Advertisement

Journal of Urban Health

, Volume 91, Issue 2, pp 394–402 | Cite as

The Correlation between Global Health Experiences in Low-Income Countries on Choice of Primary Care Residencies for Graduates of an Urban US Medical School

  • Denise Marie BrunoEmail author
  • Pascal James Imperato
  • Michael Szarek
Article

Abstract

This study sought to determine whether medical students who participate in a global health elective in a low-income country select residencies in primary care at higher rates compared with their classmates and US medical graduates in general. Given the projected increase in demand for primary care physicians, particularly in underserved areas, understanding possible factors that encourage training in primary care or enhance interest in the care of underserved populations may identify opportunities in medical school training. The authors used data from the Office of Student Affairs, SUNY Downstate College of Medicine and the National Residency Matching Program to compare rates of primary care residency selection from 2004 to 2012. Residency selections for students who participated in the SUNY Downstate School of Public Health Global Health Elective were compared with those of their classmates and with residency match data for US seniors. In 7 of the 8 years reviewed, students who participated in the SUNY Downstate School of Public Health Global Health Elective selected primary care residencies at rates higher than their classmates. Across years, 57 % of the students who completed the elective matched to primary care residences, which was significantly higher than the 44 % for the remainder of Downstate's medical student class (p = 0.0023). In 6 of the 8 years, Downstate students who participated in the Global Health Elective selected primary care residencies at rates higher than US medical school seniors in general; rates were the same for both Downstate Global Health Elective students and US medical school seniors in 2009. Students who participated in a global health experience in a low-income country selected primary care residencies at higher rates than their classmates and US medical school graduates in general. Understanding how these experiences correlate with residency selection requires further investigation; areas of future study are discussed.

Keywords

Medical school graduates Primary care residency choice Urban medical school graduates Global health electives for medical students Global health experience in low-income countries Underserved populations Residency selections Factors influencing medical residency choice Primary care residencies 

Notes

Acknowledgments

The authors would like to sincerely thank Lois Hahn of the Office of the Dean, SUNY Downstate School of Public Health, who has been responsible for many of the administrative tasks of the Global Health Elective for a number of years; the members of the Selection Committee who screen applicants for the elective; and colleagues at our overseas sites. We also wish to thank Sophie Christoforou, Lorraine Terracina, and Anne Shonbrun of the SUNY, Downstate Office of Student Affairs; Mei Liang, Director of Research for the National Residency Matching Program; and the American Medical College Application Service.

