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Jalan D, Morakis H, Arya N, Tcholakov Y, Carpenter J, Cherniak W. Global health training in Canadian family medicine residency programmes. Fam Med Community Health 2020; 8:e000250. [PMID: 32201550 PMCID: PMC7073781 DOI: 10.1136/fmch-2019-000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Canadian family medicine (FM) residency programmes are responding to the growing demand to provide global health (GH) education to their trainees; herein, we describe the various GH activities (GHAs) offered within Canadian FM programmes. Design A bilingual online survey was sent out to all 17 Canadian FM program directors (PDs) and/or an appointed GH representative. Setting Online survey via Qualtrics Participants All 17 Canadian FM PDs and/or an appointed GH representative. Results The response rate was 100% and represented 3250 first-year and second-year FM residents across English and French Canada. All schools stated that they participate in some form of GHAs. There was variation in the level of organisation, participation and types of GHAs offered. Overall, most GHAs are optional, and there is a large amount of variation in terms of resident participation. Approximately one third of programmes receive dedicated funding for their GHAs, and two thirds wish to increase the scope/variety of GHAs. Conclusion These results suggest nationwide interest in developing a workforce trained in GH, but show great discrepancies in training, implementation and education.
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Affiliation(s)
- Divyanshi Jalan
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Helene Morakis
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neil Arya
- McMaster University, Hamilton, Ontario, Canada
| | - Yassen Tcholakov
- Department of Epidemiology, Biostatistics, Occupational Health and Public Health, McGill University, Montreal, Québec, Canada
| | - Jennifer Carpenter
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - William Cherniak
- Bridge to Health Medical and Dental, Toronto, Ontario, Canada.,Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
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Edelman A, Taylor J, Ovseiko PV, Topp SM. The role of academic health centres in improving health equity: a systematic review. J Health Organ Manag 2018; 32:279-297. [PMID: 29624138 DOI: 10.1108/jhom-09-2017-0255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Academic health centres (AHCs) are organisations that pursue a "tripartite" mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity. Design/methodology/approach Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC's activity or role were included. Findings In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution. Originality/value This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.
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Affiliation(s)
- Alexandra Edelman
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University , Townsville, Australia
| | - Judy Taylor
- College of Medicine and Dentistry, Division of Tropical Health and Medicine, James Cook University , Townsville, Australia
| | - Pavel V Ovseiko
- Radcliffe Department of Medicine, Medical Sciences Division, John Radcliffe Hospital, University of Oxford , Oxford, UK
| | - Stephanie M Topp
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University , Townsville, Australia
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Ziganshin BA, Yausheva LM, Sadigh M, Ziganshina AP, Pichugin AA, Ziganshin AU, Sadigh M. Training Young Russian Physicians in Uganda: A Unique Program for Introducing Global Health Education in Russia. Ann Glob Health 2017; 81:627-35. [PMID: 27036719 DOI: 10.1016/j.aogh.2015.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Global health is a new concept in Russia. There has been an ongoing academic collaboration between the Yale School of Medicine in the United States and Makerere University College of Health Sciences in Uganda since 2010, and the US Western Connecticut Health Network/University of Vermont College of Medicine since 2012, to introduce global health concepts to Kazan State Medical University (KSMU) in Russia. The purpose was to educate Russian physicians and medical trainees about the practice of clinical medicine and medical education, as well as the general practice of global health in culturally diverse, resource-limited settings. OBJECTIVES The aim of this study was to evaluate the initial outcomes of this multi-institutional partnership and to assess the impact of the global health elective on the participants and on KSMU. METHODS Participants were selected to attend a 6-week elective in global health at Mulago Hospital in Kampala, Uganda. The elective consisted of clinical experience, education about Uganda's common diseases, and region-specific sociocultural classes. It included a predeparture orientation and, upon return, completion of a standard questionnaire to assess the program's impact. RESULTS Since 2010, there have been 20 KSMU members (4 medical students, 4 interns, 9 residents, 2 fellows, and 1 faculty member) who have participated in the program. As a result of the elective, the participants reported increased knowledge of tropical medicine (70%) and HIV/AIDS (75%), and 95% reported increased cultural sensitivity and desire to work with the underserved. The majority noted a very positive impact of their careers (90%) and personal life (80%). KSMU established the first successful collaborative program in global health education in Russia, leading to the integration of tropical medicine and global health courses in medical school curriculum. CONCLUSION This elective has proven highly effective in introducing the concept of global health to faculty, fellows, residents, and medical students at KSMU. It trained these participants to address the challenges faced by physicians in culturally diverse and resource-limited countries.
