Global Health Education in Gastroenterology Fellowship: A National Survey

Dig Dis Sci. 2016 Dec;61(12):3443-3450. doi: 10.1007/s10620-016-4308-x. Epub 2016 Oct 28.

Abstract

Background: Interest in global health (GH) education is increasing across disciplines.

Aims: To assess exposure to and perception of GH training among gastroenterology fellows and program directors across the USA.

Methods: Design: Electronic survey study.

Setting: The questionnaire was circulated to accredited US gastroenterology fellowship programs, with the assistance of the American Gastroenterological Association.

Participants: Gastroenterology program directors and fellows.

Results: The questionnaire was returned by 127 respondents (47 program directors, 78 fellows) from 55 training programs (36 % of all training programs). 61 % of respondents had prior experience in GH. 17 % of programs offered GH curriculum with international elective (13 %), didactic (9 %), and research activity (7 %) being the most common. Fellows had adequate experience managing hepatitis B (93 %), cholangiocarcinoma (84 %), and intrahepatic duct stones (84 %). 74, 69 and 68 % reported having little to no experience managing hepatitis E, tuberculosis mesenteritis, or epidemic infectious enteritis, respectively. Most fellows would participate in an elective in an underserved area locally (81 %) or a 4-week elective abroad (71 %), if available. 44 % of fellows planned on working or volunteering abroad after fellowship. Barriers to establishing GH curriculum included funding (94 %), scheduling (88 %), and a lack of standardized objectives (78 %). Lack of interest, however, was not a concern. Fellows (49 %), more than faculty (29 %) (χ 2 = 21.9; p = 0.03), believed that GH education should be included in fellowship curriculum.

Conclusions: Program directors and trainees recognize the importance of GH education. However, only 17 % of ACGME-approved fellowship programs offer the opportunity. Global health curriculum may enhance gastroenterology training.

Keywords: Curriculum; Gastroenterology fellowship; Global health; Training.

MeSH terms

  • Adult
  • Bile Duct Neoplasms / therapy
  • Bile Ducts, Intrahepatic
  • Cholangiocarcinoma / therapy
  • Cholelithiasis / therapy
  • Curriculum*
  • Enteritis / therapy
  • Fellowships and Scholarships*
  • Female
  • Gastroenterology / education*
  • Global Health / education*
  • Hepatitis B / therapy
  • Hepatitis E / therapy
  • Humans
  • Male
  • Mesentery
  • Middle Aged
  • Surveys and Questionnaires
  • Time Factors
  • Training Support
  • Tuberculosis / therapy