MethodsandtheGHSPModel

Thirty-one countries in sub-SaharanAfrica have a cri3cal shortageof health careprofessionals. To address thischallenge,manyAfricanmedicalandnursingschoolsareincreasingtheirenrollment,consequentlyincreasingthedemandontheirlimitedfaculty.

Simultaneously,USmedicalresidentsaremoreinterestedinglobalhealththaneverbeforeandtrainingprogramsarelookingforwaystoprovidehighqualityexperiencesforresidentswhilealsoaddingvaluetothehealthsystemofthehostcountry.

Medical educa3on is a key focusof theGlobalHealth ServicePartnership(GHSP).

•  In the first three years, GHSP placed 97 US physicians andnurses in medical and nursing schools in Malawi, Tanzania,and Uganda for one-year faculty assignments to teachtraineesintheclassroomandclinicalseGng.

•  GHSP educators taught 454 courses to 8,321 trainees,assisted with curriculum development, worked on qualityimprovementprojects,andenhancedteachingmethods.

BuildingonGHSP,onestrategytoimproveUSresidents’global health experiences is to create partnershipsbetween US academic ins3tu3ons and GHSP partnersites.

These partnerships would provide quality global healthexperiences for US residents while also adding to theclinical and educaJonal mission of the partner sites.Residentsandfacultywould:

•  Completeshort-termrotaJonsatthepartnersites;•  Be paired with GHSP educators embedded in the local

insJtuJon,who:•  serveasliaisonsandsupervisors,•  haveanunderstandingofsites’needsandchallenges,

and•  idenJfyeducaJonalprojects•  withoutoverburdeninglocalfaculty.

Background

Significance

Similar partnerships between US academic insJtuJons, GHSP, and local insJtuJons will createmeaningfulandsustainablewaysofenablingresidentsandfacultyacrossavarietyofspecial3estoserve in resource-limited seGngs, gaining valuable global health experience and simultaneouslyhelpingreducethecriJcalfacultyshortagesininsJtuJonsinsub-SaharanAfrica.

This model builds off the pre-exis3ng rela3onships between Seed, GHSP and partner insJtuJons,loweringthebarriertoimplementaJonforUSinsJtuJonsandincreasingon-the-groundsupport.

AddiJonally,thispartnershipwouldcreateapipelineforresidencygraduatestoconJnuetoworkinglobalhealthasGHSPVolunteers,contribuJngtoboththeUSandhostinsJtuJons.

GHSP Physician Volunteers: Years 1-3

Physicianvolunteers 44

Special3es

AnesthesiologyCardiology

FamilyMedicineInfecJousDiseaseInternalMedicine

OB/GYN

OrthopedicSurgeryPediatricsPsychiatry

PulmonologySurgery

Servicehoursreported 65,103

Courses/workshopstaught 187

Totaltraineestaught 4,008

Outcomes

RecentlypublishedguidelinesfromtheWorkingGrouponEthicsGuidelinesforGlobalHealthTraining(WEIGHT)*haveoutlinedkeyfactorsinsuccessfulglobalhealthtrainingpartnerships,including:

ElizabethHutchinson,1,2EstherJohnston,1,3JamesSco[,1,4ElizabethCunningham,1KiranMitha,1,5FolasadeMay,1,6DavidRies,1,7MaureenRies,1,8SadathSayeed,1,9,10andVanessaKerry1,9,11,12

1.SeedGlobalHealth,BostonUSA;2.SwedishFamilyMedicine-FirstHill;DepartmentofFamilyMedicine,UniversityofWashington,Sea_le,WA;3.WrightCenterFamilyMedicineResidencyatHealthPoint,Auburn,WA;4.DepartmentofEmergencyMedicine,TheGeorgeWashingtonUniversitySchoolofMedicineandHealthSciences,WashingtonDCUSA;5.DepartmentofPediatrics,DavidGeffenSchoolofMedicineatUCLA,LosAngelesUSA;6.DepartmentofMedicine,DavidGeffenSchoolofMedicineatUCLA,LosAngelesUSA;7.DepartmentofHospitalMedicine,UniversityofCaliforniaSanDiego,SanDiego,CA;8.DepartmentofObstetricsandGynecology,UniversityofCaliforniaIrvine,Orange,CA;9.DepartmentofGlobalHealthandSocialMedicine,HarvardMedicalSchool,BostonUSA;10.DivisionofNewbornHealth,DepartmentofMedicine,BostonChildren’sHospital,BostonUSA;11.MassGeneralGlobalHealth,Massachuse_sGeneralHospital,BostonUSA;12.DivisionofPulmonaryandCriJcalCare,DepartmentofMedicine,Massachuse_sGeneralHospital,BostonUSA;

