Internationalization of Medical Education—Building a Program to Prepare Future Leaders in Healthcare

  • Anette WuEmail author
  • Heike Kielstein
  • Takeshi Sakurai
  • Geoffroy Noel
  • Suvi Viranta-Kovanen
  • Chung-Liang Chien
  • Paulette Bernd


In a globally interconnected world, internationalization of medical education has become increasingly important. While many programs focus on international programs for clinical students, the number of programs for preclinical medical and dental students is small. Based in the Anatomy course, the program presented here involves early international collaborations between preclinical students from six countries. Our work involves small-group video sessions and a large international student videoconference (including cultural and didactic components). The online connections progress with in-person basic sciences summer internships undertaken at the international partner institutions. This collaborative program features unique elements that facilitate cultural exchange and help develop leadership skills in healthcare early in a student’s career. We present recommendations for international program implementation.


Internationalization of medical education Peer-to-peer collaboration Student collaboration Leadership Global health 



The authors wish to thank Dr. Kevin Roth, Chairman of the Department of Pathology and Cell Biology at Columbia University Irving Medical Center, New York, NY, USA, for his ongoing support and encouragement of this project; Dr. Michael Shelanski, Senior Vice Dean for Research at Columbia University Irving Medical Center, for his ongoing support of student research exchanges; Dr. Lawrence Stanberry, Associate Dean for International Programs and Director of “The Programs in Global Health” at Columbia University Irving Medical Center, and Dr. Lisa Mellman, Senior Associate Dean for Student Affairs at the Vagelos College of Physicians and Surgeons at Columbia University Irving Medical Center, for their tremendous efforts in establishing partnerships between the various schools; Dr. Stephen Nicholas, Founder of the Program for Global and Population Health, for his funding support of student exchanges; Dr. Henry Park from the Columbia Center for Education Research and Evaluation, Columbia University, for his help with the design of the student questionnaires; and the late Dr. Hilmar Stolte, Professor of Nephrology at the Hannover Medical School, Hannover, Germany, for connecting the medical schools of Columbia University, USA, and Martin Luther University, Germany.

The authors deeply appreciate the help of the members of the Apgar Medical Education Scholarship Group and the libraries at Columbia University (Dr. Deepthiman Gowda, Dr. Athina Vassilakis, and Anna Getselman). The authors thank Drs. Nina Rothschild and Michael Fortgang for their help with the review of the manuscript and their editorial assistance.

The authors are very grateful for the help of the international student leaders who participated in the annual student conferences.

Disclosure for Funding

This study was partially funded by the Virginia Apgar Society of Medical Educators, Columbia University, New York, NY.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

This study was approved by IRB protocol # AAAO3715 (Columbia University) and protocol # A06-B42-17A (McGill University).


