One of the questions medical students ask when researching residency programs is whether they have a global health program that will allow students to experience and participate in health care outside the United States. Given that fact, many programs have started to incorporate global health rotations -- some as short as a week, others as long as a month -- to allow their residents this exposure.
We family physicians are ideally suited to participate in global health because of our broad training. I knew early in my career that I wanted to be involved in health care internationally, so when it came time to choose a specialty, I needed one that would train me to be able to care for anyone, anytime, anywhere. That was a no-brainer. It was family medicine.
The advantage of the global health experience for those who have already decided to become family physicians is the exposure to various cultures and health care systems. Learning to navigate the intricacies of providing health care services when resources are limited, political strife is the norm and social determinants of health are not fully addressed will help and encourage us to provide better and more competent health care at home and internationally.
It also helps us appreciate how to take best practices from other places and bring them to our own communities.
There are those who try to dissuade us from participating in global health, but it is important to note that ensuring the health of other nations results in a healthier population that can better contribute to that country's economy, which in turn leads to political stability and, hence, security for us at home. A poor, hungry population may be prone to political strife that can impact our own national security.
Of course, we must recognize our own country's place in the international world and realize that one need not leave our shores to experience global health. There is a term -- "GLOCAL" health, or the local practice of global health -- that refers to trainees and practicing physicians who go to underserved areas of the United States to learn about the culture and how to use limited resources, navigate local politics and address social determinants of health. (Sound familiar?)
For those looking to get involved in global health, the AAFP can help. The Academy's Center for Global Health Initiatives is a first point of contact for family physicians with inquiries about global health. The AAFP's annual Global Health Summit is scheduled for Oct. 10-12 in Albuquerque, N.M., (with a preconference on health equity there on Oct. 9) and the Academy also has a member interest group focused on global health.
The AAFP can link you to organizations that offer global health education and experiences, and you also can learn more about global family medicine development and related initiatives around the world from the World Organization of Family Doctors, known as Wonca.
But before you venture far from home, here are some questions to ask yourself:
Finally, keep in mind the ethics of traveling outside your community. Just because the people you are likely to serve may not have resources similar to those here at home does not make them fodder on which to "practice new skills." If you would not be allowed to do a procedure or manage a case in your own community -- unless under life or death circumstances -- do not use your travel to another area as an opportunity to do so. Consider those you serve to be vulnerable, and be extremely sensitive to and protective of their needs.
Be ready to embrace the people, the culture and the experience. Learn a few words of the language -- even if it is just to say thank you. Try not to impose your values on others, and be ready to remain open to new experiences and new ideas.
Before you go, watch documentaries about the area you plan to visit, listen to its music, try its cuisine if available in your area, and watch its television stations to get a sense of the rhythm of speech there. Then go.
But above all, be humble. It is a great gift to be a family physician. Share it wisely and well.
I hope to see you on the road here or abroad, caring and advocating for anyone, anytime, anywhere.
Tochi Iroku-Malize, M.D., M.P.H., M.B.A., is a member of the AAFP Board of Directors.