1. Sustaining a Medical School Global Health Track: The Value of Alignment N. Benjamin Fredrick, MD Director, Global Health Center Associate Professor, Family & Community Medicine Pennsylvania State University College of Medicine

2. 2 Activity Disclaimer ACTIVITY DISCLAIMER It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. Ben Fredrick has indicated he has no relevant financial relationships to disclose.

3. Learning Objectives Demonstrate the value of programmatic/curricular alignment with institutional/faculty/student priorities to support sustainability of global health programming; Discuss ideas and suggestions to develop and maintain a global health track. 3

4. How did we go from 2008-2009 6 Scholars/year 1 Site 6 faculty $0 0 FTE Current State 21 Alumni & ~25 Scholars/year 5 sites >20 faculty involved Institutional support >40 presentations and publications 4

5. Global Health Scholars Program –4 year curriculum (extra-curricular) –Two month-long international trips to the same community as a group 5

6. Global Health Scholars Program

7. 7

8. GHSP 1GHSP 2GHSP 3 GHSP 4 FACULTY GHSP 1GHSP 2 GHSP 3 Site FACULTY GHSP 4 What happened?

9. Friction/Misalignments Students Faculty Institution 9

10. Frictions/Misalignments: Students Professional development GHSP Curriculum vs. Medical school 10

11. GHSP 1 Population focus GHSP 2 Population focus GHSP 3 Population focus GHSP 4 FACULTY Population focus GHSP 1 Population focus GHSP 2 GHSP 3 Site FACULTY GHSP 4 Patient care focus RESIDENCY Longitudinal/continuity, Group, Transformative Educational experience

12. 2008-2009 GHSP Curricular Approach GH Competencies “What every medical student should know…” What all students interested in GH should know…Sequenced over 4 years 12

13. 2015-16 GHSP Curricular Approach General GH sessions –Pre-travel –Global Health Ethics Alignment of content with students’ schedule –WASH during GI block –Journal Clubs 13

14. 2015-2016 GHSP Educational Approach Drawbacks –Annual syllabus revisions based on students, medical school curriculum –Great sessions might get dropped –Missing entire areas of global health –Perhaps less cohesive (unsequenced) Benefits –Flexibility, especially with major restructuring of medical school curriculum –“Just in time” learning –Plays to our strengths/resources 14

15. Feedback on Timing of Sessions “It was a great supplement to lectures. The frequency and amount of topics was appropriate.” “Excellent! I appreciated the continuity and alignment with the blocks.” “It was very helpful having those sessions during the connecting block.” “Timing was really well done. I can tell you really attempted to not schedule meetings during busy weeks (during exams, etc).” 15

16. Frictions/Misalignments: Faculty Expertise/interest Admin time Expenses 16

17. Frictions/Misalignments: Faculty San Pablo, Ecuador 17

18. Modifications: Faculty –Align with faculty interests/expertise (Champion!) Peru: Microbiology projects led by microbiologist Senegal: community health education led by Biobehavioral Health –Identify great international partners!! (Champion!) Ghana: MountCrest U. Taiwan: Taipei Medical 18

19. Modifications: Faculty –Provide smaller, manageable work for “volunteer” faculty (divide-and-conquer) Journal Club Conversations in Global Health –Eliminate elements that cannot be supported  Time-intensive work (online discussion group) 19

20. Frictions/Misalignments: Institution Institution –MSR –Resources 20

21. Frictions/Misalignments: Institution Medical Student Research (MSR) Project 21

22. Frictions/Misalignments: Institution Hypothesis-driven Disintegration of team… –Loss of cohesion, sense of ‘community’… –Reduced participation and commitment 22

23. Frictions/Misalignments: Institution Benefits of MSR –Student-pleaser –Scholarly work by students, faculty –Generated a different model aligned with student and faculty priority But not community-driven…. 23

24. Frictions/Misalignments: Institution Leadership and Resources 24 0.50FTE GHC Director $90K 0.4 FTE Admin 0.30FTE 0.25 FTE Admin Office/desk Graphic designer 5 Scholarships ($30K)

25. Tips/Suggestions Feeling frustrated? Derailed?--Clues Flexibility! –Aim for the goal –But flex to get there Take stock (play to your strengths) –Resources –Stakeholders –Institutional priorities Aim for Alignment 25

26. Programmatic Development GHSP Model Friction, Misalignments Modified GHSP 26 Identify and Address the Frictions and Misalignments Flex based on available resources and others’ priorities

27. Alignment. Thanks! 27 http://twistedsifter.com/