Medical education for international health. The Arizona experience.

At the University of Arizona we have learned that a systematic approach to educating North Americans for international health roles makes sense. We have focused on an intensive problem-based orientation course for senior medical students and residents about to embark on a field experience. We have shared with and greatly benefited from the International Health Medical Education Consortium (IHMEC). The lessons learned at Arizona focus on the importance of long-term commitment and mentoring and on the direct relationship between health care careers internationally and among our own domestic underserved populations.

A core curriculum for international health: evaluating ten years' experience at the University of Arizona.

PIP: 215 graduates (118 women and 97 men) of the University of Arizona's International Health Core Curriculum received a questionnaire after completion of their clinical practice in order to evaluate the experience of 10 years from 1982-91. The curriculum consisted of a 3- week orientation course given to 4th year medical students with core contents of population, nutrition, and infectious diseases followed up by student evaluation upon completion. 192 students were eligible for the survey of whom 154 completed it yielding an 80% response rate: 139 future physicians and 15 nurses, health educators, and nutritionists. 113 of 154 respondents completed an international health field experience after the course in 43 developing countries: 22% in Africa, 39% in Asia-Pacific, and 39% in Latin American-Caribbean. 79% were in rural and 34% in urban areas. A public health-community medicine program was incorporated in the clinical work at most sites. 95% of them participated in clinical care, 73% in community teaching, and 51% in research and evaluation. The duration of this field experience lasted 6-12 months for 69% of them. The median responses regarding the possibility of postcourse international field work and rating the worth of the course for clinical care, teaching others, and research were well or very well. They also rated the preparation of the course for subsequent work at 43 specific sites as good and dealing with limited resources and cross-culture communication as very good. All were willing to recommend the course to their peers.^ieng