Al-Shakarchi Nader, Obolensky Lucy, Walpole Sarah, Hemingway Harry, Banerjee Amitava
Medical School, University College London, London, UK.
Faculty of Medicine and Dentistry, Plymouth University Peninsula Medical School, Plymouth, UK.
BMJ Open. 2019 Aug 24;9(8):e027577. doi: 10.1136/bmjopen-2018-027577.
To assess global health (GH) training in all postgraduate medical education in the UK.
Mixed methodology: scoping review and curricular content analysis using two GH competency frameworks.
A scoping review (until December 2017) was used to develop a framework of GH competencies for doctors. National postgraduate medical training curricula were analysed against this and a prior framework for GH competencies. The number of core competencies addressed and/or appearing in each programme was recorded.
The scoping review identified eight relevant publications. A 16-competency framework was developed and, with a prior 5-competency framework, used to analyse each of 71 postgraduate medical curricula. Curricula were examined by a team of researchers and relevant learning outcomes were coded as one of the 5 or 16 core competencies. The number of core competencies in each programme was recorded.
Using the 5-competency and 16-competency frameworks, 23 and 20, respectively, out of 71 programmes contained no global health competencies, most notably the Foundation Programme (equivalent to internship), a compulsory programme for UK medical graduates. Of a possible 16 competencies, the mean number across all 71 programmes was 1.73 (95% CI 1.42 to 2.04) and the highest number were in paediatrics and infectious diseases, each with five competencies. Of the 16 core competencies, global burden of disease and socioeconomic determinants of health were the two most cited with 47 and 35 citations, respectively. 8/16 competencies were not cited in any curriculum.
Equity of care and the challenges of practising in an increasingly globalised world necessitate GH competencies for all doctors. Across the whole of postgraduate training, the majority of UK doctors are receiving minimal or no training in GH. Our GH competency framework can be used to map and plan integration across postgraduate programmes.
评估英国所有研究生医学教育中的全球健康（GH）培训情况。
混合方法：使用两个GH能力框架进行范围审查和课程内容分析。
采用范围审查（截至2017年12月）来制定医生的GH能力框架。根据此框架以及先前的GH能力框架对国家研究生医学培训课程进行分析。记录每个课程中涉及和/或出现的核心能力数量。
范围审查确定了8篇相关出版物。制定了一个包含16项能力的框架，并与先前的5项能力框架一起用于分析71个研究生医学课程中的每一个。由一组研究人员对课程进行审查，相关学习成果被编码为5项或16项核心能力之一。记录每个课程中的核心能力数量。
使用5项能力框架和16项能力框架时，71个课程中分别有23个和20个不包含全球健康能力，最明显的是基础课程（相当于实习），这是英国医学毕业生的必修课程。在可能的16项能力中，所有71个课程的平均数量为1.73（95%置信区间1.42至2.04），数量最多的是儿科和传染病，各有5项能力。在16项核心能力中，全球疾病负担和健康的社会经济决定因素被引用最多，分别有47次和35次引用。16项能力中有8项在任何课程中都未被引用。
医疗公平以及在日益全球化的世界中执业面临的挑战使得所有医生都需要具备GH能力。在整个研究生培训中，大多数英国医生接受的GH培训极少或没有接受培训。我们的GH能力框架可用于规划和整合研究生课程。