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Affiliation(s)
- Bulat A Ziganshin
- Department of International Cooperation, Kazan State Medical University, Kazan, Russia; Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
| | - Liliya M Yausheva
- Department of International Cooperation, Kazan State Medical University, Kazan, Russia
| | - Mitra Sadigh
- Department of Global Health, University of Vermont College of Medicine, Burlington, Vermont
| | - Anna P Ziganshina
- Department of International Cooperation, Kazan State Medical University, Kazan, Russia
| | - Arseniy A Pichugin
- Department of International Cooperation, Kazan State Medical University, Kazan, Russia
| | - Ayrat U Ziganshin
- Department of International Cooperation, Kazan State Medical University, Kazan, Russia
| | - Majid Sadigh
- Department of Global Health, University of Vermont College of Medicine, Burlington, Vermont; Department of Global Health, Western Connecticut Health Network, Danbury, Connecticut
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Withers M, Press D, Wipfli H, McCool J, Chan CC, Jimba M, Tremewan C, Samet J. Training the next generation of global health experts: experiences and recommendations from Pacific Rim universities. Global Health 2016; 12:34. [PMID: 27334947 PMCID: PMC4918191 DOI: 10.1186/s12992-016-0162-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 05/09/2016] [Indexed: 01/12/2023] Open
Abstract
Background Finding solutions to global health problems will require a highly-trained, inter-disciplinary workforce. Global health education and research can potentially have long-range impact in addressing the global burden of disease and protecting and improving the health of the global population. Methods We conducted an online survey of twelve higher education institutions in the Pacific Rim that spanned the period 2005–2011. Program administrators provided data on program concentrations, student enrollment and student funding opportunities for 41 public health programs, including those specific to global health. Results The Master of Public Health (MPH) was the most common degree offered. A growing demand for global health education was evident. Enrollment in global health programs increased over three-fold between 2005–2011. Very few institutions had specific global health programs or offered training to undergraduates. Funding for student scholarships was also lacking. Conclusions The growing demand for global health education suggests that universities in the Pacific Rim should increase educational and training opportunities in this field. Schools of medicine may not be fully equipped to teach global health-related courses and to mentor students who are interested in global health. Increasing the number of dedicated global health research and training institutions in the Pacific Rim can contribute to building capacity in the region. Faculty from different departments and disciplines should be engaged to provide multi-disciplinary global health educational opportunities for undergraduate and graduate students. New, innovative ways to collaborate in education, such as distance education, can also help universities offer a wider range of global health-related courses. Additional funding of global health is also required.
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Affiliation(s)
- Mellissa Withers
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90064, USA.
