What do we mean by Global Health

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What do we mean by Global Health?

• Timothy Brewer, MD, MPH
• Global Health Programs
• McGill Medical School
• July 16, 2008

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• 2.5
• 56
• 26.3
• 36
• 132,471
• 4,250,000

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(No Transcript)
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Challenges Facing Global Health Educational
Programs

• Short-term
• Rising student interest exceeds program capacity
• Little knowledge or sharing of best practices
• Lack of common learning objectives
• Lack of curriculum time, administrative support
• Long-term
• Sustainable, equitable partnerships
• Faculty development and support

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Student Participation in International Health
Electives, 1998-2007
Medical School Graduation Questionnaire Reports
Association of American Medical Colleges Division
of Medical Education, Washington, DC.
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(No Transcript)
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What are Canadian Medical Schools doing for
Undergraduate Global Health Education?

• 2005-2006 Survey of global/international health
  educational offerings in Canadian medical schools
• Deans Office, institutional representatives,
  student liaisons, faculty and web sites
• Global health courses, lectures/modules, and GH
  topics within other courses/modules
• Divided into mandatory and elective
• Definition of GH determined by respondent
• AFMC Resource Group on Global Health 2006

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Results

• No mandatory stand-alone GH courses
• Dalhousie to start in 2006-2007
• 9 Medical schools (53) had mandatory lectures or
  modules
• Ranged from 2-22 hours over 4 years
• 10 Medical schools (58) included global health
  issues in other mandatory lectures
• Community health, tropical medicine, etc.

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Izadnegahdar. Academic Med 200883192.
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Are students able to go on International Health
Electives?

• Option available at all 17 Medical Schools,
  though discouraged at Northern Ontario
• 7/16 medical schools (44) electives arranged by
  students without any clear faculty
  involvement/supervision
• Only 4 medical schools (25) required
  pre-departure training
• Range 2 hours to 43 hours of combined
  language/course work

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Izadnegahdar. Academic Med 200883192.
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Pre-Departure Training
Source Survey by the Canadian Federation of
Medical Students. 2008
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Educational Challenges for Global Health

• No uniform guidelines or objectives
• Educational content varies by
• Definition of global health
• Topics covered
• Up to 10-fold difference in time allocated
• Year of matriculation materials taught
• Mandatory or elective

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Institutional Challenges

• Expanding requirements for medical educators
  without expanding time
• Social accountability, molecular genetics
• Competing international priorities
• United Kingdom, Germany, Japan India
• Money

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Partnership Challenges an International Student
Elective

• Canada ? Thailand
• Find a site
• Visa 65
• Cover all Travel Expenses

• Thailand ? Canada
• Register with the Collège des médecins du Québec
  (CMQ) 50
• Immigration Medical Exam 150
• Visas and Work Permits
• 150
• Application processing fee
• 50
• McGill elective fee
• 400 to 800
• Cover all travel expenses

65 Travel expenses
800 to 1,200 Travel expenses
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Global Health A Working Definition

• health problems, issues, and concerns that
  transcend national boundaries, may be influenced
  by circumstances or experiences in other
  countries, and are best addressed by cooperative
  actions and solutions.
• Institute of Medicine 1997
• Encompasses political, economic and social
  dynamics in addition to disease that impact the
  health of populations
• AFMC Resource Group 2007

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Core Competencies

• Global Burden of Disease
• Distribution of major diseases in high-
  low-income countries
• Migration, Movement and Marginalization of People
• Immigrant, refugee travel medicine underserved
  populations
• Globalization of Health and Health systems
• Brain drain, trade patent agreements, rapid
  international movement of people, food, vectors
  and diseases
• Social and Environmental Determinants of Health
• Gender and economic inequalities poverty, war,
  violence and terrorism population growth,
  urbanization and the encroachment of human
  populations into previously uninhabited
  ecosystems
• Climate Change
• Healthcare in Low-Resource Settings
• Capacity building, resource utilization,
  community-based medicine

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Short-term Activities

• Create consensus on core competencies
• Knowledge, attitudes skills
• Identify resources for teaching
• Global Health Education Consortium (GHEC) Modules
• Starting with strategies that introduce content
  without adding time
• Case studies, example problems, selected readings

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Long-term Goals

• Integrated, collaborative training programs
• Multiple institutions exchanging students,
  faculty and resources
• Faculty development programs
• Masters and doctoral programs
• Residency and fellowship training
• Secure funding streams
• Salaries, programs, administrative support
• Ethics programs
• Clinical, research

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Moving Forward

• Build partnerships (home abroad)
• AFMC Resource Group on Global Health
• Social Accountability, Gender Equity
• Undergraduate Associate Deans
• Health Canada, RCPSC
• Advocacy
• Student leadership needs faculty support