Creating Sustainable Models for Short-Term Volunteers Through the Global Health Service Partnership

Global Health Service

Partnership (GHSP) Seed Global

Health

PEPFAR

Peace Corps

•  Structuredprogramsbetweenpartners;•  ComprehensivecostaccounJng;•  Mutualandreciprocalbenefits;•  Long-termrelaJonships;

•  Suitabletrainees(aGtudeandbehavior);•  On-sitementorshipandsupervision;and•  SufficienttraineepreparaJon.

*CrumpJA,SugarmanJ,WorkingGrouponEthicsGuidelinesforGlobalHealthTraining.EthicsandbestpracJceguidelinesfortrainingexperiencesinglobalhealth.AmJTropMedHyg2010;83:1178-82.

The University of Washington (UW) and University of Malawi College ofMedicine (CoM), supported by Seed, successfully demonstrated this model.Over2academicyears,25UWresidentsrotatedatCoM,supervisedbyfullJmeGHSPandSeededucatorsbasedinMalawi.UWresidentsprovidedclinicalandclassroomteachingforCoMmedicalstudents,providedconJnuingprofessionaldevelopment for hospital staff, and established quality improvement projects.FourUWresidentswhorotatedwithCoMchosetojoinGHSPalerresidency.AsurveysofUWresidents,CoMfacultyandtrainees,andstaffatthedistricthospitalreportedthatthispartnershipresultedin:

•  Increasedmedicalknowledgeandclinicalskill•  IncreasedprovidersaJsfacJonamongthehosJnginsJtuJon•  ReducedpaJentreferralstothenaJonalhospital•  Developmentoflong-termrelaJonshipsbetweenUSandinternaJonal

insJtuJons•  Providedpost-residencyglobalhealthopportuniJes•  Providedapipelineoffaculty(GHSPvolunteers)tosupportthenewCoM

FamilyMedicineresidenttrainingprogram

Number of educational institutions & training sites attended by GHSP Physician Alumni

Medicalschools 26

Residencyprograms 31

Fellowshipprograms 11

GHSP Physician Alumni current employment

Academic&clinicalappointments 31%

ClinicalpracJce 31%ClinicalFellowships 6%

OtherposiJons 13%ReJred 19%

GHSP Physician Alumni – Training sites/institutions attended and current employment

Short-termresidentrotaJons

US academic institution

• Clinicalcare• ConJnuingeducaJon&mentoring

• Locally-relevantprojects

• Residentoverlap(orientaJon&projecthandover)

Supervised by GHSP Volunteer •  Humanresourcesupport

•  PaJentcare•  Traineeandstafftraining&mentoring

•  Process/qualityimprovementoutcomes

Site impact

Long-term, mutually beneficial partnership

Post-residency global health experience and faculty pipeline

for Partner institution

Partner institution

ThroughGHSP,SeedandPeaceCorpsplaceyearlongfacultyvolunteersandprovideacademicandclinicalsupport,facilitatelogisJcsandinfrastructureneeds,and

provideevaluaJonsystems.

Education & training sites Current employment sites

Global Health Service Partnership

Yourmedicalknowledge

Yourclinicalskills Yourmorale Medicalstudentteachingoverall

Medicalstudentsupervisionoverall

Registrarmentorship/training

Faculty&staffmentorship/training

Research&projectdevelopmentatthehospital

Overallclinicalskillsatthehospital

Overalllearningenvironmentatthehospital

Reported impact on personal and hospital factors:

VeryNegaJve

VeryPosiJve

Neutral