Diana Clemow, MD Rachel Hansen, MD AnMed Health FM Residency Program Anderson, SC September 10, 2010

 Core GHT Curriculum ::: review of multiple global health tracks  AnMed Approach  Limitations of GHT  Resources  Discussion

1  International rotations  US underserved populations  Lectures  Self-study  Book Clubs / Journal Clubs  Mentorship / Career Counseling

1  International Rotations Pre trip preparation / research Post trip debriefing Trip report  US underserved populations Free Clinic HIV / TB clinic Travel Clinic

1  Lecture / Self-Study Topics Global burden of disease Institutions and organizations in GH Environmental health (water issues, natural and man-made disasters) Immigration issues Cultural, social and behavioral determinants of health Demography Staying healthy during the global health field experience

1  Lecture / Self-Study Topics (cont’d) Malaria Tuberculosis HIV Measles Malnutrition Laboratory skills Tropical diseases Availability and safety of pharmaceuticals in international settings

1  Book Clubs / Journal Clubs  Mentorship / Career Counseling Program Faculty experience International Faculty experience Resident experience

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2  Rotations Core FM rotations Infectious Disease Travel Medicine Dental procedures * Tropical Medicine * Public Health * Advanced Obstetrics * = not required *

2  International Rotations 2 weeks PGY 1; 4-8 weeks PGY 2 & 3 ::: case report / noon conference presentation Serve as a trip leader or co-leader under faculty supervision PGY 2 or PGY 3 Yearly trip to permanent clinic site: Roatan, Honduras

2  Book Club The Spirit Catches You and You Fall Down by Anne Fadiman Mountains Beyond Mountains by Tracey Kidder Open Veins of Latin America by Eduardo Galeano Not All of Us are Saints by David Hilfiker Nickel and Dimed by Barbara Ehrenreich Three Cups of Tea by Greg Mortenson and David Oliver Relin

2  Longitudinal Self-Study Curriculum Pediatrics │ ORS, WHO Malnutrition Surgery │ ATLS training Dermatology │ Tropical Derm Community Medicine │ Alma Alta declaration, social justice, cultural issues OB │ Maternity care in limited resource settings

2  Monthly Meetings Trip planning Rotation planning Mentoring Didactic Teaching

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3  International Trips Uncertain mentorship Uncertain quality of experience Resident accountability Language restriction Safety, patient load

3  Patient Continuity Restrictions Required # continuity patients seen in clinic Required # weeks spent in clinic / year  Time Restrictions Four-year programs  Financial Restrictions Grant Writing Establish 501c3

4  GHEC education modules: Forms/Presentations.aspx  GHEC Residency Guidebook  AAFP guidelines: rpsolutions/eduguide.html  Global Health E-Learning Center: USAID

4  Information Sources: Global Health Council  Developing Global Health Curricula: A Guidebook for U.S. Medical Schools. h_Curr_Guide.pdf

4  Tropical Medicine / Public Health Training Options  Gorgas Course  Walter Reed Course  Johns Hopkins Course  International Health in the Developing World: Clinical and Community Care-Arizona  InMed Course  Tropical Medicine 101

4  Books Clinical Problems in Tropical Medicine by Harries and Cook Understanding Global Health by Markle Medical Management of Vulnerable and Underserved Patients by King Introducation to Global Health by Jacobsen Tropical Medicine-Lecture Notes by Gill Travel and Tropical Medicine Manual by Jong Tropical Dermatology by Tyring Handbook of Medicine in Developing Countries by Wolfe and Palmos Textbook of Tropical Medicine by Strickland

5  Is there anything we’re missing—core components of training that programs are not covering? Core Components of GH Training  Must  Should  Could

5  How do we avoid sacrificing the development of excellent FM clinical skills for more peripheral training?  What are we trying to accomplish with our GHT curriculum? What does a well trained GHT FM resident look like?

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