Global Health: It’s Not About Becoming Worldly, It’s About Becoming Better Doctors

Heidi Chumley, MD

Heidi Chumley, MD

As we continue to evolve how we prepare medical students to join the US physician workforce, we should continue to create global health experiences that will impact how we approach clinical practice—whether that be when managing a diverse patient population or when addressing the global health issues that are now on our doorstep.

When I was in medical school, we often saw the term international health in the context of faraway villages where issues like access to clean water, sanitation, and basic understanding of the spread of disease were at the heart of figuring out how to improve a community’s well-being.

As medical students, we viewed short-term medical mission trips as our way of getting a glimpse of the world outside our environment and gaining exposure to not just tropical diseases that we would never see at home, but also to the ways that healthcare providers in these settings coped in order to care for their patients.

Things changed somewhere along the way, and what we used to call international health became global health, the term much more indicative of a connected world where diseases–and physicians–crossed borders. A decade ago it was SARS and later the avian flu. Recently we had our first cases of Ebola in Dallas and New York City. Global health, it seems, has come home.

In the journal Family Medicine, Dr John Frey III of the University of Wisconsin writes that global health experiences can be “a treatment for [US] medical myopia,” referring to a seeming inability for the US clinical and educational systems to learn from other cultures and systems. “At its best,” he writes, “global health offers a perspective based on humility rather than arrogance and on an openness and generosity of thought that changes thinking and practice in all directions.”

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Intimate Partner Violence: An Educational Priority

By Katherine Bakke, BA, Halley P. Crissman, BSc, MPH, Vijay Singh, MD, MPH, MS, and Arno K. Kumagai, MD, University of Michigan

Given their primary responsibility for the health and safety of their patients, physicians are the natural candidates to champion efforts to end intimate partner violence (IPV).1 According to the Centers for Disease Control and Prevention, nearly one in three women and one in four men report lifetime physical assault by an intimate partner, and IPV represents a leading cause of morbidity and mortality of women in this country.2 Medical education stands to play a key role in this area; however, with recent changes in the Liaison Committee on Medical Education (LCME) standards, the next generation of physicians may be even less likely to initiate conversations about IPV with their patients.

The LCME, which accredits all US and Canadian medical schools based on compliance with specific educational standards, recently announced reformatted standards that will come into effect after July 2015.3 Although perhaps not intended, the changes include a small but significant omission. In contrast to previous versions,4 the 2015 standards dropped violence and abuse as an example of a societal problem that should be covered in medical school curricula.5 While this omission may seem trivial, it is potentially of great consequence, for the risk of not educating medical students how to screen for, and assist survivors of, interpersonal violence threatens to perpetuate IPV as a significant, and more importantly preventable, cause of injury and death among women.

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Advice for Thriving During Remediation

Jhonatan Munoz  Espinoza, MD

Jhonatan Munoz
Espinoza, MD

During remediation it’s easy to think what you are doing is insignificant and that your efforts are not taking you anywhere—you are not part of a residency track, not part of the interviews tours, and not able to moonlight—but you’re wrong.

If your program put you in remediation it doesn’t mean that they are discounting you. Your program is recognizing that you need time to address whatever is going on in your life that put you in remediation—relationship stresses, mental health issues, or poor academic performance—to be the best person you can be.

Remember: you are valuable, your work still matters, and most importantly, your patients are waiting for you to be the best version of yourself!

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