| | - David Press
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90064, USA
| | - Heather Wipfli
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90064, USA
| | - Judith McCool
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Chang-Chuan Chan
- National Taiwan University (NTU) College of Public Health, Global Health Center, Taipei City, Chinese Taipei
| | - Masamine Jimba
- Department of Community and Global Health, University of Tokyo, Graduate School of Medicine, Tokyo, Japan
| | | | - Jonathan Samet
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90064, USA
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Moran D, Edwardson J, Cuneo CN, Tackett S, Aluri J, Kironji A, Cox J, Carroll B, Lie E, Fofana M, Bollinger RC, Ziegelstein RC, Chen CCG. Development of global health education at Johns Hopkins University School of Medicine: a student-driven initiative. MEDICAL EDUCATION ONLINE 2015; 20:28632. [PMID: 26220909 PMCID: PMC4518163 DOI: 10.3402/meo.v20.28632] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 07/02/2015] [Indexed: 05/21/2023]
Abstract
Global health is increasingly present in the formal educational curricula of medical schools across North America. In 2008, students at Johns Hopkins University School of Medicine (JHUSOM) perceived a lack of structured global health education in the existing curriculum and began working with the administration to enhance global health learning opportunities, particularly in resource-poor settings. Key events in the development of global health education have included the introduction of a global health intersession mandatory for all first-year students; required pre-departure ethics training for students before all international electives; and the development of a clinical global health elective (Global Health Leadership Program, GHLP). The main challenges to improving global health education for medical students have included securing funding, obtaining institutional support, and developing an interprofessional program that benefits from the resources of the Schools of Medicine, Public Health, and Nursing. Strategies used included objectively demonstrating the need for and barriers to more structured global health experiences; obtaining guidance and modifying existing resources from other institutions and relevant educational websites; and harnessing institution-specific strengths including the large Johns Hopkins global research footprint and existing interprofessional collaborations across the three schools. The Johns Hopkins experience demonstrates that with a supportive administration, students can play an important and effective role in improving global health educational opportunities. The strategies we used may be informative for other students and educators looking to implement global health programs at their own institutions.
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Affiliation(s)
- Dane Moran
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jill Edwardson
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charles Nicholas Cuneo
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sean Tackett
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James Aluri
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Antony Kironji
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacob Cox
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bryn Carroll
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Erina Lie
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mariam Fofana
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert C Bollinger
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Roy C Ziegelstein
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chi C G Chen
- Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA;
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Ton TGN, Gladding SP, Zunt JR, John C, Nerurkar VR, Moyer CA, Hobbs N, McCoy M, Kolars JC. The development and implementation of a competency-based curriculum for training in global health research. Am J Trop Med Hyg 2014; 92:163-71. [PMID: 25371189 DOI: 10.4269/ajtmh.14-0398] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The Fogarty International Center (FIC) Global Health Fellows Program provides trainees with the opportunity to develop research skills through a mentored research experience, increase their content expertise, and better understand trends in global health research, funding organizations, and pathways to generate support. The Northern Pacific Global Health Fellows Research and Training Consortium, which hosts one of the FIC Global Health Programs, sought to enhance research training by developing, implementing, and evaluating a competency-based curriculum that uses a modular, asynchronous, web-based format. The curriculum has 8 core competencies, 36 learning objectives, and 58 assignments. Nineteen trainees completed their 11-month fellowship, engaged in the curriculum, and provided pre- and post-fellowship self-assessments. Self-assessed scores significantly improved for all competencies. Trainees identified the curriculum as one of the strengths of the program. This competency-based curriculum represents a first step toward creating a framework of global health research competencies on which further efforts could be based.
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Affiliation(s)
- Thanh G N Ton
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Sophia P Gladding
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Joseph R Zunt
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Chandy John
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Vivek R Nerurkar
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Cheryl A Moyer
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Nicole Hobbs
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Molly McCoy
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Joseph C Kolars
- Departments of Neurology and Global Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Infectious Disease), University of Washington, Seattle, Washington; Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii; Global Research, Education and Collaboration in Health (REACH) and Departments of Learning Health Sciences and Internal Medicine, University of Michigan, Ann Arbor, Michigan
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Walker RJ, Campbell JA, Egede LE. Effective strategies for global health research, training and clinical care: a narrative review. Glob J Health Sci 2014; 7:119-39. [PMID: 25716404 PMCID: PMC4796426 DOI: 10.5539/gjhs.v7n2p119] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 09/03/2014] [Indexed: 11/12/2022] Open
Abstract
The purpose of this narrative review was to synthesize the evidence on effective strategies for global health research, training and clinical care in order to identify common structures that have been used to guide program development. A Medline search from 2001 to 2011 produced 951 articles, which were reviewed and categorized. Thirty articles met criteria to be included in this review. Eleven articles discussed recommendations for research, 8 discussed training and 11 discussed clinical care. Global health program development should be completed within the framework of a larger institutional commitment or partnership. Support from leadership in the university or NGO, and an engaged local community are both integral to success and sustainability of efforts. It is also important for program development to engage local partners from the onset, jointly exploring issues and developing goals and objectives. Evaluation is a recommended way to determine if goals are being met, and should include considerations of sustainability, partnership building, and capacity. Global health research programs should consider details regarding the research process, context of research, partnerships, and community relationships. Training for global health should involve mentorship, pre-departure preparation of students, and elements developed to increase impact. Clinical care programs should focus on collaboration, sustainability, meeting local needs, and appropriate process considerations.
