How Should Schools Respond to Learners' Demands for Global Health Training?

Abstract

In the past decade, more students than ever entered medical school with the desire, if not the expectation, of participating in meaningful global health experiences. Schools must now weigh benefits to students of global experiences against burdens of students' learning experiences on institutions and individuals with whom schools partner. Most often, global health training is done as offsite immersion rotations in research or clinical settings. This article explores ethical dimensions of expanding global health offerings while respecting local partners' goals by focusing on the experience of the University of Pennsylvania's global health training programs. Global Health on the Rise Awareness of global health inequality as a social concern and global health as an emerging academic discipline is growing. This growth is perhaps fostered by more widespread appreciation that health in one region often directly and rapidly influences health in another. 1 We see this increased interconnectivity via traveling, sharing food sources that carry infectious agents, and learning how infectious and noncommunicable disease incidence is influenced by social determinants or by climate or geopolitical conditions. 2,3 Awareness of global health is also bolstered by the increasing prevalence and ease of commercial and social media. 4,5 Although attention is often focused on catastrophic global health events, such events increase awareness of disparities in global disease burden and in access to basic disease prevention strategies and health care.

Ethical Considerations of Climate Justice and International Air Travel in Short-Term Electives in Global Health

“…Academic medical centers should critically review their existing programs for high-quality characteristics such as bilateral, longitudinal relationships with host sites, robust pre-departure orientation, and on-site faculty support for trainees. 9 , 10 , 13 , 14 , 16 , 17 Institutions whose STEGH offerings are sporadic, unsupported, and of a unilateral nature should consider the limited benefits to host partners and potential harms of continued rotations, including climate impact. Emulating the University of Pennsylvania, they should narrow STEGH offerings by halting international travel on rotations of limited benefit and reallocate support to quality programs, pivot to remote virtual collaboration, or reinvest in local underserved communities.…”

“…Emulating the University of Pennsylvania, they should narrow STEGH offerings by halting international travel on rotations of limited benefit and reallocate support to quality programs, pivot to remote virtual collaboration, or reinvest in local underserved communities. 9 …”

“…However, there are ethical concerns around multiple aspects of STEGH, including “medical voluntourism” and the need to decolonize medical global health education. 9 – 12 , 16 As such, many educational programs are working to improve bilateral exchange and are revisiting long-standing practices in STEGH. 1 , 13 – 15 Critical program review and pre-departure orientation education acknowledging problematic histories of colonialism and White saviorism are being implemented across U.S.-based academic medical centers.…”

A Systematic Review of Global Health Assessment for Education in Healthcare Professions

“…Although there are various definitions of global health, one that has become commonly accepted is “an area for study, research, and practice that places a priority on improving health and achieving health equity for all people worldwide [ 1 ].” The demand for global health education within health sciences has grown considerably over the last several decades [ 2 3 ]. Students are eager to participate in these experiences for a variety of reasons, including development of cultural competency, desire to reduce health disparities, interest in various cultures, and enhancement of their global health competencies prior to graduation [ 4 ].…”