The COVID-19 pandemic has reinforced Germany's role as global health player, but the education system is lagging behind and does not adequately prepare health professionals for the new challenges. This study aims to strengthen global health in undergraduate medical education in Germany. Major objectives include: to review the current situation, explore changing demand for global health and introduce innovative teaching models and the drivers for change. Mixed methods and an explorative approach were applied, comprising a scoping review, online surveys carried out at Hanover Medical School, March/ April 2020. Target groups were undergraduate medical students (n = 384) and additionally lecturers (n = 172), and finally new multiprofessional teaching courses initiated by students and developed collaboratively. The results reveal only slow pace of change on the level of the education system, while demand for global health education has increased markedly in all actor groups, but strongest in the group of students in the preclinical phase. Implementation of global health programmes illustrates how students can Alexandra Jablonka and Ellen Kuhlmann shared last authorshipThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Background Germany has started to take on greater responsibility in global health policy. Furthermore, new threats, such as climate change, have increased sensitivity. However, health professionals are not well prepared to respond to the new tasks and the changing needs of the population. Global health is still largely missing from the education and training programmes of the vast majority of professional groups in Germany. This paper aims to illustrate how students can become advocates of global health education and enhance institutional change, when health policy fails to act effectively. Methods An elective programme introduced in September 2019 in the undergraduate medical curriculum at Hannover Medical School, Germany, serves as a case study to explore the tools and substance of the programme, as well as the stakeholders involved. Results The new global health programme utilises a window of opportunity in the curriculum, which includes a small number of mandatory seminars which students can chose from. It builds on five major pillars: collaboration between students and the programme coordinator and participatory curriculum development; the SDGs as framework and guidance of the curriculum; a multiprofessional and transsectoral teaching team; collaboration with NGOs; strong networks through collaboration with the national German medical students' association. Sustainability remains a major challenge, yet there is now institutional and financial support at Hannover Medical School and the new German National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education also includes global health issues. Conclusions Students as advocates for global health can make a difference and enhance institutional change through transsectoral, participatory teaching programmes.

Background The COVID-19 pandemic calls for a skilled health workforce, yet global health is largely missing in the medical curriculum in Germany. The interdisciplinary national student “Global Health Network” therefore initiated an online lecture series. “Global Health - perspectives, opportunities and challenges” included 14 lectures on a range of topics held by German and international academics from October 2020 to January 2021. Methods Evaluations were performed prior to, at midterm and after the series, including 5-point likert scales and open questions. Using quantitative and qualitative approaches, participants' motivation and learning outcomes of global health education were analysed. Results A total of 1393 students registered for the series. Individual lectures attracted on average 400 participants, mainly female medical students between 20-25 years, but also a variety of ages, genders and disciplines. Main reasons for participation included interest in COVID-19-related developments, learning about global health-specific topics, and professional development. More than 40% of participants reported to know little about global health before attending; after the lecture series, only 10% made this statement. In addition, 90% of participants perceived an increase of motivation to learn more about the topics, while about 40% gained motivation to become practically involved in the field. The lecture series was accredited in the curriculum at some universities, thus innovating the curriculum and enabling formal credits. Conclusions The new model of student-led online teaching proved to be feasible and demonstrated students' interest and positive impact on global health knowledge. Further institutional change and inclusion of global health in the curricula have to follow. Key messages Students need global health education to respond to global health-related challenges. Volunteer student-led initiatives can increase knowledge and interest and be an important driver for change towards improving global health education.

Background The COVID-19 pandemics has reinforced Germany's role as global health player, but the education system is lagging behind and does not adequately prepare health professionals for the new challenges. This study aims to strengthen global health in undergraduate medical education in Germany. Major objectives include: to review the current situation, explore changing demand for global health and introduce innovative teaching models and the role of student as drivers for change. Methods Mixed methods and an explorative approach were applied, comprising a scoping review, online surveys carried out at Hannover Medical School, March/April 2020, and finally a new multi-professional teaching courses initiated by students and developed collaboratively. Target groups of the survey were undergraduate medical students (n = 384) and additionally lecturers (n = 172). Results The results reveal that new health policies and Germany's new global political responsibility do not adequately translate into innovation in the education system. At the same time, demand for global health education has increased markedly and students have taken action bottom-up and introduced new courses. However, the transformative power on the level of institutions is limited. There is a need for appropriate funding and comprehensive governance innovation to align health and education institutions, research and education, policy and practice, and students and lecturers. Conclusions Implementation of global health programmes illustrates how students can become change agents and enhance institutional innovation bottom-up. However, in order to achieve wider transformative potential, these efforts must be flanked by macro-level policy changes and integrated in future pandemic preparedness strategies. Key messages Strengthening global health education is driven by students’ demand and novel teaching models. Innovation driven by students needs institutional support to achieve transformative powers.