GLOBAL HEALTH An International Service Corps for Health - An Unconventional Prescription for Diplomacy

Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA.
New England Journal of Medicine (Impact Factor: 55.87). 09/2010; 363(13):1199-201. DOI: 10.1056/NEJMp1006501
Source: PubMed
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    • "Finally, we found that the majority of physicians surveyed indicated that their global and domestic health work was highly synergistic. This is perhaps our most encouraging finding, as it suggests that U.S. physicians have heard recent calls to engage in GH work [33-35] and find this work complementary to their professional responsibilities at home in the U.S. Nonetheless, the eagerness of U.S. physicians to be more involved in GH activities also underscores important questions about competencies in GH [36]. Specific challenges include how to standardize GH training experiences [37] and respond to the growing demand for GH education; [38,39] how to professionalize a core humanitarian assistance workforce; [40] and how to transcend cultural competence to develop “transnational” competence [41]. "
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    ABSTRACT: Background Interest and participation in global health activities among U.S. medical trainees has increased sharply in recent decades, yet the global health activities of physicians who have completed residency training remain understudied. Our objectives were to assess associations between individual characteristics and patterns of post-residency global health activities across the domains of health policy, education, and research. Methods Cross-sectional, mixed methods national survey of 521 physicians with formal training in clinical and health services research and policy leadership. Main measures were post-residency global health activity and characteristics of this activity (location, funding, products, and perceived synergy with domestic activities). Results Most respondents (73%) hold faculty appointments across 84 U.S. medical schools and a strong plurality (46%) are trained in internal medicine. Nearly half of all respondents (44%) reported some global health activity after residency; however, the majority of this group (73%) reported spending ≤10% of professional time on global health in the past year. Among those active in global health, the majority (78%) reported receiving some funding for their global health activities, and most (83%) reported at least one scholarly, educational, or other product resulting from this work. Many respondents perceived synergies between domestic and global health activities, with 85% agreeing with the statement that their global health activities had enhanced the quality of their domestic work and increased their level of involvement with vulnerable populations, health policy advocacy, or research on the social determinants of health. Despite these perceived synergies, qualitative data from in-depth interviews revealed personal and institutional barriers to sustained global health involvement, including work-family balance and a lack of specific avenues for career development in global health. Conclusions Post-residency global health activity is common in this diverse, multi-specialty group of physicians. Although those with global health experience describe synergies with their domestic work, the lack of established career development pathways may limit the benefits of this synergy for individuals and their institutions.
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  • JAMA The Journal of the American Medical Association 03/2011; 305(10):998. DOI:10.1001/jama.2011.243 · 35.29 Impact Factor
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    ABSTRACT: Disaster relief is an interdisciplinary field dealing with the organizational processes that help prepare for and carry out all emergency functions necessary to prevent, prepare for, respond to, and recover from emergencies and disasters caused by all hazards, whether natural, technological, or human-made. Although it is an important function of local and national governing in the developed countries, it is often wanting in resource-poor, developing countries where, increasingly, catastrophic disasters tend to occur and have the greatest adverse consequences. The devastating January 12, 2010, Haiti earthquake is a case study of the impact of an extreme cataclysm in one of the poorest and most unprepared settings imaginable. As such, it offers useful lessons that are applicable elsewhere in the developing world. Emergency preparedness includes 4 phases: mitigation or prevention, preparedness, response, and recovery. Periods of normalcy are the best times to develop disaster preparedness plans. In resource-poor countries, where dealing with the expenses of daily living is already a burden, such planning is often neglected; and, when disasters strike, it is often with great delay that the assistance from international community can be deployed. In this increasingly interconnected world, the Haiti earthquake and the important international response to it make a strong case for a more proactive intervention of the international community in all phases of emergency management in developing countries, including in mitigation and preparedness, and not just in response and recovery. Predisaster planning can maximize the results of the international assistance and decrease the human and material tolls of inevitable disasters. There should be a minimum standard of preparedness that every country has to maintain and the international assistance to achieve that. International academic medical centers interested in global health could strengthen their programs by prospectively including in them contingency planning for international relief operations. Healthcare professionals of these institutions who travel to disaster zones should rigorously prepare themselves and make provisions for collecting and reporting data, which will enrich the knowledge of this growing activity. Mt Sinai J Med 78:306–318, 2011. © 2011 Mount Sinai School of Medicine
    Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine 05/2011; 78(3):306-18. DOI:10.1002/msj.20251 · 1.62 Impact Factor
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