Global Health Program Director's Guide: Chapter 1

Chapter Authors: Nicole St Clair, MD & Jennifer Watts, MD, MPH

Key Points

enlightenedThere are multiple opportunities to incorporate GH education into a pediatric training framework, requiring variable levels of resources.

enlightenedDefinitions of GH tracks in residency programs that target Tier 3 learners vary. A draft definition is provided in this section, as well as guidance for GH faculty mentors, track directors, and track program coordinators.


Tiered Approach

As mentioned in the introduction, when considering GH education in pediatrics, there are three tiers of trainees to consider (Figure 2). This chapter provides strategies for integrating GH education into training programs that are pertinent to all tiers of trainees and offers a definition for a GH track (for programs targeting Tier 3 learners).

Opportunities for Integration

Table 1 offers sample approaches for integrating GH education into pediatric training programs, based on the target audience. As programs move further down the table, dedicated GH faculty mentorship and additional oversight are necessary.



Definition of a GH Track

There are variable definitions and interpretations of a pediatric residency GH track.3,5 Members of this author group are currently working with a team of stakeholders to reach a consensus definition. In the interim, below are draft recommendations for a GH track structure:

  • At least one dedicated GH track director (ideally with some salary support* allocated to the role)
  • At least one established partnership in a resource-limited setting where residents can do a GH elective
  • Organized GH mentorship
  • Pre-departure curriculum, on-site support, and post-return debriefing for GH electives
  • Resident salary support during GH electives
  • Maintenance of existing malpractice, health, and disability insurance during GH electives
  • Evacuation insurance for GH electives
  • Core GH curriculum that includes (and expands upon) the topics outlined in Chapters 2 and 3, either longitudinally throughout residency or in a consolidated fashion for GH track participants (eg, annual 1- to 2-week courses)
  • Opportunities for GH track residents to participate in educational activities that cater to their GH interests (eg, adoption/immigrant/refugee clinics, TB or HIV clinics, etc.)
  • Mechanisms to evaluate the track.

Additional components for a GH track could include the following:

  • A team of faculty mentors with GH-specific knowledge
  • Travel stipend opportunities for GH electives
  • Additional assessment and evaluation mechanisms for: (1) GH track resident performance; (2) GH partnerships; and (3) GH track outcomes (graduate career choice, etc.)
  • Local partnership(s) to support service learning, volunteering, and advocacy opportunities
  • GH track program coordinator
  • Engagement of GH track trainees and GH track leadership in regional and national professional networks (eg, Association of Pediatric Program Directors Global Health Learning Community; American Academy of Pediatrics Section on International Child Health; Academic Pediatric Association Global Health Special Interest Group; Consortium of Universities for Global Health)
  • Collaboration with other residency programs within the same training institution (eg, formation of a multidisciplinary GH track).

*Salary support varies widely, from 0 to 50% FTE, depending on institutional resources and GH educator roles6

"During my residency, the Global Health Track allowed me travel, perspective, experience and opportunity beyond what I would have otherwise been able to achieve in my four years of residency training. The experiences were invaluable in keeping me flexible, my differential broad, and making me continuously re-evaluate my goals and ideals of why I want to be a physician and what kind of physician I wanted to be. Besides the friendship among other like-minded people, the Global Health Track also provided medical education beyond that gained from the bread-and-butter pediatrics and internal medicine I was learning. The Track also provided the opportunity to travel and to work with practitioners who serve a variety of populations than I would not otherwise have been able learn from."

-Emily Fisher, MD, MPH

GH Faculty Mentors, Track Directors, and Program Coordinators

Although some resources exist nationally to assist with delivery of GH training in all pediatric training programs (Table 2), authors recommend GH-specific faculty mentorship for any program that engages trainees in GH electives and/or GH tracks.

  • Tier 2 trainees (GH elective participants): authors encourage programs to identify faculty mentors who have prior experience working in resource-limited settings (for elective preparation, on-site support, and debriefing). Ideally, these mentors would also be familiar with the clinical and cultural atmospheres at the trainee’s elective site and would have open communication with the host partners.
  • Tier 3 trainees (GH career interests): authors encourage programs to appoint a GH track director and a faculty mentor team, if feasible at their institutions. The author team recognizes that resources for GH training vary widely but encourages funded roles for GH track directors as well as programmatic support to ensure consistency and sustainability.5,7 Additional considerations for GH fellowships are outlined in Chapter 8.

enlightenedFor those seeking to employ a GH track director and/or a GH track program coordinator, sample position descriptions are included in Appendices B and C.

Citation: St Clair N, Abdul-Mumin A, Banker S, Condurache T, Crouse H, Helphinstine J, Kazembe P, Lukolyo H, Marton S, McQuilkin P, Pitt M, Rus M, Russ C, Schubert C, Schutze G, Steenhoff A, Uwemedimo O, Watts J, Butteris S. Global health in pediatric education: an implementation guide for program directors. American Board of Pediatrics Global Health Task Force Publication, in collaboration with the American Academy of Pediatrics Section on International Child Health and the Association of Pediatric Program Directors Global Health Learning Community. September, 2018.