Students with global experiences during medical school are more likely to work in settings that focus on the underserved: an observational study from a public U.S. institution.

Abstract

Background

Global health interest has grown among medical students over the past 20 years, and most medical schools offer global health opportunities. Studies suggest that completing global health electives during medical school may increase the likelihood of working with underserved populations in a clinical or research capacity. This study aimed to assess the association of global electives in medical school on subsequently working in global health and with underserved populations in the United States (U.S.), additionally considering students' interests and experiences prior to medical school. We also examined whether respondents perceived benefits gained from global electives.

Methods

We surveyed medical school graduates (classes of 2011-2015) from a large public medical school in the U.S. to describe current practice settings and previous global health experience. We evaluated work, volunteer, and educational experiences preceding medical school, socioeconomic status, race and ethnicity using American Medical College Application Service (AMCAS) data. We assessed the association between students' backgrounds, completing global health electives in medical school and current work in global health or with underserved populations in the U.S.

Results

In the 5 to 8 years post-graduation, 78% of 161 respondents reported work, research, or teaching with a focus on global or underserved U.S.

Populations

Completing a global health elective during medical school (p = 0.0002) or during residency (p = 0.06) were positively associated with currently working with underserved populations in the U.S. and pre-medical school experiences were marginally associated (p = 0.1). Adjusting for pre-medical school experiences, completing a global health elective during medical school was associated with a 22% greater prevalence of working with an underserved population. Perceived benefits from global electives included improved cultural awareness, language skills, public health and research skills, and ability to practice in technology-limited settings.

Conclusion

Medical school graduates who participated in global electives as students were more likely than their peers to pursue careers with underserved populations, independent of experiences prior to medical school. We hypothesize that by offering global health experiences, medical schools can enhance the interests and skills of graduates that will make them more likely and better prepared to work with underserved populations in the U.S. and abroad.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1186/s12909-021-02975-3

Publication Info

Slifko, Shay E, Nadja A Vielot, Sylvia Becker-Dreps, Donald E Pathman, Justin G Myers and Martha Carlough (2021). Students with global experiences during medical school are more likely to work in settings that focus on the underserved: an observational study from a public U.S. institution. BMC medical education, 21(1). p. 552. 10.1186/s12909-021-02975-3 Retrieved from https://hdl.handle.net/10161/31246.

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Scholars@Duke

Carlough

Martha Carlough

Visiting Professor in the Divinity School

Martha Carlough, MD MPH is family physician and Ignatian trained spiritual director and is the Director of Spiritual Formation for the Theology, Medicine and Culture Initiative. Dr. Carlough is also affiliate faculty in the Duke Global Health Initiative (DGHI) and has more than 30 years of experience in clinical and public aspects of maternal and child health, including a decade of work in Nepal. She is Professor Emeritus at UNC-Chapel Hill where she was on clinical faculty for many years and founded and directed the Office of Global Health Education. Dr. Carlough continues to care for patients and work in community health through Samaritan Health Center in Durham.


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