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Pinto AD, Cole DC, ter Kuile A, Forman L, Rouleau K, Philpott J, Pakes B, Jackson S, Muntaner C. A case study of global health at the university: implications for research and action. Glob Health Action 2014; 7:24526. [PMID: 25172428 PMCID: PMC4149743 DOI: 10.3402/gha.v7.24526] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/02/2014] [Accepted: 07/02/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Global health is increasingly a major focus of institutions in high-income countries. However, little work has been done to date to study the inner workings of global health at the university level. Academics may have competing objectives, with few mechanisms to coordinate efforts and pool resources. OBJECTIVE To conduct a case study of global health at Canada's largest health sciences university and to examine how its internal organization influences research and action. DESIGN We drew on existing inventories, annual reports, and websites to create an institutional map, identifying centers and departments using the terms 'global health' or 'international health' to describe their activities. We compiled a list of academics who self-identified as working in global or international health. We purposively sampled persons in leadership positions as key informants. One investigator carried out confidential, semi-structured interviews with 20 key informants. Interview notes were returned to participants for verification and then analyzed thematically by pairs of coders. Synthesis was conducted jointly. RESULTS More than 100 academics were identified as working in global health, situated in numerous institutions, centers, and departments. Global health academics interviewed shared a common sense of what global health means and the values that underpin such work. Most academics interviewed expressed frustration at the existing fragmentation and the lack of strategic direction, financial support, and recognition from the university. This hampered collaborative work and projects to tackle global health problems. CONCLUSIONS The University of Toronto is not exceptional in facing such challenges, and our findings align with existing literature that describes factors that inhibit collaboration in global health work at universities. Global health academics based at universities may work in institutional siloes and this limits both internal and external collaboration. A number of solutions to address these challenges are proposed.
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Affiliation(s)
- Andrew D Pinto
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada; Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;
| | - Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Aleida ter Kuile
- Department of Family and Community Medicine, Credit Valley Hospital, Mississauga, Ontario, Canada
| | - Lisa Forman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Comparative Program on Health and Society, Munk School of Global Affairs, University of Toronto, Toronto, Ontario, Canada
| | - Katherine Rouleau
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jane Philpott
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Family Medicine, Markham Stouffville Hospital, Markham, Ontario, Canada
| | - Barry Pakes
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Global Health Education Initiative, University of Toronto, Toronto, Ontario, Canada
| | - Suzanne Jackson
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Carles Muntaner
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Kulkarni A, Francis ER, Clark T, Goodsmith N, Fein O. How we developed a locally focused Global Health Clinical Preceptorship at Weill Cornell Medical College. MEDICAL TEACHER 2014; 36:573-7. [PMID: 24597684 PMCID: PMC8052984 DOI: 10.3109/0142159x.2014.886764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Global health educational programs within U.S. medical schools have the opportunity to link their "global" focus with local circumstances by examining the challenges underserved communities face in the United States. AIM Students in Weill Cornell Medical College's Global Health Clinical Preceptorship (GHCP) learn history-taking and physical examination skills while gaining exposure to local health care disparities and building cultural competency. METHODS First-year medical students in the program are placed in the office of a physician who works with underserved patient populations in New York City. Students receive an orientation session, shadow their preceptors one afternoon per week for seven weeks, complete weekly readings and assignments on topics specific to underserved populations, attend a reflection session, and write a reflection paper. RESULTS In three years, 36% of first-year students (112 of 311) opted into the elective GHCP program. Students reported gaining a better understanding of the needs of underserved patient populations, being exposed to new languages and issues of cultural competency, and having the opportunity to work with role model clinicians. CONCLUSIONS The GHCP is a successful example of how global health programs within medical schools can incorporate a domestic learning component into their curricula.
