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Global health competencies in UK postgraduate medical training: scoping review/curriculum analysis
27 August 2019
A scoping review was used to develop a framework of global health (GH) competencies for doctors. National postgraduate medical training curricula were analysed against this and a prior framework for GH competencies in a paper recently published by BMJ open.
A group of clincians led by Nader Al-Shakarchi, UCL Medical School, including the UCL IHI's Director, Professor Harry Hemingway, and Senior Lecturer, Dr Ami Banerjee carried out a scoping review and curricular content analysis using two global health (GH) competency frameworks to asses GH training in all postgraduate education in the UK.
Equity of care and the challenges of practising in an increasingly globalised world necessitate GH competencies for all doctors as they should be prepared for increasing globalisation, changing migration patterns and emerging epirdemics.This group found that across the whole of postgraduate training, the majority of UK doctors are receiving minimal or no training in GH.
The scoping review identified eight relevant publications ranging in publication date from 2011-2017 with three from the UK and USA and two from Canada. A 16-competency framework was developed and, with a prior five-competency framework, used to analyse each of 71 postgraduate medical curricula. Curricula were examined by a team of researchers and relevant learning outcomes were coded as one of the five or 16 core competencies.
Using these frameworks, 23 and 20, respectively, out of 71 programmes contained no global health competencies and of a possible 16 competencies, the mean number across all 71 programmes was 1.73 (95% CI 1.42 to 2.04) and the highest number were in paediatrics and infectious diseases, each with five competencies. Of the 16 core competencies, global burden of disease and socioeconomic determinants of health were the two most cited with 47 and 35 citations, respectively. 8/16 competencies were not cited in any curriculum.
This study found many UK programmes lack global health content. Integrating global health competencies at an early stage of postgraduate training could help equip UK trainees with the necessary GH experience to address the challenges of practising in an increasingly globalised world.
To read the full papwer visit BMJ Open.
The paper's full citation is: Al-Shakarchi N, Obolensky L, Walpole S, et al. Global health competencies in UK postgraduate medical training: a scoping review and curricular content analysis. BMJ Open 2019;9:e027577. doi:10.1136/ bmjopen-2018-027577