Innovation Report
The Global Health Service Partnership: Teaching for the World Fitzhugh Mullan, MD, and Vanessa B. Kerry, MD, MSc
Abstract Problem In many limited resource countries, medical and nursing school faculties are small and understaffed, contributing to the sparse output of physicians and nurses to support the country’s health system. The World Health Organization declared that 37 African nations suffer a “critical shortage” of health practitioners. Approach The Global Health Service Partnership (GHSP) is a new program that sends U.S. physicians and nurses to serve as faculty at medical and nursing schools in low-resource countries to increase the
Problem
Resource-limited health systems, a huge burden of disease, and a chronic insufficiency of doctors and nurses are the reality in most low-income countries, a reality dictated by the country’s economy and the expense of training and supporting doctors and nurses. These difficulties are compounded by the loss of many medical graduates seeking training and practice opportunities in North America, Europe, and the Persian Gulf. In Africa, these challenges are particularly acute—the World Health Organization has declared that 37 African nations suffer a “critical shortage” of practitioners in their health workforce. Most international medical assistance over the years has focused on diseaseDr. Mullan is founding board chair, Seed Global Health, Boston, Massachusetts, and Murdock Head Professor of Medicine and Health Policy, George Washington University, Washington, DC. Dr. Kerry is chief executive officer, Seed Global Health, and instructor in global health and social medicine, Harvard Medical School, Boston, Massachusetts. Correspondence should be addressed to Dr. Mullan, 2175 K St. NW, Suite 500, Washington, DC 20037; telephone: (202) 994-4312; e-mail: [email protected]. Acad Med. 2014;89:1146–1148. First published online May 13, 2014 doi: 10.1097/ACM.0000000000000283
1146
quantity and quality of graduates, thereby strengthening local health systems. The GHSP is a collaboration between the Peace Corps and Seed Global Health, a private nongovernmental organization, and is supported by the President’s Emergency Plan for AIDS Relief. Outcomes In July 2013, the GHSP sent 15 physicians and 15 nurses to serve as faculty at 11 schools in Uganda, Tanzania, and Malawi. These volunteers will serve for one year, working with their African counterparts teaching and building academic capacity. The program
specific interventions in areas such as immunizations, maternal and child health, and, more recently, HIV. These interventions have aimed to maximize the impact of limited resources. The arrival of antiretroviral drugs in Africa in the early 2000s changed global perceptions about the health workforce needed. The management of these life-saving medications led to the realization that a basic health system was a necessity, including the presence of adequate numbers of community health workers as well as physicians and nurses. The 2004 Joint Learning Initiative report Human Resources for Health: Overcoming the Crisis and the 2006 World Health Report Working Together for Health helped to focus global attention on the need for enhanced investments in the training of health workers across the health delivery spectrum. The 2008 reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR) highlighted the United States’ commitment to train 140,000 new health workers by 2014. Underscoring the health professional crisis, a 2010 study of sub-Saharan African medical schools documented the numerous and ubiquitous faculty shortages in medical schools throughout the region.1 This report and others singled out the lack of faculty as a major impediment to increasing the numbers of graduates and practitioners in low-resource countries.
aims to help train more physicians and nurses for patient care, some of whom will become faculty in the future. Next Steps An evaluation program will track and analyze the impact of the GHSP on the schools, the volunteers, and, over time, the impact on local health care. The authors propose a “sabbatical corps” to enable more U.S. academic medical and nursing faculty to participate in the program through the sponsorship of their home institutions. In future years, the GHSP will expand to more countries and include more health professions.
