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Perceptions of Ghanaian Medical Students Completing a Clinical Elective at the University of Michigan Medical School

Abedini, Nauzley C. MD; Danso-Bamfo, Sandra MBChB; Moyer, Cheryl A. PhD, MPH; Danso, Kwabena A. MBChB; Mäkiharju, Heather MA; Donkor, Peter MDSc; Johnson, Timothy R.B. MD; Kolars, Joseph C. MD

Academic Medicine:
doi: 10.1097/ACM.0000000000000291
Innovation Reports
Abstract

Problem: International medical electives typically represent a unidirectional flow of students from economically advantaged countries in the global “North” to resource-poor nations in the global “South.” Little is known about the impact of bilateral exchanges on students from less affluent nations.

Approach: Since 2007, students from the University of Michigan Medical School (UMMS) and medical schools in Ghana have engaged in a bilateral clinical exchange program. A 45-item online survey was distributed to all 73 Ghanaian medical students who had rotated at UMMS from 2008 to 2010 to assess perspectives on the value and impact of their participation.

Outcomes: Incoming Ghanaian students outnumbered outgoing UMMS students 73 to 33 during the study period. Of eligible Ghanaian students, 70% (51/73) participated in the survey, with 40 of 51 providing valid data on at least 50% of questions. Ninety-seven percent (37/38) reported that the UMMS rotation was valuable to their medical training, 90% (35/39) reported changes in how they approach patient care, and 77% (24/31) reported feeling better equipped to serve patients in their home community. Eighty-five percent of students (28/33) felt more inclined to pursue training opportunities outside of their home country after their rotation at UMMS.

Next Steps: More studies are needed to determine the feasibility of bidirectional exchanges as well as the short-term and long-term impact of rotations on students from underresourced settings and their hosts in more resource-rich environments.

Author Information

Dr. Abedini is a member of the Class of 2014, University of Michigan Medical School, Ann Arbor, Michigan, and performed this work while a Fogarty Scholar.

Dr. Danso-Bamfo is senior house officer, Ridge Hospital, Accra, Ghana.

Dr. Moyer is managing director, Global REACH, and assistant professor, Department of Medical Education, University of Michigan Medical School, Ann Arbor, Michigan.

Dr. Danso is professor of obstetrics and gynaecology and former dean, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Ms. Mäkiharju is student programs coordinator, Global REACH, University of Michigan Medical School, Ann Arbor, Michigan.

Dr. Donkor is former pro-vice chancellor and professor of maxillofacial surgery, Kwame Nkrumah University of Science and Technology/College of Health Sciences, Kumasi, Ghana.

Dr. Johnson is professor and chair, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan.

Dr. Kolars is professor of medicine and senior associate dean of education and global initiatives, University of Michigan Medical School, Ann Arbor, Michigan.

The authors have informed the journal that they agree that Drs. Abedini and Danso-Bamfo have completed the intellectual and other work associated with the first author.

Funding/Support: This work was supported by National Institutes of Health (NIH) Research Training Grant R25 TW009345, funded by the Fogarty International Center, the National Institute of Mental Health, and the NIH Office of the Director Office of Research on Women’s Health and the Office of AIDS Research.

Other disclosures: None reported.

Ethical approval: This study was reviewed and performed under an exemption granted by both the ethical and protocol review committee of the University of Ghana Medical School, which provided blanket exemption for all universities in Ghana, as well as the University of Michigan institutional review board.

Previous presentations: Initial findings from this study were presented at the 2011 Global Health Conference, Montreal, Quebec, Canada, November 2011, as well as at the Sujal Parikh Memorial Symposium on Health and Social Justice/Physicians for Human Rights National Conference, March 2012, Ann Arbor, Michigan.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A206.

Correspondence should be addressed to Dr. Kolars, 4122 Med Sci 1, SPC 5624, 1301 Catherine St., Ann Arbor, MI 48109-5624; telephone: (734) 615-5552; fax: (734) 615-6300; e-mail: jckolars@umich.edu.

The authors have informed the journal that they agree that Drs. Abedini and Danso-Bamfo have completed the intellectual and other work associated with the first author.

© 2014 by the Association of American Medical Colleges