Global Health Education in US Pediatric Residency Programs

Abstract

BACKGROUND AND OBJECTIVE: Despite the growing importance of global health (GH) training for pediatric residents, few mechanisms have cataloged GH educational opportunities offered by US pediatric residency programs. We sought to characterize GH education opportunities across pediatric residency programs and identify program characteristics associated with key GH education elements.METHODS: Data on program and GH training characteristics were sought from program directors or their delegates of all US pediatric residency programs during 2013 to 2014. These data were used to compare programs with and without a GH track as well as across small, medium, and large programs. Program characteristics associated with the presence of key educational elements were identified by using bivariate logistic regression.RESULTS: Data were collected from 198 of 199 active US pediatric residency programs (99.5%). Seven percent of pediatric trainees went abroad during 2013 to 2014. Forty-nine programs (24.7%) reported having a GH track, 66.1% had a faculty lead, 58.1% offered international field experiences, and 48.5% offered domestic field experiences. Forty-two percent of programs reported international partnerships across 153 countries. Larger programs, those with lead faculty, GH tracks, or partnerships had significantly increased odds of having each GH educational element, including pretravel preparation. CONCLUSIONS:The number of pediatric residency programs offering GH training opportunities continues to rise. However, smaller programs and those without tracks, lead faculty, or formal partnerships lag behind with organized GH curricula. As GH becomes an integral component of pediatric training, a heightened commitment is needed to ensure consistency of training experiences that encompass best practices in all programs. WHAT'S KNOWN ON THIS SUBJECT:In response to growing demand from trainees, many pediatric residency programs offer global health (GH) experiences for their residents. There is diversity in what is offered at programs across the country. WHAT THIS STUDY ADDS:This is the most comprehensive assessment of US pediatric residency training opportunities in GH. These opportunities are prevalent and increasingly formalized as tracks. However there remain gaps in universal pretravel preparation and coordination across GH partnerships nationally.

Impact of Global Health Education on Pediatric Residency Applicants' Rank-List and Decision Process

“…To keep pace with this interest among residents, pediatric residency programs have increasingly tried to develop, offer, and publicized their GHE activities (Castillo, Castillo, & Dewitt, 2011). In the academic year 2013-14, 64% of pediatric residency programs reported offering domestic or international GHE opportunities and about 25% had a dedicated GHE track (Butteris et al, 2015). Yet, the development of such educational experiences is not without challenges.…”

“…Yet, the development of such educational experiences is not without challenges. Perceived barriers to pursuing GHE as reported by previous surveys of program directors include: difficulty securing funding, lack of Accreditation Council for Graduate Medical Education (ACGME) approval for the electives, inadequate staffing for adequate coverage of the home institution, concern about the development and sustainability of partnerships between home and 'away' institutions, and lack of pre-travel orientation and/or post-travel debriefing (Bussell, Kihlberg, Foderingham, Dunlap, & Aliyu, 2015;Butteris et al, 2015;Castillo et al, 2011;Coombs, Feldman, Lauer, Paul Chan, & Sun, 2015;Knudson, Tarpley, & Numann, 2015;Tsai et al, 2014;Tupesis et al, 2012).…”

“…In a survey of GHE programs across the country, Liaw et al found that only 50% of program funding was supported by the parent institution, and only about 26% of the responding programs expected their funding to increase (Liaw et al, 2014). Fortunately, many institutions have begun to address this issue by implementing formal GHE curricula and partnering with the host-site institution for the same (Butteris et al, 2015). A GHE track in residency helps to alleviate the concerns of under-staffing of the program at home while the residents are at the away site.…”

“…There is mounting interest in the impact of the availability of GHE opportunities on residency programs' recruitment success in the United States, and a few specialties have reported factors influencing residency program selection (Aagaard et al, 2005;Bazemore et al, 2007;Dey, Grabowski, Gebreyes, Hsu, & VanRooyen, 2002;Flynn et al, 1993;Love et al, 2012;Nuthalapaty et al, 2004;Shull et al, 2014;Yarris et al, 2009). However, little is known about the nature and impact of various factors, including specifically the availability of GHE, on the rank list process of pediatric residency applicants (Butteris et al, 2015). Thus, the purpose of our study was to describe factors associated with pediatric residency program ranking by residency applicants in the United States, over six consecutive years.…”

Interested in global health? Here is where to start: a checklist for United States dermatology residents

“…Global health (GH) is increasingly incorporated into health education. In dermatology, international clinical rotations during residency have increased . This correspondence offers suggestions for residents interested in GH – suggestions that emerged from the authors' experiences with GH programs, practicing dermatology abroad, and mentoring trainees (Table ).…”