Global Health Education for Pediatric Residents: Trends, Training Experiences, and Career Choices

Abstract

BACKGROUND AND OBJECTIVES: Knowledge and skills related to global child health are increasingly recognized as important to the practice of pediatrics. However, little is known about the status and trends in global health (GH) education in US pediatric residency programs. Our aim was to measure trends in residents' exposure to GH training, their GH education assessments, and GH career plans. METHODS:We analyzed GH-focused questions from national American Academy of Pediatrics surveys of graduating residents in 2008 and 2016. Logistic regression was used to estimate changes over time by using derived predicted values. RESULTS:A total of 1100 graduating pediatric residents participated; response rates were 58.8% for 2008 and 56.0% for 2016. The percentage of residents reporting that their programs offered GH training grew from 59.1% in 2008 to 73.1% in 2016 (P < .001). The majority were somewhat likely, very likely, or definitely planning to work or volunteer in a low-or middle-income country after their residency (predicted value of 70.3% in 2008 and 69.4% in 2016; P = .76). Fourteen percent of respondents reported having completed an international elective in 2016; of those, 36.5% did not receive formal preparation before the experience, and 24.3% did not participate in debriefing sessions on return. Overall, 27.3% of respondents in 2016 reported excellent (8.8%) or very good (18.5%) GH training. CONCLUSIONS:Although a substantial percentage of pediatric residents participate in international electives and plan to include GH activities in their careers, gaps remain, including suboptimal preparation and debriefing for GH electives. abstract

Global Health Experience and Interest: Results From the AAP Periodic Survey

“…This has been mirrored by evidence that residents that are interested in subspecialty training are very likely or likely to incorporate GH clinical work or research in an international setting. 6 Furthermore, subspecialist participation is significantly higher than general pediatrician involvement in the past year (9.0% vs 2.9%), with an increased intent to participate in the next 3 years (40.6% vs 26.3%). These differences may reflect a change in practice and increasing demands in LMICs for more subspecialty care and teaching.…”

“…These increases mirror the significant rise of trainee participation and interest in GH at both the medical school and residency levels. [1][2][3]5,6,8 Interestingly, there is a significant increase in participation in GH experiences in pediatricians .50. Increasingly, practicing pediatricians want shorter-term experiences, ideally ,1 month in duration.…”

“…Participation at both the undergraduate and postgraduate medical school levels has clearly increased, [1][2][3] and this has been mirrored by increased participation in GH experiences in many specialties. 4,5 Surveys of pediatric training programs revealed that 7.3% of pediatric residents participated in overseas GH electives during the 2013-2014 academic year, 5 13.5% of pediatric residents completed an overseas GH elective during their 3 years of training, 6 and 58.1% of all residency training programs offered GH experiences overseas. 5 Unfortunately, there has been little exploration of GH engagement at the practicing physician level over the past 30 years.…”

Global Guide: A Comprehensive Global Health Education Resource for Pediatric Program Directors

“…Pediatric trainees are increasingly seeking global health (GH) educational opportunities, with ∼1 in 4 participating in a GH elective during residency. 1,2 Training programs have responded to this demand: surveys suggest that ∼58% of residency and 47% of fellowship training programs offer GH electives. 3,4 In accordance with best practices pertaining to shortterm GH electives, many programs are attempting to build GH training opportunities beyond electives, including longitudinal GH curricula at their respective institutions, predeparture preparation training, postreturn debriefing, and global training partnerships.…”

“…3,4 In accordance with best practices pertaining to shortterm GH electives, many programs are attempting to build GH training opportunities beyond electives, including longitudinal GH curricula at their respective institutions, predeparture preparation training, postreturn debriefing, and global training partnerships. 1,2,[4][5][6][7][8][9][10][11] Concomitantly, educators are recognizing that all trainees, not just those planning to work abroad, need to learn about GH-related topics. The "local global health" framework 12 highlights that diseases do not respect borders, resource limitation is not unique to low-and middleincome countries (LMICs), and core skills are necessary for all trainees caring for patients and families from (and going to) diverse settings.…”