ABSTRACT
BACKGROUND AND OBJECTIVES: To determine the impact of international health experiences on physicians in training, we studied 60 US medical students who participated in an International Health Fellowship Program (IHFP). METHODS: In 1995 and 1996, US medical students were selected to participate in the IHFP, which included training at three US medical schools and at seven medical schools in developing countries. The program included a 2-week preparatory course at a US school and a 6- to 8-week field experience. Evaluative data were collected prior to the course, after the course, after the field experience, and 1-2 years later. RESULTS: A total of 60 students were selected from 145 applicants. At the end of the fellowship, a majority of participants noted that the exposure affected them in the following ways: changed world views; increased cultural sensitivity; enhanced community, social, and public health awareness; enhanced clinical and communication skills; more appropriate resource utilization; changes in career plans; and a greater understanding of the challenges of working in areas with scarce resources. After the international field experience, students more strongly agreed with the importance of oral rehydration, communication skills, and patient education. According to student self-assessments, the IHFP significantly improved core medical skills. Ninety-six percent of participants recommended international health experiences for other students. CONCLUSIONS: This study of IHFP fellows demonstrates multiple significant impacts of international health experiences on US medical students in training. The knowledge, attitudes, and skills gained through international health experiences are important for medical practice in the United States and abroad. Given the high interest of medical students in international health and the potential for positive educational impacts, medical schools should increase the availability of high-quality international experiences.
Subject(s)
Education, Medical , Global Health , Attitude , Career Choice , Clinical Competence , Communication , Culture , Developing Countries , Fluid Therapy , Follow-Up Studies , Health Care Rationing , Health Knowledge, Attitudes, Practice , Health Resources , Humans , International Cooperation , Patient Education as Topic , Program Development , Program Evaluation , Schools, Medical , Social Responsibility , Students, Medical , United StatesABSTRACT
As a result of a massive public health system and state-of-the-art tertiary medical care services, Cuba's health profile now indicates a high incidence of chronic noncommunicable diseases; Cuban health authorities concluded that this required a community-based primary care solution. In the early 1980s the Ministry of Health (MINSAP) implemented a national family medicine program with the goal of providing one "Medico de la Familia" (family physician) for every 700 persons. To attain and ensure the sustainability of this primary care model, MINSAP reformed the medical education curriculum. The reform strategies created a primary care "specialty" and provided a broad-based interdisciplinary approach to primary care training. The reforms place primary care in a prominent position within the predoctoral medical education curriculum. Cuba's approach is an innovation for a country that attained impressive medical advances through a specialized high-technology medical system.