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Affiliation(s)
| | | | | | - Nichole Goodsmith
- Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program
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Wipfli H, Press DJ, Kuhn V. Global health education: a pilot in trans-disciplinary, digital instruction. Glob Health Action 2013; 6:1-7. [PMID: 23643297 PMCID: PMC3644060 DOI: 10.3402/gha.v6i0.20747] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 03/28/2013] [Accepted: 03/29/2013] [Indexed: 11/14/2022] Open
Abstract
Background The development of new global health academic programs provides unique opportunities to create innovative educational approaches within and across universities. Recent evidence suggests that digital media technologies may provide feasible and cost-effective alternatives to traditional classroom instruction; yet, many emerging global health academic programs lag behind in the utilization of modern technologies. Objective We created an inter-departmental University of Southern California (USC) collaboration to develop and implement a course focused on digital media and global health. Design Course curriculum was based on core tenants of modern education: multi-disciplinary, technologically advanced, learner-centered, and professional application of knowledge. Student and university evaluations were reviewed to qualitatively assess course satisfaction and educational outcomes. Results ‘New Media for Global Health’ ran for 18 weeks in the Spring 2012 semester with N=41 students (56.1% global health and 43.9% digital studies students). The course resulted in a number of high quality global health-related digital media products available at http://iml420.wordpress.com/. Challenges confronted at USC included administrative challenges related to co-teaching and frustration from students conditioned to a rigid system of teacher-led learning within a specific discipline. Quantitative and qualitative course evaluations reflected positive feedback for the course instructors and mixed reviews for the organization of the course. Conclusion The development of innovative educational programs in global health requires on-going experimentation and information sharing across departments and universities. Digital media technologies may have implications for future efforts to improve global health education.
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Affiliation(s)
- Heather Wipfli
- USC Institute for Global Health, University of Southern California, Los Angeles, CA, USA.
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Yassi A, Breilh J, Dharamsi S, Lockhart K, Spiegel JM. The Ethics of Ethics Reviews in Global Health Research: Case Studies Applying a New Paradigm. JOURNAL OF ACADEMIC ETHICS 2013. [DOI: 10.1007/s10805-013-9182-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Truglio J, Graziano M, Vedanthan R, Hahn S, Rios C, Hendel-Paterson B, Ripp J. Global health and primary care: increasing burden of chronic diseases and need for integrated training. ACTA ACUST UNITED AC 2013; 79:464-74. [PMID: 22786735 DOI: 10.1002/msj.21327] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Noncommunicable diseases, including cardiovascular disease, chronic respiratory disease, diabetes, cancer, and mental illness, are the leading causes of death and disability worldwide. These diseases are chronic and often mediated predominantly by social determinants of health. Currently there exists a global-health workforce crisis and a subsequent disparity in the distribution of providers able to manage chronic noncommunicable diseases. Clinical competency in global health and primary care could provide practitioners with the knowledge and skills needed to address the global rise of noncommunicable diseases through an emphasis on these social determinants. The past decade has seen substantial growth in the number and quality of US global-health and primary-care training programs, in both undergraduate and graduate medical education. Despite their overlapping competencies, these 2 complementary fields are most often presented as distinct disciplines. Furthermore, many global-health training programs suffer from a lack of a formalized curriculum. At present, there are only a few examples of well-integrated US global-health and primary-care training programs. We call for universal acceptance of global health as a core component of medical education and greater integration of global-health and primary-care training programs in order to improve the quality of each and increase a global workforce prepared to manage noncommunicable diseases and their social mediators.
