To the Editor:
The COVID-19 pandemic has killed over a million people, stressed health care systems, and disrupted economies and societies globally. It has also created havoc in higher medical education. 1,2 This has been particularly notable in global health, where travel restrictions have brought traditional clinical global health rotations to a halt. These drastic changes in the learning environment offer an opportunity to rethink and improve global health education.
The most concrete change is reduced international travel. Despite the possible adverse effects of short-term experiences in global health, 3,4 many academic institutions struggle to ensure that they meet the highest standards of long-term, bidirectional engagement. The pandemic-enforced travel pause may allow medical educators to refocus toward insuring longitudinal and high-quality programs rather than maximizing the number of trainees traveling. We can have a frank reckoning with finances, benefits, and sustainability.
As travel is now removed as the “required” activity of global health education, we must rethink how we teach. In fact, many of us structure our curricula based on the fixed point of the trip, the experiential learning experience. Best practices in global health educational programs include robust predeparture training with significant time and energy spent preparing students for the local context. Educators should reconsider appropriate overarching learning objectives for global health. Can distance learning fulfill these requirements? Is it truly a sufficient replacement for in-country rotations? As medical educators, we need to reexamine the paradigmatic assumptions and “ground rules” implicitly built into our belief systems of what constitutes effective global health training. 5
The pandemic has now forced academic global health partnerships to be locally driven in practice rather than often previously only in theory. This has also accelerated innovation in partnering—virtual collaborations, investment in mobile health applications, funding for local activities, and astounding collaboration in global research.
While exposing the still existing colonial aspects of global health, the pandemic highlights the critical importance of global health concepts. Disparate COVID-19 infection and mortality rates in underserved or minority communities underscore the importance of social determinants of health. The importance of proper funding for and training in public health is now painfully obvious. Global health education programs must use this opportunity to critically examine our paradigmatic grounding. We are invited to thoughtfully adapt and evolve promising practices and curricula to train the next generation to meet this challenge.
1. Ahmed H, Allaf M, Elghazaly H. COVID-19 and medical education. Lancet Infect Dis. 2020;20:777–778.
2. Rose S. Medical student education in the time of COVID-19. JAMA. 2020;323:2131–2132.
3. Rozier MD, Lasker JN, Compton B. Short-term volunteer health trips: Aligning host community preferences and organizer practices. Glob Health Action. 2017;10:1267957.
4. Doobay-Persaud A, Evert J, DeCamp M, et al. Extent, nature and consequences of performing outside scope of training in global health. Global Health. 2019;15:60.
5. Brown MEL, Duenas AN. A medical science educator’s guide to selecting a research paradigm: Building a basis for better research. Med Sci Educ. 2020;30:545–553.