TY - JOUR
T1 - US medical specialty global health training and the global burden of disease
AU - Kerry, Vanessa B.
AU - Walensky, Rochelle P.
AU - Tsai, Alexander C.
AU - Bergmark, Regan W.
AU - Bergmark, Brian A.
AU - Rouse, Chaturia
AU - Bangsberg, David R.
N1 - Funding Information:
Competing interests: All authors have completed the Unified Competing Interest form at www.ic-mje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organization for the submitted work; Drs Bangsberg, Tsai and Walensky have received research grants from the National Institutes for Health; Dr Bangsberg’s institution has received research funds from the National Institute for Mental Health; Dr Walensky consults for LeClair Ryan; Dr Kerry is an employee of and has received conference travel support from the Massachusetts General Hospital Center for Global Health; Dr Kerry has received payments for general global health lectures from the US Department of State. The authors declare no other relationships or activities that could appear to have influenced the submitted work.
Funding Information:
Acknowledgments: The authors would like to thank Jason Harlow and Brett MacAulay for their skilled assistance in creating several of the figures. Funding: This work was supported by the Mark and Lisa Schwartz Foundation, the Klingenstein Family Foundation, and the Harvard University Center for AIDS Research NIAID P30 AI060354. Dr Bangsberg was supported by K24 MH87227. Dr Walensky was supported by National Institute of Allergy and Infectious Diseases R01 AI058736. Dr R. Bergmark and Dr B. Bergmark received funding through Benjamin Kean Traveling Fellowships from the London School of Hygiene and Tropical Medicine. All authors receive a portion of their salary from global health activities. Dr Tsai receives salary support from NIH K23 MH–096620. The sponsors had no role in interpretation of data or decision to publish. Ethical Approval was not required for this study. Authorship declaration: VBK prepared the initial manuscript and final submission. ACT prepared the statistical analysis. RPW, ACT, RB, BB, CR, and DRB reviewed and revised the manuscript. VBK is the guarantor for the article.
Funding Information:
This work was supported by the Mark and Lisa Schwartz Foundation, the Klingenstein Family Foundation, and the Harvard University Center for AIDS Research NIAID P30 AI060354. Dr Bangsberg was supported by K24 MH87227. Dr Walensky was supported by National Institute of Allergy and Infectious Diseases R01 AI058736. Dr R. Bergmark and Dr B. Bergmark received funding through Benjamin Kean Traveling Fellowships from the London School of Hygiene and Tropical Medicine. All authors receive a portion of their salary from global health activities. Dr Tsai receives salary support from NIH K23 MH-096620. The sponsors had no role in interpretation of data or decision to publish
Publisher Copyright:
© 2013 Journal of Global Health.
PY - 2013
Y1 - 2013
N2 - Background: Rapid growth in global health activity among US medical specialty education programs has lead to heterogeneity in types of activities and global health training models. The breadth and scope of this activity is not well chronicled. Methods: Using a standardized search protocol, we examined the characteristics of US medical residency global health programs by number of programs, clinical specialty, nature of activity (elective, research, extended curriculum based field training), and geographic location across seven different clinical medical residency education specialties. We tabulated programmatic activity by clinical discipline, region and country. We calculated the Spearman's rank correlation coefficient to estimate the association between programmatic activity and country-level disease burden. Results: Of the 1856 programs assessed between January and June 2011, there were 380 global health residency training programs (20%) working in 141 countries. 529 individual programmatic activities (elective-based rotations, research programs, extended curriculum- based field training, or other) occurred at 1337 specific sites. The majority of the activities consisted of elective-based rotations. At the country level, disease burden had a statistically significant association with programmatic activity (Spearman's ρ = 0.17) but only explained 3% of the total variation between countries. Conclusions: There were a substantial number of US medical specialty global health programs, but a relative paucity of surgical and mental health programs. Elective-based programs were more common than programs that offer longitudinal experiences. Despite heterogeneity, there was a small but statistically significant association between program location and the global burden of disease. Areas for further study include the degree to which US-based programs develop partnerships with their program sites, the significance of this activity for training, and number and breadth of programs in medical specialty global health education in other countries around the world.
AB - Background: Rapid growth in global health activity among US medical specialty education programs has lead to heterogeneity in types of activities and global health training models. The breadth and scope of this activity is not well chronicled. Methods: Using a standardized search protocol, we examined the characteristics of US medical residency global health programs by number of programs, clinical specialty, nature of activity (elective, research, extended curriculum based field training), and geographic location across seven different clinical medical residency education specialties. We tabulated programmatic activity by clinical discipline, region and country. We calculated the Spearman's rank correlation coefficient to estimate the association between programmatic activity and country-level disease burden. Results: Of the 1856 programs assessed between January and June 2011, there were 380 global health residency training programs (20%) working in 141 countries. 529 individual programmatic activities (elective-based rotations, research programs, extended curriculum- based field training, or other) occurred at 1337 specific sites. The majority of the activities consisted of elective-based rotations. At the country level, disease burden had a statistically significant association with programmatic activity (Spearman's ρ = 0.17) but only explained 3% of the total variation between countries. Conclusions: There were a substantial number of US medical specialty global health programs, but a relative paucity of surgical and mental health programs. Elective-based programs were more common than programs that offer longitudinal experiences. Despite heterogeneity, there was a small but statistically significant association between program location and the global burden of disease. Areas for further study include the degree to which US-based programs develop partnerships with their program sites, the significance of this activity for training, and number and breadth of programs in medical specialty global health education in other countries around the world.
UR - http://www.scopus.com/inward/record.url?scp=84928264221&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928264221&partnerID=8YFLogxK
U2 - 10.7189/jogh.03.020406
DO - 10.7189/jogh.03.020406
M3 - Article
AN - SCOPUS:84928264221
SN - 2047-2978
VL - 3
JO - Journal of Global Health
JF - Journal of Global Health
IS - 2
M1 - 020406
ER -