Reframing undergraduate medical education in global health: Rationale and key principles from the Bellagio Global Health Education Initiative

Abstract

Global health education (GHE) continues to be a growing initiative in many medical schools across the world. This focus is no longer limited to participants from high-income countries and has expanded to institutions and students from low- and middle-income settings. With this shift has come a need to develop meaningful curricula through engagement between educators and learners who represent the sending institutions and the diverse settings in which GHE takes place. The Bellagio Global Health Education Initiative (BGHEI) was founded to create a space for such debate and discussion and to generate guidelines towards a universal curriculum for global health. In this article, we describe the development and process of our work and outline six overarching principles that ought to be considered when adopting an inclusive approach to GHE curriculum development.

Acknowledgements

We thank the Rockefeller Foundation for its financial support of the initial meeting.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Global Health: A field of socially responsive healthcare rooted in the concepts of health equity, collaborative and multidisciplinary practice, population-level focus, and cross-cultural medicine.

Global Health Curriculum: A set of educational experiences aimed at training medical professionals in the theory and practice of global health, which may be implemented in a home or away context. This may include, but is not limited to, the following: experiences in a classroom setting, experiences in a clinical setting, experiences in a nonclinical health-related setting (e.g. a laboratory, public health institute, governmental or nongovernmental organization, or community setting), self-directed learning, and the informal learning experiences of the learner which occur in pursuit of the above.

Notes on contributors

Michael Peluso, MD, MPhil, MHS is a resident physician in the Department of Medicine and Division of Global Health Equity at Brigham and Women's Hospital, an affiliate of Harvard Medical School. His global health work is related to HIV/AIDS, underserved populations, and educational capacity building within the healthcare system of Botswana.

Susan van Schalkwyk, PhD is Professor and Director of the Centre for Health Professions Education in the Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. She advises on projects within the Faculty and recently completed a five-year study investigating clinical training of medical students on a rural platform.

Anne Kellett is Administrative Director of the Yale University School of Medicine Office of International Medical Student Education. She oversees the international clinical electives program, which supports both visiting medical students to Yale and Yale medical students to clinical sites around the world.

Timothy F. Brewer, MD, MPH is the Vice-Provost, Interdisciplinary and Cross Campus Affairs at UCLA. Dr. Brewer has served on advisory boards for the World Health Organization, the National Institutes of Health, the Canadian Institutes of Health Research, and the US Centers for Disease Control and Prevention. He is the Chair of the Board of Directors for the Consortium of Universities for Global Health.

A. Mark Clarfield, MD, FRCPC is certified in Family Medicine, Community Medicine and Geriatrics. He is the Director of the Medical School for International Health and Vice Dean at the Faculty of Health Sciences at Ben Gurion University of the Negev.

David Davies, PhD is Associate Professor in Medical Education and Head of Digital Technologies at Warwick Medical School. His education and research interests have centered around the use of technology to enhance learning in international settings.

Bishan Garg, MD, PhD is Dean of the MGIMS and Director-Professor of the department of Community Medicine & Director of Dr. Sushila Nayar School of Public Health. He is also in charge of WHO Collaborative Centre for Research and Training in Community Based Maternal, Newborn and Child Health.

Tobin Greensweig, MD, is an Internal Medicine and Pediatrics resident at Indiana University with an interest in global health informatics. He is an active contributor to the Open MRS software platform, an open source electronic medical records (EMR) system for use in the developing world.

Janet P. Hafler, EdD is Associate Dean for Educational Scholarship, and Professor of Pediatrics at the Yale University School of Medicine. She directs the Teaching and Learning Center, and her work is focused on enhancing the work of the faculty in their teaching, curriculum development, and assessment.

Jianlin Hou, PhD, MA, MSPH is associate research professor, Institute of Medical Education, Peking University. He studies the impact of international experiences on health professional education.

Moira Alison Maley, MSc, PhD, PGCertMedEd, DipNautSci. Originally a medical research scientist with a strong interest in experiential learning Moira sought formal qualification in medical education. Specialising in education technology, the rural context provided unique opportunities to improve learning outcomes. As a scholar her interests include applying appropriate frameworks for reflection and transformative learning in varied contexts.

Harriet Mayanja-Kizza, MD is Professor of Medicine at Makerere University. She was Chair of Medicine for 8 years, and is currently Dean of the School of Medicine, Makerere University, and director of the Makerere-Yale global health program. Her research interests are in the area of HIV/Tuberculosis co-interaction and immuno-pathogenesis.

Senga Pemba, PhD is a medical educationist working as Director of the Tanzanian Training Centre for International Health and Deputy Principal for Academic Affairs at Saint Francis University College of Health in Tanzania. He is a member of the WHO Human Resources for Health Expert Group for African Region and member of the WHO group on preservice training curriculum development in adolescent health.

Janette “Jenny” Samaan, PhD directs the Association of American Medical Colleges’ Global Health Learning Opportunities Collaborative, a global network of institutions that facilitates clinical, public health, and research electives abroad for medical and public students and promotes faculty and staff engagement.

Stephen C. Schoenbaum, MD, MPH is Special Advisor to the President of the Josiah Macy Jr. Foundation with a particular interest in interprofessional education. He has extensive experience as a clinician, epidemiologist, and manager.

Babulal “B” Sethia, MD is a congenital heart surgeon at the Royal Brompton Hospital in London and President of the Royal Society of Medicine where he has also established a program in Global Health.

Juan Pablo Uribe, MD, MPH, MPA is the Director General of the Fundacion Santa Fe de Bogota, a leading organization in Colombia committed to improving the wellbeing of communities and individuals through its efforts in health care, health education and public health.

Carmi Margolis, MD, a pediatrician, was founding Dean of the Medical School for International Health and Chair of the Center for Medical Education at Ben Gurion University. His three research areas are teaching clinical problem solving and decision making, the methodology of clinical practice guidelines and clinical algorithms and implementation of clinical practice guidelines.

Robert Rohrbaugh, MD is Professor of Psychiatry and Faculty Director of the Office of International Medical Student Education at the Yale University School of Medicine. He oversees international clinical elective programs at 14 partner sites in low- and middle-income countries, a Certificate in Global Medicine program, and international students participating in clinical electives. He works on competency based residency education in China.

Additional information

Funding

We thank the Rockefeller Foundation for its financial support of the initial meeting.