Developing a Longitudinal Case-Based Global Health Curriculum for the Medical Student Clerkship Year

Abstract

Introduction: Although over 20% of U.S. medical students express interest in global health (GH), only 39% of medical schools offer formal GH education. We designed a longitudinal case-based curriculum for the core clerkships to incorporate GH into clinical education, increase awareness of barriers to care globally, and create opportunities for students to meet GH faculty. Methods: We conducted an institution-wide survey to determine baseline GH interest. We then developed three case-based sessions incorporated into medicine, surgery, and pediatrics clerkships at Harvard Medical School. The cases included clinical learning targeted to each clerkship while exploring fundamental GH concepts. Cases were developed with GH faculty, and the pilot was implemented from October to December 2019 with 55 students. We used pre- and post-didactic surveys to assess interest in GH and plans to pursue GH, and to elicit qualitative feedback. A follow-up survey assessed students’ understanding of GH and barriers to care relevant to their patients domestically. Results: Students felt clinical management, physical exam skills, epidemiology, and social determinants of health were strengths of the sessions, and felt they were able to apply more critical thinking skills and cultural humility to their patients afterwards. Students felt that simulation would be a great addition to the curriculum, and wanted both more time per session and more sessions overall. Discussion: Integrating GH didactics into the core clerkships has potential to address gaps in GH education and to help students make connections between clinical learning and GH, enhancing their care of patients both domestically and in future GH work.