Department of Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, US.
Department of Medicine, Weill Cornell Medical College, New York, NY, US.
Ann Glob Health. 2018 Nov 5;84(4):692-703. doi: 10.9204/aogh.2379.
The prevalence of global health in graduate medical education in the United States (US) has soared over the past two decades. The majority of US internal medicine and pediatric residency programs now offer global health electives abroad. Despite the prevalence of global health electives among US graduate medical programs today, challenges exist that may impact the experience for visiting trainees and/or host institutions. Previous reviews have predominately focused on experiences of undergraduate medical students and have primarily described positive outcomes.
The aim of this study was to summarize the overall impact of global health electives on US internal medicine, medicine-pediatric, and pediatric residents, paying specific attention to any negative themes reported in the literature.
An Ovid MEDLINE and Ovid EMBASE literature search was conducted to identify studies that evaluated the effects of global health electives on US internal medicine, medicine-pediatric, and pediatric residents.
Ten studies were included. Four positive themes emerged: (1) improvement of medical knowledge, physical examination, and procedural skills, (2) improvement in resourcefulness and cost-effectiveness, (3) improvement in cultural and interpersonal competence, and (4) professional and career development. Two negative themes were identified: (1) health risks and (2) safety risks.
Global health electives provide a number of perceived benefits for US medical trainees; however, we importantly highlight health and safety concerns described while abroad. Global health educators should recognize the host of unique challenges experienced during a global health elective and investigate how to best mitigate these concerns. Incorporation of mandatory pre-, intra-, and post-elective training programs and establishment of universally adopted global health best practice guidelines may serve to address some the challenges visiting trainees encounter while abroad.
在过去的二十年中，全球健康在美国（美国）研究生医学教育中的普及程度飙升。现在，大多数美国内科和儿科住院医师培训计划都提供国外的全球健康选修课程。尽管今天美国研究生医学课程中普遍开设了全球健康选修课程，但仍存在一些挑战，可能会影响访问学员和/或接待机构的体验。以前的评论主要集中在本科医学生的经验上，并且主要描述了积极的结果。
本研究的目的是总结全球健康选修课程对美国内科，内科-儿科和儿科住院医师的总体影响，特别注意文献中报告的任何负面主题。
进行了 Ovid MEDLINE 和 Ovid EMBASE 文献检索，以确定评估全球健康选修课程对美国内科，内科-儿科和儿科住院医师影响的研究。
共纳入 10 项研究。出现了四个积极的主题：（1）提高医学知识，体检和程序技能，（2）提高应变能力和成本效益，（3）提高文化和人际交往能力，以及（4）职业和职业发展。确定了两个负面主题：（1）健康风险和（2）安全风险。
全球健康选修课程为美国医学受训者提供了许多公认的好处；然而，我们重要的是要强调在国外描述的健康和安全问题。全球健康教育者应认识到在全球健康选修课程中所经历的一系列独特挑战，并研究如何最好地减轻这些担忧。强制性的预，中，后选修培训计划的纳入以及普遍采用的全球健康最佳实践指南的建立，可能有助于解决访问学员在国外遇到的一些挑战。
