1Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts.
2Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Am J Trop Med Hyg. 2021 Apr 19;104(6):2286-2292. doi: 10.4269/ajtmh.20-1589.
Postgraduate clinical global health (GH) training is a rapidly evolving field. To understand and improve training opportunities, we sought the perspectives of current and former trainees related to their advanced clinical training or global health fellowships and the anticipated impact on their careers. Clinical GH fellowships across North America were identified through websites and previous studies. An e-mail was sent to program directors to invite all current and former GH fellows to complete a web-based questionnaire. We contacted 100 GH fellowship programs. Fifty-two fellows from 10 different specialties completed the survey. The median fellowship length was 23.3 months, with an annual median of 4.8 months spent in low-income and middle-income countries, which was less than their reported ideal of 6 months. The majority reported satisfaction, the anticipation of career benefits, and that they would recommend fellowship training to others. Challenges included insufficient funding, mentorship, and formal curricula. Conducting research in high-income countries was a significant negative predictor of fellowship satisfaction. Most fellows (73.1%) were not at all or only a little concerned about the absence of fellowship accreditation, with only 17.3% desiring accreditation. Survey respondents were largely satisfied with their training and valued program flexibility and educational opportunities, including advanced tropical medicine certificates or diplomas. However, to improve fellowship training, improvements are needed in mentorship, standardized curricula, institutional support, and funding. For GH fellowship training to be effective and sustainable, institutions will need to balance the needs of fellows, training programs, and the communities (low-, middle-, and high-income countries) where the fellows serve.
研究生临床全球健康（GH）培训是一个快速发展的领域。为了了解和改善培训机会，我们征求了当前和以前的受训者的意见，了解他们的高级临床培训或全球健康研究员的情况，以及他们对职业的预期影响。通过网站和先前的研究确定了北美的临床 GH 研究员。向项目主任发送电子邮件，邀请所有现任和前任 GH 研究员完成基于网络的问卷调查。我们联系了 100 个 GH 研究员项目。来自 10 个不同专业的 52 名研究员完成了调查。研究员的平均工作时间为 23.3 个月，每年有 4.8 个月在低收入和中等收入国家度过，这低于他们报告的理想的 6 个月。大多数人表示满意，预计会有职业收益，并会向其他人推荐研究员培训。挑战包括资金不足、指导和正式课程。在高收入国家开展研究是影响研究员满意度的一个显著负面因素。大多数研究员（73.1%）根本不担心或只担心研究员培训没有认证，只有 17.3%的人希望获得认证。调查受访者对他们的培训大多感到满意，并重视项目的灵活性和教育机会，包括高级热带医学证书或文凭。然而，为了改善研究员培训，需要在指导、标准化课程、机构支持和资金方面进行改进。为了使全球健康研究员培训有效和可持续，机构将需要平衡研究员、培训项目和研究员服务的社区（低收入、中等收入和高收入国家）的需求。
