GLOBAL HEALTH PATHWAY IN INTERNAL MEDICINE (THE GLOBAL HEALTH SCHOLARS PROGRAM) Basia Najarro, MBA Rupa Patel, MD, MPH, DTM&H Co-Directors, GHS Program.

GLOBAL HEALTH PATHWAY IN INTERNAL MEDICINE(THE GLOBAL HEALTH SCHOLARS PROGRAM)

Basia Najarro, MBA

Rupa Patel, MD, MPH, DTM&H

Co-Directors, GHS Program

GHS and the GH Pathway• This year the Global Health Scholars Program is transitioning

into a pathway within the internal medicine residency. Therefore the GHS Program will also be called the GH Pathway in Internal Medicine

• This GH Pathway and its resources have been created to serve the general purpose of assisting any internal medicine resident develop a career in global health

• It has been structured to create more scholarly accomplishments by the residents who travel abroad

• The following slides have information about this transition and the pathway

3 GH Pathway Goals

1. Preparing residents for competitive careers in Global Health through:

a. Clinical experienceb. Research experiencec. Capacity building experienced. Knowledge of key topics in Global Health

3 GH Pathway Goals

2. Providing service in Global Healtha. Direct patient careb. Capacity building academic medical centers and community partnersc. Health advocacy

3. Conducting Global Health research for sustainable solutions witha. Academic medical centersb. Community partners

4 GH Pathway Academic Components

1. Monthly Evening 1.5 hr Didactic GH Core Curriculum (in PGY2 only over 11 months)

• Journals, Clinical Cases, Speakers, Career, Research Meetings, Practical Sessions, etc.

• Key GH Topic Lectures (including Research Methodology, Health Systems, Climate Change, etc.)

2. Subspecialty GH ½ Day Clinic Sessions (PGY2 & 3, within protected time)

• Travel, TB/STI County/City, Casa de Salud, HIV, etc.

4 GH Pathway Academic Components

3. Four Week Combined Clinical and Research International Experience at Wash U or Other Site (at the end of PGY2, within protected time)

-travel/transport/accommodations funded

4. Scholarly Presentation (PGY2 & PGY3, PGY3 protected time during subspecialty clinic sessions)

• IRB Project Submission (PGY2)• Abstract Submission (PGY3)• Poster Presentation (PGY3, May, Wash U Internal Conference & Other National

Conferences)• Manuscript Preparation (PGY3, At Least 1 Journal Submission)

GH Pathway Certificate Requirements

• Exact requirements are to be determined based on first GH Pathway class feedback

• Tentative requirements include:• Near 70% attendance of didactic lectures; based on clinical schedule there

can be pre-approved absences• Near 70% of GH ½ day clinic session attendance; based on clinical schedule

there can be pre-approved absences• International or Domestic Field Experience• PGY3 (May) Wash U internal conference abstract submission and poster

presentation and 1 other national conference abstract submission• Manuscript creation and submission to at least 1 journal

3 Year Timeline for ResidentsPGY1 PGY2 PGY3

Application Oct Core CurriculumIRB SubmissionsSubspecialty clinics

Manuscript PreparationSubmit AbstractsSubspecialty clinics

Acceptance Jan 1 Poster Preparation

Select Mentors/Site/Project Topic

4 WK TRAVELCore CurriculumSubspecialty clinics

Subspecialty clinicsManuscript Submission

Make Career Development Plan

Poster Presentation, Graduate

GH Pathway Application Process• Application opens in October

• Application form• CV

• Applicants are contacted for an interview• Application deadline Friday, November 22, 2013• Applicant Selection in December by pathway co-directors• Number of applicants selected to be determined based on the quality

and number of applicants• Maximum 6 pathway residents selected per year; residents will work

on projects and travel in pairs• There are electives also• Total of 8 residents selected per year for both the pathway and

electives

Non-GH Pathway Elective

• This elective is limited to only PGY2s

• There will only be elective placements if there are openings within the GH Pathway allotted slots

• The requirements are the same as the GH Pathway EXCEPT:• you do not have to attend clinic sessions• you have to attend only 2 GH lectures that are related to your project • you may not be given the full 4 weeks of protected time• funding may differ depending on a separate funding application,

which takes into consideration your project site

GH Pathway Project and Site Selection

• Once accepted, the applicant will select the site, the mentor, and the project based on their career development plan and the GH Pathway resources. Residents can go to sites outside of the Wash U system based on a clear project feasibility plan. Projects should be feasible in a short time frame such as cross sectional surveying on a defined population pre-departure.

• The resident is required to meet the site director at least once and choose a project mentor in the appropriate field (e.g. sepsis curricula development would be a mentor in IM, ID, or Critical Care). The resident is required to meet with the mentor every 8 weeks or another designated timeline for project planning and for abstract/poster/manuscript completion. Email communication for reviewing of materials is recommended to save time.

• If the site mentor and director is different, then the project should be reviewed by the director to ensure cultural competency. Sites should also have a designated onsite mentor if possible to communicate with regarding the project tool prior to arrival and during project piloting and conduction.

• IRB submission at Wash U is required for projects unless otherwise discussed

• Travel dates for the project will be decided 1 year in advance for site logistic planning

GH Pathway International Experience Standardized Goals

In a low-resource setting to:

1. To view health systems infrastructure (e.g. public vs. private sector)

2. To have a clinical care experience with patients

3. To have a research project experience

4. To have an experience working with different health providers (e.g. doctors, nurses, etc.) and human resources staff in the setting of their clinical and research project

5. To have a personal travel and living experience

GH Pathway Standardized Site Schedule

For 6 Months Pre-Departure: Project, Travel Logistics, & Abstract/Poster/Manuscript Planning and Initiation

TravelWeek 1: visit different hospitals and clinics to understand the country health infrastructure (as feasible) and pilot survey

• 1 government hospital, 1 government clinic, 1 private clinic/hospital(maybe project site), 1 non-profit community center

• Different specialties clinics/hospitals/wards such as dermatology, TB, HIV, etc.

• Go over survey with onsite mentor; pilot survey; finish planning the logistics for survey conduction that was started before arrival

Week 2-4: clinical and research experience• See patients and teach residents/medical students• Conduct project, data entry, data cleaning

Within 3-6 Months Post-Arrival: statistical analysis, abstract/poster/manuscript completion

Questions/Concerns• There will be flexibility in the selection process and

determining project work since this is the first pathway year

• In creating this pathway, we are interested in your comments and questions

• Thank you for your time, mentorship, and support!!!