Family Medicine Global Health Fellowship Competencies: A Modified Delphi Study

BACKGROUND AND OBJECTIVES

Many US medical schools and family medicine departments have responded to a growing interest in global health by developing global health fellowships. However, there are no guidelines or consensus statements outlining competencies for global health fellows. Our objective was to develop a mission and core competencies for Family Medicine Global Health Fellowships.

METHODS

A modified Delphi technique was used to develop consensus on fellowship competencies. A panel, comprised of 13 members with dual expertise in global health and medical education, undertook an iterative consensus process, followed by peer review, from April to December 2014.

RESULTS

The panel developed a mission statement and identified six domains for family medicine global health fellowships: patient care, medical knowledge, professionalism, communication and leadership, teaching, and scholarship. Each domain includes a set of core and program-specific competencies.

CONCLUSION

The family medicine global health competencies are intended to serve as an educational framework for the design, implementation, and evaluation of individual family medicine global health fellowship programs.

The impact on rural New Mexico of a family medicine residency

PURPOSE

To determine the impact on rural New Mexico of the large, decentralized University of New Mexico (UNM) family medicine residency.

METHOD

A cross-sectional study was conducted of all 317 residency's graduates from 1974 to 2004. Location of current practice was correlated with the residents' gender, ethnicity, medical school of origin, and whether most training took place in the urban program or one of three rural programs. The residency's impact on rural communities was assessed.

RESULTS

There was no significant gender difference between graduates who went into urban or rural practice. Compared with non-minority graduates, a significantly greater percentage of ethnic minority graduates were in rural and urban New Mexico practices and fewer in out-of-state practices. A greater percentage of graduates who had been medical students in New Mexico practiced in both rural and urban New Mexico areas compared with graduates of out of state medical schools. Finally, a greater percentage of graduates from the three rural family medicine residencies remained in the state and practiced in rural areas compared with graduates from the urban program. The graduates' contributions to the school of medicine and to rural New Mexico are described.

CONCLUSIONS

Graduates of UNM's family medicine residency have contributed significantly to the state's rural health workforce. Ethnic minority status, graduation from New Mexico's medical school, and training in one of the three rurally based residencies favored in-state and rural retention, while gender had no significant effect. The rural orientation of the residencies offered rural communities economic benefits.

Christian mission hospitals as family practice educational resources

With the worldwide family practice movement, a need has arisen to develop new residency training programs in economically developing countries. Christian mission hospitals exist in many areas where there is a need for more family physicians. These hospitals have been providing service and education, and some are now becoming training sites for family physicians. Currently, seven such institutions have operational family practice residency programs, all of which welcome personnel exchanges with faculty or residents in North American training programs. Christian mission hospitals with family practice residency programs exist in South America, Asia, and Africa.

Persistent scabies in nursing home patients

Persistent scabies outbreaks in extended care facilities result from multiple factors: atypical presentations in the elderly, leading to delayed or inaccurate diagnosis; incomplete or ineffective treatment of the patient and exposed population; and failure to coordinate notification, education, treatment, and disinfection. A case report of scabies in an elderly resident of an extended care facility illustrates various types of scabies manifestations, the advisability of obtaining diagnostic scrape preparations, and the efficacy and safety of permethrin. Guidelines for an aggressive and comprehensive effort for eradication are offered.