BackgroundPhysicians today are increasingly faced with healthcare challenges that require an understanding of global health trends and practices, yet little is known about what constitutes appropriate global health training.MethodsA literature review was undertaken to identify competencies and educational approaches for teaching global health in medical schools.ResultsUsing a pre-defined search strategy, 32 articles were identified; 11 articles describing 15 global health competencies for undergraduate medical training were found. The most frequently mentioned competencies included an understanding of: the global burden of disease, travel medicine, healthcare disparities between countries, immigrant health, primary care within diverse cultural settings and skills to better interface with different populations, cultures and healthcare systems. However, no consensus on global health competencies for medical students was apparent. Didactics and experiential learning were the most common educational methods used, mentioned in 12 and 13 articles respectively. Of the 11 articles discussing competencies, 8 linked competencies directly to educational approaches.ConclusionsThis review highlights the imperative to document global health educational competencies and approaches used in medical schools and the need to facilitate greater consensus amongst medical educators on appropriate global health training for future physicians.

BackgroundBreast and cervical cancer screening rates remain low among immigrant women and those of low socioeconomic status. The Cancer Awareness: Ready for Education and Screening (CARES) project ran a peer-led multi-lingual educational program between 2012 and 2014 to reach under and never-screened women in Central Toronto, where breast and cervical cancer screening rates remain low.The objective of this qualitative study was to better understand how Chinese and South Asian immigrants – the largest and most under-screened immigrant groups according to national and provincial statistics - conceive of breast and cervical cancer screening. We explored their experiences with screening to date. We explicitly inquired about their perceptions of the health care system, their screening experiences with family physicians and strategies that would support screening in their communities.MethodsWe conducted 22 individual interviews and two focus groups in Bengali and Mandarin with participants who had attended CARES educational sessions. Transcripts were coded through an iterative constant comparative and interpretative approach.ResultsThemes fell into five major, overlapping domains: risk perception and concepts of preventative health and screening; health system engagement and the embedded experience with screening; fear of cancer and procedural pain; self-efficacy, obligation, and willingness to be screened; newcomer barriers and competing priorities. These domains all overlap, and contribute to screening behaviours. Immigrant women experienced a number of barriers to screening related to ‘navigating newness’, including transportation, language barriers, arrangements for time off work and childcare. Fear of screening and fear of cancer took many forms; painful or traumatic encounters with screening were described. Female gender of the provider was paramount for both groups. Newly screened South Asian women were reassured by their first encounter with screening. Some Chinese women preferred the anonymous screening options available in China. Women generally endorsed a willingness to be screened, and even offered to organize women in their community hubs to access screening.ConclusionsThe experience of South Asian and Chinese immigrant women suggests that under and never-screened newcomers may be effectively integrated into screening programs through existing primary care networks, cultural-group specific outreach, and expanding access to convenient community -based screening.

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Context Health advocacy is an essential component of postgraduate medical education, and is part of many physician competency frameworks such as the Canadian Medical Education Directives for Specialists (CanMEDS) roles. There is little consensus about how advocacy should be taught and assessed in the postgraduate context. There are no consolidated guides to assist in the design and implementation of postgraduate health advocacy curricula. Objectives This scoping review aims to identify and analyse existing literature pertaining to health advocacy education and assessment in postgraduate medicine. We specifically sought to summarise themes from the literature that may be useful to medical educators to inform further health advocacy curriculum interventions. Methods MEDLINE, Embase and ERIC were searched using MeSH (medical student headings) and non‐MeSH search terms. Additional articles were found using forward snowballing. The grey literature search included Google and relevant stakeholder websites, regulatory bodies, physician associations, government agencies and academic institutions. We followed a stepwise scoping review methodology, followed by thematic analysis using an inductive approach. Results Of the 123 documents reviewed in full, five major themes emerged: (i) conceptions of health advocacy have evolved towards advocating with rather than for patients, communities and populations; (ii) longitudinal curricula were less common but appeared the most promising, often linked to scholarly or policy objectives; (iii) hands‐on, immersive opportunities build competence and confidence; (iv) community‐identified needs and partnerships are increasingly considered in designing curriculum, and (v) resident‐led and motivated programmes appear to engage residents and allow for achievement of stated outcomes. There remain significant challenges to assessment of health advocacy competencies, and assessment tools for macro‐level health advocacy were notably absent. Conclusions There is considerable heterogeneity in the way health advocacy is taught, assessed and incorporated into postgraduate curricula across programmes and disciplines. We consolidated recommendations from the literature to inform further health advocacy curriculum design, implementation and assessment.