From the Department of Neurology (J.L.L.), Brigham and Women's Hospital, Boston, MA; the American Academy of Neurology (M.E.C.), Minneapolis, MN; the Department of Neurology (J.W.E.), University of California at San Francisco; the Department of Neurology (F.J.M.), Massachusetts General Hospital, Boston; and the Department of International Health (F.J.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Neurology. 2014 Jan 14;82(2):119-25. doi: 10.1212/WNL.0000000000000019. Epub 2013 Dec 6.
To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs.
There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown.
A survey was distributed to all program directors in the United States and Canada (December 2012-February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives.
Approximately half of responding programs (53%) allow residents to pursue global health-related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%-9% of residents (55% of programs) and 10%-19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives.
In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority of Canadian programs that responded allow international electives, likely due to clearer guidelines from the Royal College of Physicians and Surgeons of Canada compared to the Accreditation Council of Graduate Medical Education. However, the number of both Canadian and US neurology trainees venturing abroad remains a minority. Most program directors are interested in learning more information related to global health electives for neurology residents.
确定美国和加拿大研究生神经学项目中全球健康培训和人道主义救援机会的现状。
北美受训者对在低收入和中等收入国家进行医学选修课程越来越感兴趣。这种培训机会提供了许多教育和人道主义方面的好处，但也带来了与组织、人力资源、资金以及受训者和患者安全相关的若干挑战。目前，神经学研究生培训计划对受训者参加国际轮转的支持和参与情况尚不清楚。
通过美国神经病学学会向美国和加拿大的所有项目主任（2012 年 12 月至 2013 年 2 月）分发了一份调查，以评估培训机会、机构合作关系以及为国际神经学选修课程提供的支持。
约一半的回应项目（53%）允许住院医师进行与全球健康相关的选修课程，11%的项目报告称至少有 1 名受训者在培训期间参与了人道主义救援（调查回复率 61%，143/234 位项目主任）。与美国项目相比，加拿大项目更有可能允许住院医师进行国际选修课程（10/11，91%对 65/129，50%，p=0.023）。参加国际选修课程的受训者人数较少：55%的项目（0%-9%的住院医师）和 21%的项目（10%-19%的住院医师）。缺乏资金是住院医师不参加全球健康选修课程的最常见原因。如果有资金，93%的项目主任表示会有时间让住院医师参加。大多数项目主任（75%）对全球健康选修课程的进一步信息感兴趣。
尽管存在很高的认知兴趣，但只有一半的美国神经学培训项目包括国际选修课程，主要是因为报告称缺乏资金。相比之下，回应的加拿大项目大多允许国际选修课程，这可能是因为与毕业后医学教育认证委员会相比，加拿大皇家内科和外科医师学院提供了更明确的指导方针。然而，无论是在加拿大还是在美国，冒险出国的神经学受训者人数仍然是少数。大多数项目主任都有兴趣了解更多关于神经学住院医师全球健康选修课程的信息。
