P2B150: A Review of Local Global Health Education in Post-graduate Medical Education Programs Around the World

Background: Recent frameworks for global health (GH) programs have begun adopting a post-colonialism model. Local global health education and training opportunities use a post-colonial framework consisting of seven components that were agreed upon by experienced GH educators (community engagement, global framework/local solutions and transferable skills, focus on social justice and health care disparities, bi-directional learning, experiential/clinical learning, interprofessional approach, and reflective components) to provide training and education within a local community of interest. To date, there are no reviews published on local global health (‘glocal’) education initiatives. This scoping review aims to describe the current landscape of local global health education activities among post-graduate medical education (PGME) programs around the world.

Methods: A post-colonialism conceptual framework was used to determine the establishment of inclusion and exclusion criteria, as well as variables for full-text article extraction. The review was conducted by a medical librarian in seven databases, which were searched in May and June 2022. Articles related to glocal education opportunities within a PGME context published in English from 2000-2022 were included.

Results: After removing duplicate articles, the initial search yielded 5,483 abstracts to be reviewed for inclusion criteria. A total of 68 articles were included and analyzed in this scoping review. Most articles came from the United States of America (75%), Canada (13%), and Australia (6%). Residencies and fellowships of many specialties offered ‘glocal’ education opportunities, with pediatrics publishing the most, followed by internal medicine and internal medicine-pediatrics. Educational activities included: rotations or field experiences, lectures or didactics, community engagement , and cases or discussions. Patient populations served included: First Peoples, immigrants/refugees/asylum seekers, low income, and rural groups. Successful programs included components, such as faculty mentoring, community involvement, and a formal curriculum. Barriers varied across programs, including a lack of funding and protected time, partnerships, and logistical difficulties. Utilizing the post-colonial framework on ‘glocal’ programs, community engagement (84%) was the most common component, followed by experiential/clinical learning (78%), interprofessionalism (64%), global framework/local solutions and transferable skills (58%), social justice and health care disparities (47%), reflection (36%), and bi-directionality (31%) (Figure 1).

Conclusion: To our knowledge, this is the first scoping review of local global health education curricula for PGME trainees around the world. Few programs described a comprehensive curriculum, learning objectives, educational methods, learner assessments, and faculty development. Even fewer included all seven post-colonial framework components. The heterogeneity of educational experiences suggests a need for standardization, such that the post-colonial framework can be used to meet the needs of patient populations and work toward health equity.