  1. 1.
    Koplan JP, Bond TC, Merson MH, Reddy KS, Rodriguez MH, Sewankambo NK, et al. Towards a common definition of global health. Lancet. 2009;373(9679):1993–5. Scholar
  2. 2.
    Adams LV, Wagner CM, Nutt CT, Binagwaho A. The future of global health education: training for equity in global health. BMC medical education. 2016;16(1):296. Google Scholar
  3. 3.
    Arthur MA, Battat R, Brewer TF. Teaching the basics: core competencies in global health. Infect Dis Clin N Am. 2011;25(2):347–58. Scholar
  4. 4.
    Rowson M, Smith A, Hughes R, Johnson O, Maini A, Martin S, et al. The evolution of global health teaching in undergraduate medical curricula. Glob Health. 2012;8(1):35–42. Scholar
  5. 5.
    Aulakh A, Tweed S, Moore J, Graham W. Integrating global health with medical education. Clin Teach. 2017;14(2):119–23. Scholar
  6. 6.
    Stern DT, Ben-David MF, De Champlain A, Hodges B, Wojtczak A, Schwarz MR. Ensuring global standards for medical graduates: a pilot study of international standard-setting. Med Teach. 2005;27(3):207–13. Scholar
  7. 7.
    Battat R, Seidman G, Chadi N, Chanda MY, Nehme J, Hulme J, et al. Global health competencies and approaches in medical education: a literature review. BMC Med Educ. 2010;10:94. Scholar
  8. 8.
    Purkey E, Hollaar G. Developing consensus for postgraduate global health electives: definitions, pre-departure training and post-return debriefing. BMC Med Educ. 2016;16(1):159. Google Scholar
  9. 9.
    Khan OA, Guerrant R, Sanders J, Carpenter C, Spottswood M, Jones DS, et al. Global health education in U.S Medical schools. BMC Med Educ. 2013;13(1):3. Google Scholar
  10. 10.
    Eichbaum Q. The problem with competencies in global health education. Acad Med. 2015;90(4):414–7. Google Scholar
  11. 11.
    Drain PK, Mock C, Toole D, Rosenwald A, Jehn M, Csordas T, et al. The emergence of undergraduate majors in Global Health: systematic review of programs and recommendations for future directions. Am J Trop Med Hyg. 2017;96(1):16–23. Scholar
  12. 12.
    May EL. Global lessons for U.S. healthcare leaders. Healthc Exec. 2013;28(5):32–4 6-8.Google Scholar
  13. 13.
    Knipper M, Baumann A, Hofstetter C, Korte R, Krawinkel M. Internationalizing medical education: the special track curriculum ‘Global Health’ at Justus Liebig University Giessen. GMS Z Med Ausbild. 2015;32(5):Doc52. Scholar
  14. 14.
    Bateman C, Baker T, Hoornenborg E, Ericsson U. Bringing global issues to medical teaching. Lancet. 2001;358(9292):1539–42.Google Scholar
  15. 15.
    Imperato PJ, Bruno DM, Monica Sweeney M. Ensuring the health, safety and preparedness of U.S. medical students participating in global health electives overseas. J Community Health. 2016;41(2):442–50. Scholar
  16. 16.
    Elit L, Hunt M, Redwood-Campbell L, Ranford J, Adelson N, Schwartz L. Ethical issues encountered by medical students during international health electives. Med Educ. 2011;45(7):704–11. Scholar
  17. 17.
    Dharamsi S, Osei-Twum JA, Whiteman M. Socially responsible approaches to international electives and global health outreach. Med Educ. 2011;45(5):530–1. Scholar
  18. 18.
    Anderson KC, Slatnik MA, Pereira I, Cheung E, Xu K, Brewer TF. Are we there yet? Preparing Canadian medical students for global health electives. Acad Med. 2012;87(2):206–9. Scholar
  19. 19.
    Kumwenda B, Royan D, Ringsell P, Dowell J. Western medical students' experiences on clinical electives in sub-Saharan Africa. Med Educ. 2014;48(6):593–603. Scholar
  20. 20.
    Ramjiawan B, Pierce GN, Anindo MI, Alkukhun A, Alshammari A, Chamsi AT, et al. An international basic science and clinical research summer program for medical students. Adv Physiol Educ. 2012;36(1):27–33. Scholar
  21. 21.
    Houpt E, Pearson R, Hall T. Three domains of competency in global health education: recommendations for all medical students. Acad Med. 2007;82:222–5. Scholar
  22. 22.
    De Wit H, Hunter F, Egron-Polak E, Howard L. Internationalisation of higher education. Brussels: European Parliament. Brussels: European Parliament; 2015.Google Scholar
  23. 23.
    Kritz M. Globalisation and internationalisation of tertiary education:, 2006.
  24. 24.
    Green W, Whitsed C. Critial perpectives on internationalising the curriculum in disciplines. Internationalsing the curriculum in health. Rotterdam: Sense Publishers; 2015. p. 153-158.Google Scholar
  25. 25.
    Altbach PG. Global perspective on higher education. Baltimore: Johns Hopkins Univeristy Press; 2016.Google Scholar
  26. 26.
    Patricio M. GLOBAL: Internationalisation and medical education : University world news - the global window of higher education. 2011.
  27. 27.
    Harden RM. International medical education and future directions: a global perspective. Acad Med. 2006;81(12 Suppl):S22–9. Scholar
  28. 28.
    Eaton DM, Redmond A, Bax N. Training healthcare professionals for the future: internationalism and effective inclusion of global health training. Med Teach. 2011;33(7):562–9. Scholar
  29. 29.
    Hansen L. Internationalising the curriculum in health. In: Green W, Whitsed C, editors. Critical perspectives on internationalising the curriculum in disciplines. Berlin: Springer; 2015.Google Scholar
  30. 30.
