A comprehensive framework for international medical programs: A 2017 consensus statement from the American College of Academic International Medicine

Abstract

The American College of Academic International Medicine (ACAIM) represents a group of clinicians who seek to promote clinical, educational, and scientific collaboration in the area of Academic International Medicine (AIM) to address health care disparities and improve patient care and outcomes globally. Significant health care delivery and quality gaps persist between high-income countries (HICs) and low-and-middle-income countries (LMICs). International Medical Programs (IMPs) are an important mechanism for addressing these inequalities. IMPs are international partnerships that primarily use education and training-based interventions to build sustainable clinical capacity. Within this overall context, a comprehensive framework for IMPs (CFIMPs) is needed to assist HICs and LMICs navigate the development of IMPs. The aim of this consensus statement is to highlight best practices and engage the global community in ACAIM's mission. Through this work, we highlight key aspects of IMPs including: (1) the structure; (2) core principles for successful and ethical development; (3) information technology; (4) medical education and training; (5) research and scientific investigation; and (6) program durability. The ultimate goal of current initiatives is to create a foundation upon which ACAIM and other organizations can begin to formalize a truly global network of clinical education/training and care delivery sites, with long-term sustainability as the primary pillar of international inter-institutional collaborations.

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“…[ 282 370 ] Consequently, despite significant technological progress in learning platforms, and increasing use of such platforms in HICs,[ 637 ] partners in LMICs may not be able to take full advantage of bidirectional information exchanges and various other virtual educational opportunities. [ 638 639 ]…”

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“…While the learners drew substantial benefit from the ACS faculty’s expertise in systems assessment and development and local delivery of emergency and essential surgical care, this dual role at times may have also limited their time and availability to mentor energetic and innovative learners. Solutions to this vexing and well recognized issue have been difficult to identify [ 19 ], and ultimately would require systematic negotiated allowance for higher ratios of protected academic to clinical time (i.e., for research and mentorship responsibilities) for participating faculty. Finally, in the present era of health system and education cost containment in the HIC, SSS program creators and academic administrators are facing significant resource constraints affecting development of innovative education paradigms as evidenced by the disparate funding for DGH and CGS students which may limit student participation due to personal financial circumstances.…”

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“…Parallel to these developments will be the phased introduction of LCC as a voluntary medium of exchange for various international medical programs (IMPs) collaborating within our global network of institutions, providers, and clinical sites. [ 30 ]…”