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Global Health Program Director's Guide: Chapter 7

Chapter Author: Gordon Schutze, MD

Key Points

enlightenedAt present, any individuals who take more than 6 months of clinical electives away from a training program (such as a GH elective) require review and approval by the ABP, unless they are enrolled in an ACGME-approved GH program.

enlightenedGH Tracks are usually developed within the confines of standard residency training, and individuals enrolled in tracks do not require ABP approval unless they impinge on the aforementioned 6-month rule.

enlightenedAlthough the ACGME and ABP expect that almost all clinical training in the United States will be supervised by board-certified or board-eligible providers, this is not feasible nor required during GH electives. However, programs are expected to seek supervisors who routinely provide health care to infants and children.

 

The Accreditation Council for Graduate Medical Education (ACGME) accredits all training programs, whereas the American Board of Pediatrics (ABP) certifies individual physicians. In order for a physician to be approved for the initial certifying examination, training must be completed in an ACGME-accredited program and the individual must satisfactorily complete all requirements and be evaluated as competent by the program director on the final Verification of Competence Form. 

Time Away During Training

In 2017, both the ACGME and the ABP increased the allowed time away from the parent program from 3 to 6 months as part of the new 6-month individualized curriculum. Individuals who spend more than 6 months away from the primary or affiliated training site require review and approval by the ABP. 

GH Tracks

Many residency programs are developing GH tracks, with the majority occurring within the standard 36 months of pediatric residency training. The Baylor College of Medicine/Texas Children’s Hospital Kelly DeScioli Global Child Health residency program is an example of a 4-year program that allows the resident to spend a year working in a resource-limited area while fulfilling all other criteria required to be considered a board-eligible pediatrician. This program was vetted and approved by the ACGME prior to accepting the first resident. The ABP has no concerns about GH tracks or programs approved by the ACGME, even if they add additional time to the resident’s training as outlined above, as long as the trainee meets all of the core requirements in the 36 months of accredited training. For those individuals who may want to develop their own GH experience outside of their ACGME- approved residency program, the ABP would need to approve that individual’s training prior to sitting for the board examination. Supplemental experiences such as these cannot be considered as replacements for the core training that residents experience at their parent program.

Supervisor Requirements During GH Electives

The ACGME and ABP expect that almost all clinical training in the United States will be supervised by board-certified or board-eligible physicians and must meet all other requirements set forth by these accrediting bodies (goals and objectives, milestones, etc). Clinical experiences outside the United States would most likely be supervised by local practitioners who would not be eligible to sit for the ABP examinations because their training did not occur in the United States. These practitioners should, however, routinely provide health care to infants and children and therefore be able to provide adequate supervision for and evaluation of the trainee working in the resourced-limited area.

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. abp.org/ghpdguidehome