Siegert Thomas F, Gladding Sophia P, Walker Patricia F, Tupesis Janis P, Steenhoff Andrew P, Doobay-Persaud Ashti A, Barnett Elizabeth D, Sanders John W, Hendel-Paterson Brett R
Department of Pediatrics, Division of Medicine-Pediatrics, The Warren Alpert Medical School at Brown University, Providence, Rhode Island.
Yukon-Kuskokwim Health Corporation, Bethel, Alaska.
Am J Trop Med Hyg. 2024 Nov 12;112(1):226-233. doi: 10.4269/ajtmh.24-0377. Print 2025 Jan 8.
The number of global health (GH) fellowships in the United States has increased over the past two decades. However, there are currently no standard requirements, shared core content, or widespread systems of accreditation. With the growth in programs, it is appropriate to consider these issues. We conducted a national survey to understand GH fellowship leaders' perspectives on the existence of core content and competencies and on the need for accreditation, including by the Accreditation Council of Graduate Medical Education (ACGME). We sent survey invitations to 123 fellowship leaders. Forty-five completed the survey (37%), representing seven specialties. Eighty-nine percent of respondents indicated that there is important core content for fellows to learn regardless of specialty; 30% indicated that accreditation would be "very" or "extremely" beneficial, whereas 21% indicated that it would be "not at all" beneficial. When asked what form of accreditation would result in training the most competent GH practitioners, 35% indicated that accreditation is unnecessary. Of those selecting a form of accreditation, the largest proportion (21%) selected accreditation from a professional society; 52% "disagreed" or "strongly disagreed" that ACGME accreditation is needed. More than 65% indicated that loss of training flexibility, funding restrictions, and increased administrative and fellow funding burdens are "very" or "extremely" important barriers. These results suggest that broad agreement on important core content exists across specialties, with a lack of consensus about the need for accreditation. More discussion with stakeholders, including international partners, is needed to understand their perceptions and build consensus before pursuing fellowship accreditation.
在过去二十年中，美国全球健康（GH）奖学金项目的数量有所增加。然而，目前尚无标准要求、共享的核心内容或广泛的认证体系。随着项目的增多，考虑这些问题是恰当的。我们开展了一项全国性调查，以了解GH奖学金项目负责人对核心内容和能力的存在情况以及认证需求的看法，包括由毕业后医学教育认证委员会（ACGME）进行认证的需求。我们向123位奖学金项目负责人发送了调查邀请。45人完成了调查（37%），涵盖七个专业。89%的受访者表示，无论专业如何，学员都有重要的核心内容需要学习；30%的受访者表示认证会“非常”或“极其”有益，而21%的受访者表示认证“完全”没有益处。当被问及哪种认证形式会培养出最有能力的GH从业者时，35%的受访者表示认证没有必要。在选择认证形式的受访者中，最大比例（21%）选择了专业协会的认证；52%的受访者“不同意”或“强烈不同意”需要ACGME认证。超过65%的受访者表示培训灵活性的丧失、资金限制以及行政和学员资金负担的增加是“非常”或“极其”重要的障碍。这些结果表明，各专业在重要核心内容上存在广泛共识，但在认证需求方面缺乏共识。在推进奖学金项目认证之前，需要与包括国际合作伙伴在内的利益相关者进行更多讨论，以了解他们的看法并达成共识。