Approach
Senator and presidential candidate John F. Kennedy first proposed the Peace Corps in a campaign speech at the University of Michigan in 1960. He posed the question, “How many of you, who are going to be doctors, are willing to spend your days in Ghana?”2 Although the Peace Corps was created a few months later, the program never sent significant numbers of doctors and nurses abroad. The idea of a formalized medical service corps has been talked about for many years. In 2005, the Institute of Medicine published a report, Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/ AIDS,3 which described the findings from a study commissioned by PEPFAR. The report called for the creation of a U.S. global health service corps to send more U.S. health professionals to countries greatly affected by AIDS.3,4 Despite broad endorsement of the report and a bill introduced by Senator Bill Frist, legislation creating the corps was never passed. In 2010, a new proposal for sending U.S. health professionals abroad was published.5 The Peace Corps stepped forward and agreed to host this new dedicated doctor and nurse program, working with Seed Global Health, a private organization founded by a small group of faculty at the Massachusetts General
Academic Medicine, Vol. 89, No. 8 / August 2014
Innovation Report
Hospital and the George Washington University, committed to building health leadership capacity abroad. PEPFAR agreed to provide basic funding for the program as part of its commitment to building a stronger workforce in countries with a high prevalence of HIV/AIDS. The program, the Global Health Service Partnership (GHSP), was built from intergovernmental, international, and public–private partnerships. It was based on the multiplier effect of education—by sending physician and nurse volunteers abroad to serve as medical and nursing faculty, the program would add both providers and teachers to the participating health systems. Medical and nursing faculty, the GHSP founders reasoned, would help to increase the quantity and quality of local graduates with the intention that these graduates then would staff and therefore strengthen their country’s health systems. Faculty support at the postgraduate level also would help to increase the number of local graduates receiving residency training, thus preparing to become, in time, faculty themselves. The program called for Seed Global Health to collaborate with the Peace Corps in recruitment, site development, orientation, in-service support, monitoring, and evaluation. The Peace Corps selected Tanzania, Malawi, and Uganda for the initial placements and, in consultation with Seed Global Health, worked with the ministries of health and of higher education in each country to select the specific sites. The GHSP was publicized through Peace Corps communications, medical and nursing society meetings, grand rounds presentations, news articles, and by word-of-mouth. During the fall of 2012, 100 nurses and 70 physicians applied to the program. The Peace Corps and Seed Global Health interviewed qualified applicants and considered the specialties requested by the sites and the applicants’ skills sets and experience in global health and teaching in selecting and placing volunteers. Both organizations also collaborated in a one-month orientation program for the selected volunteers, which included time in Washington, DC, and the respective countries. The orientation included time spent on tropical medicine, HIV management, teaching techniques, medical and nursing education in Africa, culture, and personal security and health.
Academic Medicine, Vol. 89, No. 8 / August 2014
Outcomes
Next Steps
In July 2013, 30 U.S. physicians and nurses embarked on yearlong assignments as faculty at 11 medical and nursing schools in Tanzania, Malawi, and Uganda (see Table 1). Some physicians came from traditional academic backgrounds, while others were clinicians who had worked abroad or in the United States in resourcelimited settings and had taught in various capacities. Four of the 15 physicians were 55 years or older, while 11 were within 2 years of completing residency or fellowship. During the selection process, the latter group was deemed prepared for clinical teaching because they had completed rigorous residency training in the United States. The GHSP selected only masters-prepared nurses with a minimum of three years of clinical work in their area of expertise and experience as educators to ensure the necessary professional background. Three placements called for midwives or women’s health specialists; others called for nurses with expertise in emergency/trauma, family practice, pediatrics, community health, surgery, and psychiatric care. Volunteers received a Peace Corps living allowance, benefits, and housing, as well as eligibility for debt repayment of up to $30,000 per year. Seed Global Health privately raised the funds for this debt repayment.
While constructed from the lessons of prior programs, the GHSP is a new and untested initiative. This fact could be a liability, but a number of circumstances augur well for the program. Global consensus about the critical need for trained physicians and nurses in resourcelimited countries exists. The chronic and severe faculty shortage in these same countries stands as a well-identified barrier to the needed workforce expansion. Many U.S. physicians and nurses are eager to work abroad, and fulfilling the role of the medical/nursing educator has a strong appeal. The last of these issues is the most challenging—identifying sufficient numbers of U.S. medical educators who are willing and able to make commitments of a year or more to teach overseas.
