programs represent an important effort to codify ethics and best practices for global health experiences.…”

“…14,20 The disparity occurs in an increasingly globalized world and at a time when physicians in both resource-rich and resource-limited settings are expected to have broad knowledge of current approaches to diagnosis and management of a variety of acute and chronic health conditions. 21,22 One mechanism of accomplishing that is through hosting international learners from institutional partners in resource-limited settings.…”

Training Programs Within Global Networks: Lessons Learned in the Fogarty International Clinical Research Scholars and Fellows Program

“…8 Structured partnerships mitigate ethical, cultural, and sustainability compromises. 9,10 Egalitarianism is an important principle, avoiding academic imperialism; Westerners are being trained, and local talent must also be nurtured and developed with sincere and substantial effort.…”

“…15 This component provided significant value to both US and LMIC trainees as well as reciprocity among research sites and host countries. 10,24,25 Simultaneously with the selection process for US trainees each year, international sites and their US partners nominated and selected local doctoral students, post-doctoral trainees, and junior faculty members to pair with incoming US trainees at the international site. The sites and their US partners had substantial flexibility in selecting the local twin.…”