Supporting International Initiatives in Medical Education

In an article in the 3 November 2001 issue of The Lancet entitled "Bringing Global Issues to Medical Teaching," Catherine Bateman and colleagues stress the importance of training future physicians to meet the global health challenges of tomorrow. The authors likewise describe the efforts of medical students worldwide to enhance their medical training with curricular and co-curricular activities of an international nature. The International Federation of Medical Students' Associations (IFMSA) applauds the attention that the authors have given to this important issue, and we join their call for an increased emphasis on global health issues within medical education curricula.

Medical education must accept the development of culturally sensitive and tolerant physicians as a primary mandate. Exposure to the customs, lifestyles, and socioeconomic realities of persons from other countries can and must play an important role in the education of our future physicians, if they are to be equipped to face the health challenges of the new millennium. Examples abound that it is no longer sufficient to consider health issues from a strictly national standpoint:

• Links between poverty and health are increasingly evident. Decreasing life expectancy and increased disease burden in some developing countries depletes these societies of a functional labour force. Technological advances are not distributed evenly throughout the world, leaving the disparity of health status between the developed and developing world at risk for increasing further.
• In June, the United Nations conducted its first-ever General Assembly Special Session on a health issue, as world leaders and public health experts addressed the global crisis of HIV-AIDS. Governments and philanthropists have responded in kind, establishing a global AIDS fund that has resulted in a dramatic increase of funding to combat this epidemic.
• Events on and since 11 September have dramatically altered the global landscape of public health. Communities are examining their readiness to respond to a disaster situation; nation-states are assessing their capability of meeting the health needs of their citizenry in the event of a biological or chemical attack; governments are shifting priorities to meet these growing health concerns.

Medical schools must respond appropriately. Students have long pursued international initiatives as a supplement to their education; institutional support for these activities is inconsistent between universities, and opportunities to pursue international health coursework for academic credit are sporadic. Nonetheless, a significant number of students worldwide remain interested in, and committed to, international health issues. With proper channelling of this interest, medical schools have a golden opportunity to produce a new generation of physician-healers, committed to changing the inequities that shape global health.

Co-curricular opportunities for students to pursue international interests are plentiful, and medical school administrators can play an integral role in facilitating these initiatives. Countless students pursue an international elective as part of their training, and administrators can help by facilitating the development of a local exchange program or by offering academic credit for these electives. Students worldwide are involved in the development of meetings, projects, and conferences on health issues of a multinational flavour, and administrators might provide experience, connections, and technical expertise to supplement these efforts. Faculty members might also enlist other community doctors with international experience, to create a local network for students to organise seminars or develop contacts.

For fifty years, IFMSA has offered a co-curricular introduction to global heath issues for future physicians around the world. It is our hope that the article by Dr. Bateman and colleagues will represent an important landmark in the evolution of global health as an integral component of medical education curricula.