The Peace Corps and Seed Global Health hope to expand the GHSP in future years to additional countries and more health disciplines. Going forward, program evaluation will be important to improving the partnership’s impact and guiding its growth. Thus, Seed Global Health, working with the Peace Corps and incountry partners, intend to carry out quantitative and qualitative assessments of the placements and the volunteers. Some GHSP volunteers may continue in the program beyond their initial oneyear commitment, while others may find placements as educators elsewhere in resource-limited settings. Many will return to their careers in the United States enriched by their experiences and carrying new perspectives about their lives and work, as has been the case with Peace Corps volunteers since the program began. We hope that the GHSP will thrive and grow to fulfill President Kennedy’s vision of a prominent and permanent role for doctors and nurses in the Peace Corps.
The Seed Global Health debt repayment program helps with loan repayments, a factor that will be extremely important in enabling younger physicians to parti cipate in the GHSP. As we learned from the first year of recruitment, however, many midcareer physicians are not able to consider yearlong commitments that keep them from their positions and represent a significant salary reduction. Financial realities such as lingering educational debt, mortgages, tuition payments, and family obligations present individual and family impediments to joining the program midcareer. A stable form of support for time spent abroad would enable a larger number of more senior physicians to consider service. For example, the use of sabbaticals would provide an option for medical school faculty. Where sabbaticals are not available, medical schools and/or their affiliated hospitals might consider sponsoring one of their faculty for the program each year, providing a constant transfer of skills from U.S. academic institutions to their counterparts in resource-limited settings. These participants in the GHSP would remain faculty at their respective schools while teaching abroad—a “sabbatical corps” within the GHSP. From the perspective of the receiving institution, the GHSP provides welcome faculty augmentation. For the U.S. institution, it could be a major pillar of their global health program, with the participating faculty constituting the core staff of a growing, experienced,
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Innovation Report
Table 1 Global Health Service Partnership Placements, 2013a Country and school
No. of MDs
Specialties
No. of RNs
Specialties
Total no.
Malawi University of Malawi, College of Medicine
4 4
Mzuzu University
0
Kamuzu College of Nursing
0
Uganda
6
Gulu University
3
Pediatrics, internal medicine (2)
0
N/A
3
Lira School of Nursing
0
N/A
2
Comprehensive, public health/mental health
2
Mbarara University of Science and Technology
3
Pediatrics, internal medicine, infectious disease
3
Perioperative, comprehensive (2)
6
Tanzania
5
Muhimbili University of Health and Allied Sciences
2
Anesthesiology, cardiology
0
N/A
2
Mvumi Clinical Officers Training Center
1
Family medicine
0
N/A
1
Mirembe School of Nursing
0
N/A
2
Community health, comprehensive
2
Bugando Medical Center
0
N/A
2
Midwifery, comprehensive
2
Sengerema Medical Center
2
Obstetrics–gynecology, pediatrics/internal medicine
0
N/A
2
Total
6 0
N/A
N/A
2
Pediatrics, comprehensive
2
N/A
4
Midwifery, pediatrics, comprehensive/infectious disease, mental health
4
Psychiatry, obstetrics– gynecology (2), pediatrics
5
11
4
15
10 4
9
15
30
Abbreviation: N/A indicates not applicable. a The numbers in parentheses after the specialties indicate the number of MDs or RNs placed in that specialty. If no number is indicated, one MD or RN was placed in the specialty.
and well-connected global health program. Faculty would return to their institutions with experiences and perspectives that would enrich their community, clinical practice, and teaching. From a school mission perspective, supporting the GHSP would make an important statement to the community about the school’s commitment to the 21st-century values of globalism and humanism. Local businesses or philanthropists might be encouraged to endow such a program to ensure its sustainability over time. If most U.S. MD- and DO-granting schools participated, this sabbatical corps could add some 150 clinical and basic science teachers to the Peace Corps and similar programs every year. This sabbatical corps could be coordinated by Seed Global Health and the Peace Corps or, alternatively, by the Association of American Medical Colleges, signifying a communitywide initiative on the part of U.S. academic medicine to reach out to its counterparts in developing nations.