References

  1. 1.
    Imperato PJ. A third world international health elective for U.S. medical students: the 25-year experience of the State University of New York, Downstate Medical Center. J Community Health. 2004; 29(5): 337–373.PubMedCrossRefGoogle Scholar
  2. 2.
    Shaywitz DA, Ausiello DA. Global health: a chance for Western physicians to give-and receive. Am J Med. 2002; 113(4): 354–357.PubMedCrossRefGoogle Scholar
  3. 3.
    McKinley DW, Williams SR, Norcini JJ, Anderson MB. International exchange programs and U.S. medical schools. Acad Med. 2008; 83(10 Suppl): S53–S57.PubMedCrossRefGoogle Scholar
  4. 4.
    Houpt ER, Pearson RD, Hall TL. Three domains of competency in global health education: recommendations for all medical students. Acad Med. 2007; 82(3): 222–225.PubMedCrossRefGoogle Scholar
  5. 5.
    Association of American Medical Colleges. 2012 Medical school graduation questionnaire all schools summary report. Washington, DC: Association of American Medical Colleges; 2012.Google Scholar
  6. 6.
    Koplan JP, Bond TC, Merson MH, et al. Towards a common definition of global health. Lancet. 2009; 373(9679): 1993–1995.PubMedCrossRefGoogle Scholar
  7. 7.
    Ramsey AH, Haq C, Gjerde CL, Rothenberg D. Career influence of an international health experience during medical school. Fam Med. 2004; 36(6): 412–416.PubMedGoogle Scholar
  8. 8.
    Smith JK, Weaver DB. Capturing medical students' idealism. Ann Fam Med. 2006;4 Suppl 1:S32–37; discussion S58–60.Google Scholar
  9. 9.
    Bissonette R, Route C. The educational effect of clinical rotations in nonindustrialized countries. Fam Med. 1994; 26(4): 226–231.PubMedGoogle Scholar
  10. 10.
    Haq C, Rothenberg D, Gjerde C, et al. New world views: preparing physicians in training for global health work. Fam Med. 2000; 32(8): 566–572.PubMedGoogle Scholar
  11. 11.
    Chando S, Tiro JA, Harris TR, Kobrin S, Breen N. Effects of socioeconomic status and health care access on low levels of human papillomavirus vaccination among Spanish-speaking Hispanics in California. Am J Public Health. 2013; 103(2): 270–272.PubMedCrossRefGoogle Scholar
  12. 12.
    Woloschuk W, Harasym PH, Temple W. Attitude change during medical school: a cohort study. Med Educ. 2004; 38(5): 522–534.PubMedCrossRefGoogle Scholar
  13. 13.
    Miller WC, Corey GR, Lallinger GJ, Durack DT. International health and internal medicine residency training: the Duke University experience. Am J Med. 1995; 99(3): 291–297.PubMedCrossRefGoogle Scholar
  14. 14.
    Gupta AR, Wells CK, Horwitz RI, Bia FJ, Barry M. The International Health Program: the fifteen-year experience with Yale University's Internal Medicine Residency Program. Am J Trop Med Hyg. 1999; 61(6): 1019–1023.PubMedGoogle Scholar
  15. 15.
    Bazemore AW, Goldenhar LM, Lindsell CJ, Diller PM, Huntington MK. An international health track is associated with care for underserved US populations in subsequent clinical practice. J Grad Med Educ. 2011; 3(2): 130–137.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Association of American Medical Colleges. AAMC statement on the physician workforce. Washington, DC.: Association of American Medical Colleges; 2006.Google Scholar
  17. 17.
    Association of American Medical Colleges. AAMC physician workforce policy recommendations. Washington, DC: Association of American Medical Colleges; 2012.Google Scholar
  18. 18.
    National Resident Matching Program, Results and Data: 2008 Main Residency Match℠. National Resident Matching Program, Washington, DC. 2008.Google Scholar
  19. 19.
    National Resident Matching Program, Results and Data: 2012 Main Residency Match℠. National Resident Matching Program, Washington, DC. 2012.Google Scholar
  20. 20.
    Taylor CE. International experience and idealism in medical education. Acad Med. 1994; 69(8): 631–634.PubMedCrossRefGoogle Scholar
  21. 21.
    Godkin M, Savageau J. The effect of medical students' international experiences on attitudes toward serving underserved multicultural populations. Fam Med. 2003; 35(4): 273–278.PubMedGoogle Scholar
  22. 22.
    Jeffrey J, Dumont RA, Kim GY, Kuo T. Effects of international health electives on medical student learning and career choice: results of a systematic literature review. Fam Med. 2011; 43(1): 21–28.PubMedGoogle Scholar
  23. 23.
    Thompson MJ, Huntington MK, Hunt DD, Pinsky LE, Brodie JJ. Educational effects of international health electives on U.S. and Canadian medical students and residents: a literature review. Acad Med. 2003; 78(3): 342–347.PubMedCrossRefGoogle Scholar
  24. 24.
    Eckhert NL. Getting the most out of medical students' global health experiences. Ann Fam Med. 2006;4 Suppl 1:S38–39; discussion S58–60.Google Scholar

Copyright information

© The New York Academy of Medicine 2013

Authors and Affiliations

  • Denise Marie Bruno
    • 1
    Email author
  • Pascal James Imperato
    • 2
  • Michael Szarek
    • 3
  1. 1.Department of Community Health SciencesState University of New York, Downstate Medical Center, School of Public HealthBrooklynUSA
  2. 2.State University of New York, Downstate Medical Center, School of Public HealthBrooklynUSA
  3. 3.Department of Epidemiology and BiostatisticsState University of New York, Downstate Medical Center, School of Public HealthBrooklynUSA

Personalised recommendations