The need for global health in the postgraduate curricula to support international placements
As a group working to enhance the availability of educational
opportunities in global health we wholeheartedly welcome the Working Group
on Ethics Guidelines for Global Health Training (WEIGHT) guidance(1). Too
often international placements are undertaken without due consideration to
the burden placed on the host institution or to the necessary preparation
of the individual. This editorial is particularly timely as several
recent events and publications have raised the issue of the competence of
health professionals to engage in global health activities. For example,
there was the Lancet Commission(2) on the education of health
professionals for the 21st Century and Lord Crisp, author of the Crisp
Report(3), raised the matter in the House of Lords(4). In addition there
was a recent editorial in the British Journal of General Practice about
the role of primary care in global health(5). This surge of activity
demonstrates the need for competence in global health issues and a
consensus that health professionals of all specialities are currently
unprepared for appropriate engagement in global health activities. There
is therefore clearly a need to further global health education within
United Kingdom postgraduate health professional training to address this.
As Lord Crisp highlighted, though there is a lot of interest and agreement
on this issue, "what we need now is some action" (4).
We believe that to rectify this situation, postgraduate health
professional curricula need to be reviewed to enhance their global
relevance. Moreover, training programmes need not just to recognise the
benefits to trainees, the National Health Service and host countries of
appropriately planned and approved overseas experience, as listed in
Vermund et al's editorial (1), but to actively facilitate it. Some work
is already underway: Medsin has produced a global health curriculum for
medical students; Alma Mata has developed a proposal for postgraduate
training in global health (6); and our nascent group linking like-minded
junior doctors across Royal College speciality committees is tackling the
issue of the curricula. However, these efforts will need high level
support in order to effect change in an educational system that has not
kept pace with the challenges of the 21st Century.
Dr Jennifer Hall, MFPH, Public Health ST4, Intercollegiate Global
Health Junior Doctors Working Group Chair and Faculty of Public Health's
International Health Trainees' Group Chair
Dr Colin Brown, MRCP, NIHR Academic Clinical Fellow in Infectious
Diseases on behalf of Alma Mata Global Health Graduates' Network Working
Dr Luisa Pettigrew, MRCGP, First 5 GP
1. Vermund S, Audet C, Martine M, Heimburger D. Training programmes
in global health. BMJ. 2010; 341: p. 1231-1232.
2. Frenk J, Chen L, Bhutta Z, Cohen J, Crisp N, Evans T, et al.
Health Professionals for a new century: transforming education to
strengthen health systems in an interdependent world. Lancet. 2010
November; 376: p. 1923-58.
3. Crisp N. Global health partnerships: the UK contribution to health
in developing countries. London:, Department of Health; 2007.
4. Houses of Parliment. [Online]. Available from:
5. de Maeseneer J, Twagirumukiza M. The contribution of primary
health care to global health. British Journal of General Practice. 2010;
60(581): p. 875-876.
6. Brown C, Martineau F, Spry E, Yudkin J. Postgraduate Training in
Global Health - Ensuring UK doctors can contribute to health in resource-
poor countries. Clinical Medicine. 2011.
Competing interests: We are all junior doctors with an interest in global health issues who are advocating for their greater inclusion into all post graduate medical curricula.