1148
The Peace Corps and Seed Global Health have taken the first steps in regularizing development assistance in medical edu cation by sending medical and nursing educators to join the faculty of African schools in 2013. The idea is a simple one built on medical collegiality and the profoundly challenging circumstances of many medical faculties in resource-limited countries. The GHSP is seen by many as a new chapter in the Peace Corps’s storied history. For Seed Global Health, it is a first step in building academic partnerships to strengthen health systems. The GHSP is addressing a compelling need that will only grow. U.S. academic medicine stands to play an important role in the quality and durability of the GHSP going forward. Acknowledgments: The authors wish to thank Jennifer Goldsmith for her assistance in tracking application and placement data. Funding/Support: Funding for the Global Health Service Partnership is provided by the President’s Emergency Plan for AIDS Relief, the Engelhard Foundation, Draper Richards Kaplan Foundation, Pfizer Foundation, Exxon Mobil Foundation, the Hess Foundation, and Goldman Sachs Gives.
Other disclosures: None reported. Ethical approval: Reported as not applicable. Previous presentations: Presentations on the develo ping Global Health Service Partnership were made at the Association of American Medical Colleges 2012 annual meeting in San Francisco, California, at the Consortium of Universities for Global Health in 2013 and 2014, and at special sessions at a number of universities in 2012 through 2014.
References 1 Mullan F, Frehywot S, Omaswa F, et al. Medical schools in sub-Saharan Africa. Lancet. 2011;377:1113–1121. 2 Remarks of Senator John F. Kennedy. University of Michigan, October 14, 1960. http://www.jfklibrary.org/AssetViewer/6zcM4SPU0UeTnoAA72pyIA.aspx. Accessed March 4, 2014. 3 Institute of Medicine. Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS. Washington, DC: National Academy Press; 2005. 4 Mullan F. Responding to the global HIV/ AIDS crisis: A Peace Corps for health. JAMA. 2007;297:744–746. 5 Kerry VB, Auld S, Farmer P. An international service corps for health—an unconventional prescription for diplomacy. N Engl J Med. 2010;363:1199–1201.
Academic Medicine, Vol. 89, No. 8 / August 2014
The Global Health Service Partnership: Teaching for the World Fitzhugh Mullan, MD, and Vanessa B. Kerry, MD, MSc
Abstract Problem In many limited resource countries, medical and nursing school faculties are small and understaffed, contributing to the sparse output of physicians and nurses to support the country’s health system. The World Health Organization declared that 37 African nations suffer a “critical shortage” of health practitioners. Approach The Global Health Service Partnership (GHSP) is a new program that sends U.S. physicians and nurses to serve as faculty at medical and nursing schools in low-resource countries to increase the
Problem
Resource-limited health systems, a huge burden of disease, and a chronic insufficiency of doctors and nurses are the reality in most low-income countries, a reality dictated by the country’s economy and the expense of training and supporting doctors and nurses. These difficulties are compounded by the loss of many medical graduates seeking training and practice opportunities in North America, Europe, and the Persian Gulf. In Africa, these challenges are particularly acute—the World Health Organization has declared that 37 African nations suffer a “critical shortage” of practitioners in their health workforce. Most international medical assistance over the years has focused on diseaseDr. Mullan is founding board chair, Seed Global Health, Boston, Massachusetts, and Murdock Head Professor of Medicine and Health Policy, George Washington University, Washington, DC. Dr. Kerry is chief executive officer, Seed Global Health, and instructor in global health and social medicine, Harvard Medical School, Boston, Massachusetts. Correspondence should be addressed to Dr. Mullan, 2175 K St. NW, Suite 500, Washington, DC 20037; telephone: (202) 994-4312; e-mail: [email protected]. Acad Med. 2014;89:1146–1148. First published online May 13, 2014 doi: 10.1097/ACM.0000000000000283
1146
quantity and quality of graduates, thereby strengthening local health systems. The GHSP is a collaboration between the Peace Corps and Seed Global Health, a private nongovernmental organization, and is supported by the President’s Emergency Plan for AIDS Relief. Outcomes In July 2013, the GHSP sent 15 physicians and 15 nurses to serve as faculty at 11 schools in Uganda, Tanzania, and Malawi. These volunteers will serve for one year, working with their African counterparts teaching and building academic capacity. The program
specific interventions in areas such as immunizations, maternal and child health, and, more recently, HIV. These interventions have aimed to maximize the impact of limited resources. The arrival of antiretroviral drugs in Africa in the early 2000s changed global perceptions about the health workforce needed. The management of these life-saving medications led to the realization that a basic health system was a necessity, including the presence of adequate numbers of community health workers as well as physicians and nurses. The 2004 Joint Learning Initiative report Human Resources for Health: Overcoming the Crisis and the 2006 World Health Report Working Together for Health helped to focus global attention on the need for enhanced investments in the training of health workers across the health delivery spectrum. The 2008 reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR) highlighted the United States’ commitment to train 140,000 new health workers by 2014. Underscoring the health professional crisis, a 2010 study of sub-Saharan African medical schools documented the numerous and ubiquitous faculty shortages in medical schools throughout the region.1 This report and others singled out the lack of faculty as a major impediment to increasing the numbers of graduates and practitioners in low-resource countries.
