Office of Global Health Education, Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, 1002 Bondurant, CB# 9535, Chapel Hill, USA.
Department of Family Medicine, University of North Carolina, Chapel Hill, USA.
BMC Med Educ. 2021 Oct 29;21(1):552. doi: 10.1186/s12909-021-02975-3.
Global health interest has grown among medical students over the past 20 years, and most medical schools offer global health opportunities. Studies suggest that completing global health electives during medical school may increase the likelihood of working with underserved populations in a clinical or research capacity. This study aimed to assess the association of global electives in medical school on subsequently working in global health and with underserved populations in the United States (U.S.), additionally considering students' interests and experiences prior to medical school. We also examined whether respondents perceived benefits gained from global electives.
We surveyed medical school graduates (classes of 2011-2015) from a large public medical school in the U.S. to describe current practice settings and previous global health experience. We evaluated work, volunteer, and educational experiences preceding medical school, socioeconomic status, race and ethnicity using American Medical College Application Service (AMCAS) data. We assessed the association between students' backgrounds, completing global health electives in medical school and current work in global health or with underserved populations in the U.S.
In the 5 to 8 years post-graduation, 78% of 161 respondents reported work, research, or teaching with a focus on global or underserved U.S.
Completing a global health elective during medical school (p = 0.0002) or during residency (p = 0.06) were positively associated with currently working with underserved populations in the U.S. and pre-medical school experiences were marginally associated (p = 0.1). Adjusting for pre-medical school experiences, completing a global health elective during medical school was associated with a 22% greater prevalence of working with an underserved population. Perceived benefits from global electives included improved cultural awareness, language skills, public health and research skills, and ability to practice in technology-limited settings.
Medical school graduates who participated in global electives as students were more likely than their peers to pursue careers with underserved populations, independent of experiences prior to medical school. We hypothesize that by offering global health experiences, medical schools can enhance the interests and skills of graduates that will make them more likely and better prepared to work with underserved populations in the U.S. and abroad.
在过去的 20 年中，医学生对全球健康的兴趣日益浓厚，大多数医学院都提供全球健康机会。研究表明，在医学院期间完成全球健康选修课程可能会增加以临床或研究为基础为服务不足人群工作的可能性。本研究旨在评估医学生全球选修课程与随后在美国（美国）从事全球健康工作和服务不足人群的关联，同时考虑学生在医学院之前的兴趣和经验。我们还研究了受访者是否认为从全球选修课程中获得了收益。
我们调查了来自美国一所大型公立医学院的医学生毕业生（2011-2015 年毕业），以描述当前的实践环境和以前的全球健康经验。我们使用美国医学院申请服务（AMCAS）数据评估医学院前的工作、志愿和教育经验、社会经济地位、种族和民族。我们评估了学生背景、在医学院完成全球健康选修课程与当前在美国从事全球健康或服务不足人群工作之间的关联。
在毕业后的 5 到 8 年中，161 名受访者中有 78%报告从事全球或美国服务不足人群的工作、研究或教学。
在医学院期间（p=0.0002）或住院期间（p=0.06）完成全球健康选修课程与目前在美国为服务不足人群工作呈正相关，而医前经验则呈边缘相关（p=0.1）。在校前经验调整后，在医学院期间完成全球健康选修课程与从事服务不足人群工作的比例增加 22%。全球选修课程的收益包括提高文化意识、语言技能、公共卫生和研究技能以及在技术有限的环境中执业的能力。
参加过全球选修课程的医学生毕业生比同龄人更有可能从事服务不足人群的职业，这与他们在医学院之前的经验无关。我们假设，通过提供全球健康经验，医学院可以增强毕业生的兴趣和技能，使他们更有可能并更好地准备在美国和国外为服务不足的人群服务。