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Sakran JV, Greer SE, Werlin E, McCunn M. Care of the injured worldwide: trauma still the neglected disease of modern society. Scand J Trauma Resusc Emerg Med 2012; 20:64. [PMID: 22980446 PMCID: PMC3518175 DOI: 10.1186/1757-7241-20-64] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 09/11/2012] [Indexed: 11/10/2022] Open
Abstract
Traditionally, surgical diseases including emergency and injury care have garnered less attention and support internationally when compared to other medical specialties. Over the past decade however, healthcare professionals have increasingly advocated for the need to address the global burden of non-communicable diseases. Surgical disease, including traumatic injury, is among the top causes of death and disability worldwide and the subsequent economic burden is substantial, falling disproportionately on low- and middle-income countries (LMICs). The future of global health in these regions depends on a redirection of attention to diseases managed within surgical, anesthesia and emergency specialties. Increasing awareness of these disparities, as well as increasing focus in the realms of policy and advocacy, is crucial. While the barriers to providing quality trauma and emergency care worldwide are not insurmountable, we must work together across disciplines and across boundaries in order to negotiate change and reduce the global burden of surgical disease.
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Affiliation(s)
- Joseph V Sakran
- Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas Street (MSC 613/CSB 420), Charleston, SC 29425-6130, USA.
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Francis ER, Goodsmith N, Michelow M, Kulkarni A, McKenney AS, Kishore SP, Bertelsen N, Fein O, Balsari S, Lemery J, Fitzgerald D, Johnson W, Finkel ML. The global health curriculum of Weill Cornell Medical College: how one school developed a global health program. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:1296-302. [PMID: 22929431 PMCID: PMC8052981 DOI: 10.1097/acm.0b013e3182628edb] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Since 2009, a multidisciplinary team at Weill Cornell Medical College (WCMC) has collaborated to create a comprehensive, elective global health curriculum (GHC) for medical students. Increasing student interest sparked the development of this program, which has grown from ad hoc lectures and dispersed international electives into a comprehensive four-year elective pathway with over 100 hours of training, including three courses, two international experiences, a preceptorship with a clinician working with underserved populations in New York City, and regular lectures and seminars by visiting global health leaders. Student and administrative enthusiasm has been strong: In academic years 2009, 2010, and 2011, over half of the first-year students (173 of 311)participated in some aspect of the GHC, and 18% (55 of 311) completed all first-year program requirements.The authors cite the student-driven nature of GHC as a major factor in its success and rapid growth. Also important was the foundation previously established by WCMC global health faculty, the serendipitous timing of the GHC's development in the midst of curricular reform and review, as well as the presence of a full-time, nonclinical Global Health Fellow who served as a program coordinator. Given the enormous expansion of medical student interest in global health training throughout the United States and Canada over the past decade, the authors hope that medical schools developing similar programs will find the experience at Weill Cornell informative and helpful.
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Goldner BW, Bollinger RC. Global health education for medical students: New learning opportunities and strategies. MEDICAL TEACHER 2012; 34:e58-e63. [PMID: 22250696 DOI: 10.3109/0142159x.2012.638008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND A new course was offered to introduce basic global health concepts to all first year Johns Hopkins medical students, that took advantage of new distance learning capacity to connect medical students in Baltimore with students and faculty in Uganda, Ethiopia, Pakistan and India. AIMS Lessons learned from the launch of this new course will optimize the conduct of future global health courses at JHUSOM and may be of value to other institutions. METHODS Feedback from the Hopkins students was obtained through an on-line structured course evaluation questionnaire. Unstructured student and faculty feedback from partners institutions was solicited via email. RESULTS Students reported high levels of satisfaction with the course content and format, as well as achievement of course competencies and objectives. CONCLUSIONS Distance learning can support unique, high-quality medical educational experiences that leverage technology and global connectivity, but also the power of group learning and "South-to-North" capacity building.