aims to help train more physicians and nurses for patient care, some of whom will become faculty in the future. Next Steps An evaluation program will track and analyze the impact of the GHSP on the schools, the volunteers, and, over time, the impact on local health care. The authors propose a “sabbatical corps” to enable more U.S. academic medical and nursing faculty to participate in the program through the sponsorship of their home institutions. In future years, the GHSP will expand to more countries and include more health professions.
Approach
Senator and presidential candidate John F. Kennedy first proposed the Peace Corps in a campaign speech at the University of Michigan in 1960. He posed the question, “How many of you, who are going to be doctors, are willing to spend your days in Ghana?”2 Although the Peace Corps was created a few months later, the program never sent significant numbers of doctors and nurses abroad. The idea of a formalized medical service corps has been talked about for many years. In 2005, the Institute of Medicine published a report, Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/ AIDS,3 which described the findings from a study commissioned by PEPFAR. The report called for the creation of a U.S. global health service corps to send more U.S. health professionals to countries greatly affected by AIDS.3,4 Despite broad endorsement of the report and a bill introduced by Senator Bill Frist, legislation creating the corps was never passed. In 2010, a new proposal for sending U.S. health professionals abroad was published.5 The Peace Corps stepped forward and agreed to host this new dedicated doctor and nurse program, working with Seed Global Health, a private organization founded by a small group of faculty at the Massachusetts General
Academic Medicine, Vol. 89, No. 8 / August 2014
Innovation Report
Hospital and the George Washington University, committed to building health leadership capacity abroad. PEPFAR agreed to provide basic funding for the program as part of its commitment to building a stronger workforce in countries with a high prevalence of HIV/AIDS. The program, the Global Health Service Partnership (GHSP), was built from intergovernmental, international, and public–private partnerships. It was based on the multiplier effect of education—by sending physician and nurse volunteers abroad to serve as medical and nursing faculty, the program would add both providers and teachers to the participating health systems. Medical and nursing faculty, the GHSP founders reasoned, would help to increase the quantity and quality of local graduates with the intention that these graduates then would staff and therefore strengthen their country’s health systems. Faculty support at the postgraduate level also would help to increase the number of local graduates receiving residency training, thus preparing to become, in time, faculty themselves. The program called for Seed Global Health to collaborate with the Peace Corps in recruitment, site development, orientation, in-service support, monitoring, and evaluation. The Peace Corps selected Tanzania, Malawi, and Uganda for the initial placements and, in consultation with Seed Global Health, worked with the ministries of health and of higher education in each country to select the specific sites. The GHSP was publicized through Peace Corps communications, medical and nursing society meetings, grand rounds presentations, news articles, and by word-of-mouth. During the fall of 2012, 100 nurses and 70 physicians applied to the program. The Peace Corps and Seed Global Health interviewed qualified applicants and considered the specialties requested by the sites and the applicants’ skills sets and experience in global health and teaching in selecting and placing volunteers. Both organizations also collaborated in a one-month orientation program for the selected volunteers, which included time in Washington, DC, and the respective countries. The orientation included time spent on tropical medicine, HIV management, teaching techniques, medical and nursing education in Africa, culture, and personal security and health.
