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Global health vocational training: has its time come?



Dr Lloyd Nash, Global Ideas Forum

Associate Professor Rosemary Aldrich, Director of Medical Services, Calvary Mater Hospital, Newcastle

Dr Georgina Phillips, emergency physician, St Vincent’s Hospital, Melbourne

Dr Suman Majumdar, infectious diseases physician, Burnet Institute, Melbourne

Dr Vincent Atua, Director, Emergency Department, Modilon General Hospital, Madang, PNG

Medical colleges have been put on notice that years of neglect of global health in vocational training has to end, as increasing numbers of doctors clamour for opportunities to train and work in the speciality.

Global Ideas Forum founder Dr Lloyd Nash, who chaired the session, said increasing awareness of, and exposure to, yawning inequities in health care around the world was driving demand among medical students, junior doctors and even well-established practitioners for global health training.

But, Dr Nash said, the fact that few medical colleges included global health in their vocational training curricula meant that many seeking to develop a career in global health were either frustrated or left largely to their own devices in piecing together a career path.

Dr Suman Majumdar said a survey of medical students identified three main obstacles standing in the way of people pursuing a career in global health – not realising that it was an option; family and personal choices; and training pathways.

Dr Majumdar said that it can be daunting for doctors-in-training interested in global health that, which colleagues in other specialties have a clear six-year training pathway, there is nothing similar for them.

Associate Professor Rosemary Aldrich had a similar experience, albeit at a later stage in her medical career. She recounted how, when she went looking for global health training opportunities, she drew a blank.

A/Professor Aldrich, who is part of a group of liked-minded doctors who have developed a draft Global Health Practice Curriculum that is being considered by the Royal Australasian College of Physicians, said that at the time there was a gap in global health training opportunities for experienced specialists.

One of the obstacles most commonly raised is discussions about global health training is the challenge of identifying appropriately skilled and experienced supervisors to oversee in situ training in resource poor countries.

But Dr Georgina Phillips told the Conference this was far from an insurmountable problem.

Dr Phillips talked of the success of the Visiting Clinical Lecturer Program she helped set up involving the Divine Word University and the Modilon General Hospital in Madang, PNG.

She said under the program, advanced emergency medicine trainees lived at Divine Word University and provided academic, clinical and bedside teaching for rural health students, as well as working alongside their PNG colleagues.

Dr Phillips said, where a placement lasted longer than three months, the VCLP was recognised as a valid site of training by the Australasian College for Emergency Medicine.

The Conference heard a first-hand account from Modilon General Hospital Emergency Department Director Dr Vincent Atua about what the Program had meant for his hospital and patients.

Dr Atua said the arrangement had resulted in “huge improvements” in the delivery of emergency care, including a much better organisational culture.

An important spin off, he said, was the development of a Primary Trauma Care course, which had seen 500 local primary health care workers receive training in trauma care.

Dr Atua said that, so far, eight local specialist emergency physicians had been trained with support from physicians and instructors who had come to PNG under the Visiting Clinical Lecturer Program.

Dr Nash said one of the biggest concerns for colleges was that they lacked the systems and expertise to provide the necessary personal support for trainees working in resource poor countries.

But he told the Conference that, rather than trying to develop such capacity in house, it made more sense to look a developing partnerships with organisations like Australia Volunteers Abroad, which already had extensive experience arranging for the safe and effective placement of staff in challenging environments.

Dr Suman Majumdar said a survey of medical students had identified

Adrian Rollins