    Kritz M. Globalisation and internationalisation of tertiary education: Department of Economic and Social Affairs, United Nations Secretariat Turin, Italy, 2006 28–30 June 2006 Contract No.: UN/POP/MIG/SYMP/2006/02/Rev.Google Scholar
  31. 31.
    Godkin M, Savageau J. The effect of medical students’ international experiences on attitudes toward serving underserved multicultural populations. Fam Med. 2003;35.Google Scholar
  32. 32.
    McKinley DW, Williams SR, Norcini JJ, Anderson MB. International exchange programs and U.S. medical schools. Acad Med. 2008;83(10 Suppl):S53–7. Scholar
  33. 33.
    Fennell R. The impact of an international health study abroad program on university students from the United States. Glob Health Promot. 2009;16(3):17–23. Scholar
  34. 34.
    Heinrich D, Wenzel M, Dimitriadis K, Muhlstadt M. An international medical curriculum: first steps of implementation. Med Educ. 2013;47(5):516. Scholar
  35. 35.
    Tillmanns RW, Ringwelski A, Kretschmann J, Spangler LD, Curry RH. The profession of medicine: a joint US-German collaborative project in medical education. Med Teach. 2007;29(9):e269–75. Scholar
  36. 36.
    Ambrose M, Murray L, Handoyo NE, Tunggal D, Cooling N. Learning global health: a pilot study of an online collaborative intercultural peer group activity involving medical students in Australia and Indonesia. BMC Med Educ. 2017;17(1):10. Google Scholar
  37. 37.
    Moran D, Edwardson J, Cuneo CN, Tackett S, Aluri J, Kironji A, et al. Development of global health education at Johns Hopkins University School of Medicine: a student-driven initiative. Med Educ online. 2015;20:28632. Scholar
  38. 38.
    Vora N, Mina C, Pandya H, Hasham A, Lazarus C. A student-initiated and student facilitated international health elective for preclinical medical students. Med Educ online. 2010;15(1):1–11. Scholar
  39. 39.
    Huhn D, Eckart W, Karimian-Jazi K, Amr A, Herzog W, Nikendei C. Voluntary peer-led exam preparation course for international first year students: Tutees’ perceptions. BMC Med Educ. 2015;15:106. Scholar
  40. 40.
    Roberts D. Friendship fosters learning: the importance of friendships in clinical practice. Nurse Educ Pract. 2009;9(6):367–71. Scholar
  41. 41.
    Keren D, Lockyer J, Ellaway RH. Social studying and learning among medical students: a scoping review. Perspect Med Educ. 2017;6:311–8. Scholar
  42. 42.
    Woolf K, Potts HW, Patel S, McManus IC. The hidden medical school: a longitudinal study of how social networks form, and how they relate to academic performance. Med Teach. 2012;34(7):577–86. Scholar
  43. 43.
    Godkin MA, Savageau JA. The effect of a global multiculturalism track on cultural competence of preclinical medical students. Fam Med. 2001;33(3):178–86.Google Scholar
  44. 44.
    Pawlina W, Drake RL. Driving effective communication through anatomy. Anat Sci Educ. 2008;1(2):49. Scholar
  45. 45.
    Pawlina W, Drake RL. Anatomical sciences education: a partner on the road to scholarship in teaching and learning. Anat Sci Educ. 2010;3(1):1–2. Scholar
  46. 46.
    Macauley K, Skov H, Lehtonen K, Shulman B. Perceptions of an international interprofessional education experience: findings from students based in Europe and North America. J Interprof Care. 2016;30(5):606–14. Scholar
  47. 47.
    Holmes D, Zayas LE, Koyfman A. Student objectives and learning experiences in a global health elective. J Community Health. 2012;37(5):927–34. Scholar
  48. 48.
    Wood MJ, Atkins M. Immersion in another culture: one strategy for increasing cultural competency. J Cult Divers. 2006;13(1):50–4.Google Scholar
  49. 49.
    Steglitz I. Education abroad for freshman. Int Educ (1059–4221). 2010;19(6):50–3.Google Scholar
  50. 50.
    Majoor GD. Internationalization of undergraduate medical studies: promoting clinical tourism or academic development? Med Educ. 2001;35(12):1162–3. Scholar
  51. 51.
    Bode MF, Hilgendorf I. Integrating basic science in academic cardiology training: two international perspectives on a common challenge. Clin Res Cardiol. 2018;108:1–5. Google Scholar
  52. 52.
    Kwan JM, Daye D, Schmidt ML, Conlon CM, Kim H, Gaonkar B, et al. Exploring intentions of physician-scientist trainees: factors influencing MD and MD/PhD interest in research careers. BMC Med Educ. 2017;17(1):115. Google Scholar
  53. 53.
    Elharram M, Dinh T, Lalande A, Ge S, Gao S, Noel G. Global health values of a multidirectional near peer training program in surgery, pathology, anatomy, research methodology, and medical education for Haitian, Rwandan, and Canadian medical students. Ann Glob Health. 2017;83(2):274–80. Scholar

Copyright information

© International Association of Medical Science Educators 2019

Authors and Affiliations

  1. 1.Department of Pathology and Cell Biology, Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  2. 2.Department of Anatomy and Cell Biology, Medical FacultyMartin Luther University Halle-WittenbergHalle (Saale)Germany
  3. 3.Department of Drug Discovery Medicine, Medical Innovation CenterKyoto University Graduate School of MedicineKyotoJapan
  4. 4.Department of Anatomy and Cell Biology, Faculty of MedicineMcGill UniversityMontrealCanada
  5. 5.Department of Anatomy, School of MedicineUniversity of HelsinkiHelsinkiFinland
  6. 6.Department of Anatomy and Cell Biology, College of MedicineNational Taiwan UniversityTaipeiTaiwan

Personalised recommendations