Academic Medicine, Vol. 89, No. 8 / August 2014
Outcomes
Next Steps
In July 2013, 30 U.S. physicians and nurses embarked on yearlong assignments as faculty at 11 medical and nursing schools in Tanzania, Malawi, and Uganda (see Table 1). Some physicians came from traditional academic backgrounds, while others were clinicians who had worked abroad or in the United States in resourcelimited settings and had taught in various capacities. Four of the 15 physicians were 55 years or older, while 11 were within 2 years of completing residency or fellowship. During the selection process, the latter group was deemed prepared for clinical teaching because they had completed rigorous residency training in the United States. The GHSP selected only masters-prepared nurses with a minimum of three years of clinical work in their area of expertise and experience as educators to ensure the necessary professional background. Three placements called for midwives or women’s health specialists; others called for nurses with expertise in emergency/trauma, family practice, pediatrics, community health, surgery, and psychiatric care. Volunteers received a Peace Corps living allowance, benefits, and housing, as well as eligibility for debt repayment of up to $30,000 per year. Seed Global Health privately raised the funds for this debt repayment.
While constructed from the lessons of prior programs, the GHSP is a new and untested initiative. This fact could be a liability, but a number of circumstances augur well for the program. Global consensus about the critical need for trained physicians and nurses in resourcelimited countries exists. The chronic and severe faculty shortage in these same countries stands as a well-identified barrier to the needed workforce expansion. Many U.S. physicians and nurses are eager to work abroad, and fulfilling the role of the medical/nursing educator has a strong appeal. The last of these issues is the most challenging—identifying sufficient numbers of U.S. medical educators who are willing and able to make commitments of a year or more to teach overseas.
The Peace Corps and Seed Global Health hope to expand the GHSP in future years to additional countries and more health disciplines. Going forward, program evaluation will be important to improving the partnership’s impact and guiding its growth. Thus, Seed Global Health, working with the Peace Corps and incountry partners, intend to carry out quantitative and qualitative assessments of the placements and the volunteers. Some GHSP volunteers may continue in the program beyond their initial oneyear commitment, while others may find placements as educators elsewhere in resource-limited settings. Many will return to their careers in the United States enriched by their experiences and carrying new perspectives about their lives and work, as has been the case with Peace Corps volunteers since the program began. We hope that the GHSP will thrive and grow to fulfill President Kennedy’s vision of a prominent and permanent role for doctors and nurses in the Peace Corps.
The Seed Global Health debt repayment program helps with loan repayments, a factor that will be extremely important in enabling younger physicians to parti cipate in the GHSP. As we learned from the first year of recruitment, however, many midcareer physicians are not able to consider yearlong commitments that keep them from their positions and represent a significant salary reduction. Financial realities such as lingering educational debt, mortgages, tuition payments, and family obligations present individual and family impediments to joining the program midcareer. A stable form of support for time spent abroad would enable a larger number of more senior physicians to consider service. For example, the use of sabbaticals would provide an option for medical school faculty. Where sabbaticals are not available, medical schools and/or their affiliated hospitals might consider sponsoring one of their faculty for the program each year, providing a constant transfer of skills from U.S. academic institutions to their counterparts in resource-limited settings. These participants in the GHSP would remain faculty at their respective schools while teaching abroad—a “sabbatical corps” within the GHSP. From the perspective of the receiving institution, the GHSP provides welcome faculty augmentation. For the U.S. institution, it could be a major pillar of their global health program, with the participating faculty constituting the core staff of a growing, experienced,
1147
Innovation Report
Table 1 Global Health Service Partnership Placements, 2013a Country and school
No. of MDs
Specialties
No. of RNs
Specialties
Total no.
