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Khalighi M. Literature Review: Importance Of International Health ProgramsInternational health programs (IHP) are gaining popularity among US residency programs especially, Emergency Medicine and Family Practice residencies; however, structured programs are still scarce in Internal Medicine residencies. Several studies outline the importance of such opportunities for residents as well as residencies.Eight- and fifteen-year experiences with IHP at the Duke and Yale Universities respectively indicate an important impact on the decisions and attitudes of participating residents after their training. IHP participating residents who changed career plans during residency tended to move towards areas of public health and primary care in contrast to their nonparticipating peers who chose private practice or subspecialization. In addition to individual growth in cultural and ethical perspectives, other studies have shown that early exposure to international health during residency also promotes continued participation in volunteer activities after graduation. These studies also clearly indicate a positive effect of IHP on residency rankings. In a Johns Hopkins Emergency Medicine study, 62% of interviewing medical students and 68% of those with prior international health experience considered the availability of international opportunities a positive factor in ranking residency programs. At the Duke University, 42% of the applicants identified the IHP as a significant factor for their selection of the Duke Medicine Residency. A review of Family Practice residencies revealed some form of international health curriculum at 54% of the respondents; however, only 15% of the programs provided significant support for resident involvement in international health. In addition to a structured IHP, several other factors were associated with resident participation. A strong correlation was found with 1) the number of faculty who had prior experience in international health, 2) the number of months of salary paid while on an international elective, 3) paid living expenses while on an elective, and 4) length of time a program had offered an international health experience. With these important findings in mind, international health experiences should be encouraged as much as possible in Internal Medicine residencies. References
1. Miller WC, Corey GR, et al. International health and
internal medicine residency training: the Duke University experience.
Am J Med 1995; 99(3): 291-7.
2. Gupta AR, Wells CK, et al. The International Health Program: the fifteen-year experience with Yale University’s Internal Medicine Residency Program. Am J Trop Med Hyg 1999; 61(6): 1019-23. 3. Dey CC, Grabowski JG, et al. Influence of international emergency medicine opportunities on residency program selection. Acad Emerg Med 2002; 9(7): 679-83. 4. Enterz RM, Dittus RS, et al. General internal medicine and technologically less developed countries. J Gen Intern Med 1990; 5(5): 454-5. 5. Haskell A, Rovinsky D, et al. The University of California at San Francisco international orthopaedic elective. Clin Orthop 2002; 396: 12-8. 6. Schultz SH, Rousseau S. International health training in family practice residency programs. Fam Med 1998; 30(1): 29-33. 7. VanRooyen MJ, Townes DA, et al. International Health Fellowship: a proposed curriculum for emergency physicians. J Emerg Med 1997; 15(2): 249-52. 8. Clem KJ, Green SM. Emergency medicine expeditions to the developing world: the Loma Linda University experience in Papua New Guinea. Acad Emerg Med 1996; 3(6): 624-33. |
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