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Affiliation(s)
- Brian W Goldner
- Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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Establishing and Upgrading Physical Therapist Education in Developing Countries: Four Case Examples of Service by Japan and United States Physical Therapist Programs to Nigeria, Suriname, Mongolia, and Jordan. ACTA ACUST UNITED AC 2012. [DOI: 10.1097/00001416-201210000-00007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jahangiri K, Izadkhah YO, Montazeri A, Hosseinip M. People's perspectives and expectations on preparedness against earthquakes: Tehran case study. J Inj Violence Res 2011; 2:85-91. [PMID: 21483203 PMCID: PMC3134911 DOI: 10.5249/jivr.v2i2.25] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2009] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Public education is one of the most important elements of earthquake preparedness. The present study identifies methods and appropriate strategies for public awareness and education on preparedness for earthquakes based on people's opinions in the city of Tehran. METHODS This was a cross-sectional study and a door-to-door survey of residents from 22 municipal districts in Tehran, the capital city of Iran. It involved a total of 1 211 individuals aged 15 and above. People were asked about different methods of public information and education, as well as the type of information needed for earthquake preparedness. RESULTS "Enforcing the building contractors' compliance with the construction codes and regulations" was ranked as the first priority by 33.4% of the respondents. Over 70% of the participants (71.7%) regarded TV as the most appropriate means of media communication to prepare people for an earthquake. This was followed by "radio" which was selected by 51.6% of respondents. Slightly over 95% of the respondents believed that there would soon be an earthquake in the country, and 80% reported that they obtained this information from "the general public". Seventy percent of the study population felt that news of an earthquake should be communicated through the media. However, over fifty (58%) of the participants believed that governmental officials and agencies are best qualified to disseminate information about the risk of an imminent earthquake. Just over half (50.8%) of the respondents argued that the authorities do not usually provide enough information to people about earthquakes and the probability of their occurrence. Besides seismologists, respondents thought astronauts (32%), fortunetellers (32.3%), religious figures (34%), meteorologists (23%), and paleontologists (2%) can correctly predict the occurrence of an earthquake. Furthermore, 88.6% listed aid centers, mosques, newspapers and TV as the most important sources of information during the aftermath of an earthquake, Discussion: A participatory approach to earthquake-preparedness planning is recommended. This would ensure that program planners use methods, tools, media, and educational materials that are compatible with the culture, needs, and skills of the local communities. CONCLUSIONS The findings of this study also reveal methods and tools that the local community considers to be most effective for earthquake-preparedness planning and management. The development of an earthquake-resistance and a safe community requires a high level of collaboration between broadcasting organizations, seismologists, experts in the disaster- preparedness field, as well as the local community. This will allow for timely planning, development, and dissemination of essential information to all stakeholders including the local communities.
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Affiliation(s)
- Katayoun Jahangiri
- Health Services Management Department, Iranian Institute for Health Sciences Research, Iranian Academic Center for Education, Culture and Research, Iran.
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Bryant JH, Velji A. Global health and the role of universities in the twenty-first century. Infect Dis Clin North Am 2011; 25:311-21. [PMID: 21628047 DOI: 10.1016/j.idc.2011.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A vast gap exists between knowledge, generation of knowledge, and the application of knowledge to the needs and benefit of the global population. In middle-income and lower-income countries, universities are becoming more engaged with the communities in which they are located to try to solve the difficult problems of poverty and poor health. Global collaborations and reform of medical education in the twenty-first century will help move universities out of cloistered academic settings and into the community to bring the changes needed to equitably meet the health needs of all.
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Affiliation(s)
- John H Bryant
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
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Farquhar C, Nathanson N. The Afya Bora Consortium: an Africa-US partnership to train leaders in global health. Infect Dis Clin North Am 2011; 25:399-409. [PMID: 21628054 DOI: 10.1016/j.idc.2011.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The Afya Bora Consortium is a partnership of 8 academic health institutions, 4 in Africa and 4 in the United States. The Consortium is developing a Global Health Leadership Fellowship for medical, nursing, and public health professionals, largely drawn from the 4 African partner countries. The fellowship provides trainees with practical skills to prepare them for future positions leading the design, implementation, and evaluation of large, high-impact programs in governmental agencies, nongovernmental organizations, and academic health institutions in their own countries. This article describes a Pilot of the proposed program.
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Affiliation(s)
- Carey Farquhar
- Division of Allergy and Infectious Disease, Departments of Medicine and Epidemiology and Global Health, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA.