Malawi University of Malawi, College of Medicine
4 4
Mzuzu University
0
Kamuzu College of Nursing
0
Uganda
6
Gulu University
3
Pediatrics, internal medicine (2)
0
N/A
3
Lira School of Nursing
0
N/A
2
Comprehensive, public health/mental health
2
Mbarara University of Science and Technology
3
Pediatrics, internal medicine, infectious disease
3
Perioperative, comprehensive (2)
6
Tanzania
5
Muhimbili University of Health and Allied Sciences
2
Anesthesiology, cardiology
0
N/A
2
Mvumi Clinical Officers Training Center
1
Family medicine
0
N/A
1
Mirembe School of Nursing
0
N/A
2
Community health, comprehensive
2
Bugando Medical Center
0
N/A
2
Midwifery, comprehensive
2
Sengerema Medical Center
2
Obstetrics–gynecology, pediatrics/internal medicine
0
N/A
2
Total
6 0
N/A
N/A
2
Pediatrics, comprehensive
2
N/A
4
Midwifery, pediatrics, comprehensive/infectious disease, mental health
4
Psychiatry, obstetrics– gynecology (2), pediatrics
5
11
4
15
10 4
9
15
30
Abbreviation: N/A indicates not applicable. a The numbers in parentheses after the specialties indicate the number of MDs or RNs placed in that specialty. If no number is indicated, one MD or RN was placed in the specialty.
and well-connected global health program. Faculty would return to their institutions with experiences and perspectives that would enrich their community, clinical practice, and teaching. From a school mission perspective, supporting the GHSP would make an important statement to the community about the school’s commitment to the 21st-century values of globalism and humanism. Local businesses or philanthropists might be encouraged to endow such a program to ensure its sustainability over time. If most U.S. MD- and DO-granting schools participated, this sabbatical corps could add some 150 clinical and basic science teachers to the Peace Corps and similar programs every year. This sabbatical corps could be coordinated by Seed Global Health and the Peace Corps or, alternatively, by the Association of American Medical Colleges, signifying a communitywide initiative on the part of U.S. academic medicine to reach out to its counterparts in developing nations.
1148
The Peace Corps and Seed Global Health have taken the first steps in regularizing development assistance in medical edu cation by sending medical and nursing educators to join the faculty of African schools in 2013. The idea is a simple one built on medical collegiality and the profoundly challenging circumstances of many medical faculties in resource-limited countries. The GHSP is seen by many as a new chapter in the Peace Corps’s storied history. For Seed Global Health, it is a first step in building academic partnerships to strengthen health systems. The GHSP is addressing a compelling need that will only grow. U.S. academic medicine stands to play an important role in the quality and durability of the GHSP going forward. Acknowledgments: The authors wish to thank Jennifer Goldsmith for her assistance in tracking application and placement data. Funding/Support: Funding for the Global Health Service Partnership is provided by the President’s Emergency Plan for AIDS Relief, the Engelhard Foundation, Draper Richards Kaplan Foundation, Pfizer Foundation, Exxon Mobil Foundation, the Hess Foundation, and Goldman Sachs Gives.
Other disclosures: None reported. Ethical approval: Reported as not applicable. Previous presentations: Presentations on the develo ping Global Health Service Partnership were made at the Association of American Medical Colleges 2012 annual meeting in San Francisco, California, at the Consortium of Universities for Global Health in 2013 and 2014, and at special sessions at a number of universities in 2012 through 2014.
References 1 Mullan F, Frehywot S, Omaswa F, et al. Medical schools in sub-Saharan Africa. Lancet. 2011;377:1113–1121. 2 Remarks of Senator John F. Kennedy. University of Michigan, October 14, 1960. http://www.jfklibrary.org/AssetViewer/6zcM4SPU0UeTnoAA72pyIA.aspx. Accessed March 4, 2014. 3 Institute of Medicine. Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS. Washington, DC: National Academy Press; 2005. 4 Mullan F. Responding to the global HIV/ AIDS crisis: A Peace Corps for health. JAMA. 2007;297:744–746. 5 Kerry VB, Auld S, Farmer P. An international service corps for health—an unconventional prescription for diplomacy. N Engl J Med. 2010;363:1199–1201.
Academic Medicine, Vol. 89, No. 8 / August 2014
