Hyperglobalist, sceptical, and transformationalist perspectives on globalization in medical education

Educational priorities of low-and middle-income country medical diaspora organisations: A critical discourse analysis

Rising global migration levels have led to growing diaspora populations. There has been interest in the role of diaspora healthcare professionals (HCPs) from low- and middle-income countries (LMICs) in development aid to their origin countries, although there has been comparatively less focus on their educational activities. This study examined the stated educational priorities of LMIC medical diaspora organisations, with a particular focus on the tension between promoting professional opportunities afforded by medical migration and contributing to healthcare workforce shortages due to migration away from LMICs.We gathered a textual archive from webpages and public documents of 89 LMIC medical diaspora organisations in high income countries, predominantly the US and UK. We employed Foucauldian critical discourse analysis to examine presented rationales around educational policies and practices, with a focus on encouragement towards, and discouragement from, medical migration. Two discourses dominated this archive. The first was of preservation and framed the educational work of these organisations as a means of providing unity and social networks to diaspora HCPs, with a focus on maintaining their cultural identity and heritage, and medical connections with their origin countries. The second was of aspiration and framed their educational work as providing support to diaspora HCPs to advance their careers and maximise training opportunities, often through directly enabling and supporting migration to high income countries. There was a discursive absence around brain drain with no policies or practices that overtly sought to deter against, or offset the negative effects of, medical migration. Notwithstanding the valuable contributions that LMIC medical diaspora organisations make in global health, the discursive framings that shape their educational work are linked primarily to protecting and progressing diaspora HCPs rather than on LMIC workforce challenges. Further research is needed to examine potential impacts of these positions on HCP migratory behaviours.

Blind spots in medical education - International perspectives

BACKGROUND

All individuals and groups have blind spots that can create problems if unaddressed. The goal of this study was to examine blind spots in medical education from international perspectives.

METHODS

From December 2022 to March 2023, we distributed an electronic survey through international networks of medical students, postgraduate trainees, and medical educators. Respondents named blind spots affecting their medical education system and then rated nine blind spot domains from a study of U.S. medical education along five-point Likert-type scales (1 = much less attention needed; 5 = much more attention needed). We tested for differences between blind spot ratings by respondent groups. We also analyzed the blind spots that respondents identified to determine those not previously described and performed content analysis on open-ended responses about blind spot domains.

RESULTS

There were 356 respondents from 88 countries, including 127 (44%) educators, 80 (28%) medical students, and 33 (11%) postgraduate trainees. At least 80% of respondents rated each blind spot domain as needing 'more' or 'much more' attention; the highest was 88% for 'Patient perspectives and voices that are not heard, valued, or understood.' In analyses by gender, role in medical education, World Bank country income level, and region, a mean difference of 0.5 was seen in only five of the possible 279 statistical comparisons. Of 885 blind spots documented, new blind spot areas related to issues that crossed national boundaries (e.g. international standards) and the sufficiency of resources to support medical education. Comments about the nine blind spot domains illustrated that cultural, health system, and governmental elements influenced how blind spots are manifested across different settings.

DISCUSSION

There may be general agreement throughout the world about blind spots in medical education that deserve more attention. This could establish a basis for coordinated international effort to allocate resources and tailor interventions that advance medical education.

Competency-Based Workforce Development and Education in Global Oncology

The healthcare workforce plays a pivotal role in cancer care delivery, leadership, policy, education, and research in complex cancer systems. To ensure quality and relevance, health professionals must have the necessary competencies to deliver patient-centered and efficient care, coupled with the ability to work in teams and manage health resources wisely. This paper aims to review the concept of competency-based medical education (CBME) in the context of oncology to provide insights and guidance for those interested in adopting or adapting competency-based education in training programs. The results of a scoping review of CBME in oncology are presented here to describe the current status of CBME in oncology. The literature describing the implementation and evaluation of CBME in oncology training programs for medical professionals internationally is summarized and key themes identified to provide practical guidance for educators. Further, the paper identifies critical competencies for oncology education and training globally and presents recommendations and opportunities for collaboration in competency-based education and training in oncology. The authors argue for increased global collaboration and networking in the realm of CBME to facilitate the establishment of a competent global cancer care workforce.