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The medical mission and modern cultural competency training. J Am Coll Surg 2010; 212:124-9. [PMID: 21115375 DOI: 10.1016/j.jamcollsurg.2010.08.019] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 07/20/2010] [Accepted: 08/17/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND Culture has increasingly appreciated clinical consequences on the patient-physician relationship, and governing bodies of medical education are widely expanding educational programs to train providers in culturally competent care. A recent study demonstrated the value an international surgical mission in modern surgical training, while fulfilling the mandate of educational growth through six core competencies. This report further examines the impact of international volunteerism on surgical residents, and demonstrates that such experiences are particularly suited to education in cultural competency. METHODS Twenty-one resident physicians who participated in the inaugural Operation Smile Regan Fellowship were surveyed one year after their experiences. RESULTS One hundred percent strongly agreed that participation in an international surgical mission was a quality educational experience and 94.7% deemed the experience a valuable part of their residency training. In additional to education in each of the ACGME core competencies, results demonstrate valuable training in cultural competence. CONCLUSIONS A properly structured and proctored experience for surgical residents in international volunteerism is an effective instruction tool in the modern competency-based residency curriculum. These endeavors provide a unique understanding of the global burden of surgical disease, a deeper appreciation for global public health issues, and increased cultural sensitivity. A surgical mission experience should be widely available to surgery residents.
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Abstract
BACKGROUND Surgical trainees have participated in international missions for decades and are now seeking out these experiences in record numbers. Resident participation in humanitarian service has been highly controversial in the academic plastic surgery community, and little evidence exists elucidating the value of these experiences. This report examines the impact of international volunteerism on surgical training. METHODS Twenty-one resident physicians who participated in the inaugural Operation Smile Regan Fellowship were surveyed 1 year after their experiences. RESULTS One hundred percent responded that participation in an international surgical mission had an overall positive impact on their lives, and 94.7 percent reported that they had achieved marked personal growth. Results demonstrate significant education in each of the Accreditation Council for Graduate Medical Education core competencies and insights into global health and cultural competency. One hundred percent "strongly agreed" that the Regan Fellowship was a quality educational experience, and 94.7 percent deemed the experience a valuable part of their residency training. CONCLUSIONS Resident physicians are calling for more international health opportunities, and they should be generously supported. A properly structured and proctored experience for surgical residents in international volunteerism is an effective instruction tool in the modern competency-based residency curriculum. These endeavors provide a unique understanding of the global burden of surgical disease, a deeper appreciation for global public health issues, and increased cultural sensitivity. Plastic surgery training programs can contribute mightily to global health and improved resident education by embracing and fostering the development of international humanitarian opportunities. A surgical mission experience should be widely available to plastic surgery residents.
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Conrad PA, Mazet JA, Clifford D, Scott C, Wilkes M. Evolution of a transdisciplinary "One Medicine-One Health" approach to global health education at the University of California, Davis. Prev Vet Med 2009; 92:268-74. [PMID: 19819575 PMCID: PMC7132481 DOI: 10.1016/j.prevetmed.2009.09.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In today's world health events in one nation or geographic area often have repercussions for the health and well-being of populations beyond that region; sometimes even globally. In recent years many factors, most notably concern about emerging infectious diseases, have contributed to an increasing appreciation of the interdependency of human, animal and ecosystem health worldwide. Integrated global approaches to improve the health of humans, animals and their shared environments are proving to be in the best interest of many countries. A special symposium and award were established in memoriam to the internationally renowned epidemiologist, Dr. Calvin W. Schwabe, who (while at the University of California, Davis) was a significant advocate of the “One Medicine” approach to public health, calling upon all health professionals, including veterinarians, to work collaboratively and comparatively to improve human health. This paper discusses the evolution of the “One Medicine” concept into a global “One Health” approach to research, training capacity and service infrastructure, focused not only on disease, but also on health at the individual, population, and ecosystem levels. Projects involving UCD faculty which attempt to integrate a One Health approach include the Health for Animals and Livelihood Improvement (HALI) Project in Tanzania, Envirovet Summer Institute, Avian Flu School and Newcastle Immunization Program in Africa, a web-based virtual global health training program, and the Calvin Schwabe One Health Project.
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Affiliation(s)
- Patricia A Conrad
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616, United States.
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