Global Is Local: Does Formal Resident Global Health Medical Education Improve Clinical Care in the United States?

Abstract

We administered a standardized 41-item questionnaire to a convenience sample of graduates of five residency programs with formal global health pathways and compared findings to a national cohort of practicing physicians to evaluate the comparative effectiveness of an overarching global health pathway on residency program graduates. Compared with the national cohort database, global health pathway graduates self-reported that they felt better prepared to treat immigrants, refugees, patients with limited English proficiency (LEP), racial/ethnic minorities, those with non-Western health beliefs, international travelers, and military veterans (P < 0.05). They were more likely to report using best practices when working with lesbian, gay, bisexual, transgender, queer/questioning patients, immigrant and refugee patients, patients with non-Western health beliefs, patients with LEP, and patients communicating via American Sign Language (P < 0.05). They also reported being more familiar with 11 of 14 high-impact or common infections encountered in travelers, immigrants, and military personnel (P < 0.05). Our findings suggest that formal postgraduate training focused on global health improves knowledge, attitudes, and self-reported medical practices when caring for diverse and marginalized populations in the United States.

Underprepared: influences of U.S. medical students’ self-assessed confidence in immigrant and refugee health care

“…Dedicated global health (GH) curricula during residency not only provide opportunities to develop these skills but have also been shown to increase resident emphasis on the physical exam and resource-conscious practice, in addition to creating opportunities to learn to develop meaningful international partnerships [ 14–16 ]. Physicians who trained in residency programs with formal global health pathways describe feeling more prepared to care for immigrants, refugees, and patients with non-English language preferences [ 17 ]. Demand for training in GH and on immigrant and refugee health is high among residents [ 8 , 18 , 19 ].…”