Field-based curriculum in Global Health and Social Medicine for medical students (US, Haiti, Rwanda)

There is a marked demand from students in the US and abroad for pre-service (i.e., undergraduate and pre-clinical medical school level) education in global health. Specifically, students want both training in the principles of the delivery of care in resource-limited settings and opportunity to experience the work first hand. Generally, experiential learning of global health has been ad hoc and based on individual projects and relationships. The Program in Global Medical Education and Social Change is working to develop a common rotation in social medicine and community health for medical students from Harvard Medical School well as the medical schools in Haiti and Rwanda. The goal of this rotation is to develop common learning objectives and experience for US and local national medical students to work and learn jointly in the field.

Master of Medical Sciences in Global Health Delivery

The Master of Medical Sciences in Global Health Delivery (MMSc-GHD) combines a rigorous cross-university curriculum focused on the development of the tools needed to perform social and delivery science and policy research in resource-limited settings. The core component of the MMSc-GHD is a field-based mentored research project in global health. Students submit a master’s thesis based on this work. Please note that this program does not offer clinical training and that there is neither coursework nor project work involving direct patient care.

Residency in Global Health Equity (Brigham and Women’s Hospital)

In 2004, Dr. Paul Farmer and Dr. Howard Hiatt created a global health track for internal medicine residents at the Brigham and Women’s Hospital. Through the Doris and Howard Hiatt Residency in Global Health Equity, residents spend approximately 11 months of their training in clinical rotations at international sites and earn a Master's degree in Clinical Effectiveness from the Harvard T.H. Chan School of Public Health. Graduates of the four-year program are expected to develop a career as global health leaders and to accompany colleagues and leaders in low-income countries through the daunting process of strengthening their health care systems. As more medical institutions in the U.S. offer global health training, there is an urgent need to develop and evaluate the formal pedagogy for residency training. The Program in Global Medical Education and Social Change is working with the residency at the Brigham and Women’s Hospital and elsewhere to develop and evaluate this curriculum.

Support for residency programs in Haiti

The majority of physicians in resource-poor settings have not had the benefit of residency training. Those with residency training were often trained in areas without the medicines or other tools needed to properly care for the poorest and sickest patients. After the 2010 earthquake, the organization Partners In Health (PIH) focused their support on medical and nursing education.  The residencies in family medicine, internal medicine, surgery, pediatrics, OB-GYN, and emergency medicine are now offered in public facilities supported by PIH—the University Hospital at Mirebalais and Saint Nicolas Hospital in St. Marc, Haiti. These residencies leverage the expertise of leading academic institutions in the United States to train residents within public facilities that have been reinforced with adequate staff and supplies by the work of PIH. The transformation of a health care facility into a teaching hospital is conceptually appealing as a way to increase staffing ratios, improve the quality of care, and increase the pipeline of medical professionals with experience in and commitment to the public health system of Haiti.

Fellowship in Global Health Delivery (Haiti)

To create a locally owned and operated model of care, it was necessary to train a cadre of Haitian health workers to the difficult work of implementing HIV care while improving primary health care within the public sector. The Fellowship in Global Health Delivery was created to meet this need. It includes a didactic component, which includes: the teaching of the principles of social medicine, human rights, the community-based approach as well as approaches to common conditions—such as HIV, TB, Malaria, and non-communicable diseases. In addition, clinical and programmatic work is mentored by experienced faculty from both the Brigham and Women’s Hospital and international sites.