Family Medicine Global Health Fellowship Columbia

Training for medical service throughout the world

Over the last decade, there has been an overwhelming increase in opportunities for service in the medical field throughout the world, and a responding surge of physician interest in seeking out that service.

Many doctors and donors want to alleviate the dramatic health disparities that persist despite decades of economic development and medical advances. Unfortunately, the physicians committing to these lofty goals often feel unprepared or underprepared to the challenges they will face.

The Prisma Health/University of South Carolina School of Medicine Columbia Global Health Fellowship Program aims to help address the following areas:

• Practice of medicine in resource-poor settings: U.S. residency graduates are well prepared in formulating differential diagnoses, treating common conditions, and understanding the cutting edge of medical science. This training is a tremendous asset in any setting, but these doctors may have little experience with the diseases of poverty rarely seen in the United States. They would like to become experts in managing malnutrition, malaria, and intestinal worms. Also, physicians need to learn how to work with limited resources. They often seek additional training in diagnostic modalities such as ultrasound, or in procedures such as cesarean delivery, orthopedic care, or trauma.
• Public Health: Many physicians working abroad find they not only are called upon to provide patient care, but also to help develop sustainable indigenous health care. This goal requires additional talents not always attained in clinical training. These health care leaders must be able to collect, review, and analyze public health data to identify local health care needs. They will need to understand and implement quality improvement measures in a limited-resource hospitals and clinics. They also will assess national health care systems to understand key resources and key gaps in care. Training in public health can help them identify local problems and propose sustainable solutions.
• Project management: International relief and development usually works on a very different economic model than the insurance-based billing system that our clinicians learn. Sustainable work in this realm requires understanding and experience with project cycles, grant proposals and data collection.
• Networking: Providing quality patient care within the U.S. often requires a team approach. This also applies to international work. The path to full-time global employment also can grow out of developing contacts throughout multiple programs.
• Teaching and leadership: As the model for the "global physician" leans more towards developing local physicians and health care providers, constructing quality educational plans and implementing them cross-culturally becomes very important. While most physicians have experience training junior residents and students, they have less experience at identifying educational needs, finding appropriate outcome measures, developing interventions to meet those needs, and leading local teams to implement the interventions.