Scholarly Concentration in Global Health

Concentration Directors

Delma-Jean Watts, MD
Assistant Professor of Pediatrics
Email: [email protected]
Phone: (401) 444-8531
Potter Suite 200, Rhode Island Hospital

Silvia Chiang, MD
Assistant Professor of Pediatrics
Email: [email protected]
Phone: (401) 444-8360
Center for International Health Research
55 Claverick Street, Providence   

Overview

There are two purposes of the Global Health Scholarly Concentration. First, to educate medical students about the breadth and depth of global health, with an emphasis on populations in low and middle income countries (LMICs) characterized as resource-poor communities who are medically underserved. These communities have low levels of population health with respect to general measures of mortality and morbidity and specific measures of disease and risk factor prevalence and incidence. Second, to provide and support a close mentoring relationship between medical students and both Brown University and hospital-based faculty. Students will conduct a longitudinal (spanning approximately three years) scholarly project in global health under the direction of a faculty member.

The final result of this mentored relationship and learning is a scholarly product in global health. This product may take the form of an abstract, manuscript, technical report on a clinical or public health intervention, teaching module, or another output defined by the student and faculty mentor(s), and approved by the leaders of the Global Health Scholarly Concentration. The expectation is that students continue to work on their longitudinal project throughout medical school; however, given the demands of the medical school curriculum, most of the work likely will be done during the summer between Years I and II and potentially in Year IV, when students have more flexibility. Presentation of student work at a regional or national conference will also be encouraged.

Examples of projects and the scholarly output from Global Health Scholarly Concentration graduates are available here

Timeline

The timeline of the Scholarly Concentration in Global Health is as follows: (1) recruitment, applications, and admission in Year I; (2) preparation for, and implementation of, summer experience between Years I and II; (3) global health seminars in Year II; (4) continued work on longitudinal project between Years II and IV; (5) completion of a relevant clinical elective in Year IV; and (6) completion of scholarly product in Year IV.

Recruitment, Applications, and Admission

The first component pertains to annual selection of students for the Global Health Scholarly Concentration. Early in Year I and well in advance of the February application date, interested students will meet with concentration leaders to identify an area of interest and a specific faculty mentor. Together, they will develop a summer experience, investigate summer funding opportunities, and outline a plan to carry out a longitudinal project that will culminate in a scholarly product.  The completed applications for entrance into the Global Health Scholarly Concentration will be due to the Scholarly Concentrations Office in February. The faculty leaders of the Global Health Scholarly Concentration will review applications for project merit and determine program acceptance. A list of faculty and their international interests can be found on the Global Health Initiative site or by searching Researchers @ Brown.

Summer Experience between Years I and II

During the summer months between Years I and II, students will engage in in-depth summer experiences (~8-10 weeks). Both experiences at foreign sites and experiences at domestic sites with immigrant and refugee populations are suitable. Some students elect to spend the summer analyzing data collected at foreign sites. This is another good option, as it provides an excellent opportunity to learn and refine skills in data analysis and interpretation under close mentorship. Ideally, most of the work on the scholarly product will be done as part of this summer experience. However, since global health often does not go as planned, there will be a lot of flexibility.

A global health summer experience must be preceded by adequate preparation and close mentoring by faculty. Ideally, the summer experience would occur after intensive training in interdisciplinary aspects of global health perspectives and methods, but such preparation usually is not possible because of the demands of the medical school curriculum. Though clinical electives are highly valuable and inspire many students, these alone do not meet the requirements of the concentration. Further, at this juncture in medical student training, many students are not sufficiently prepared to make significant contributions to direct patient care.

Students should plan a summer experience that will lead to a scholarly product; students should articulate in their Global Health Scholarly Concentration application not only what they will do during their first summer, but how they will continue to work on their scholarly product over the ensuing 3 years and how their work will impact human health.

The period of March to June will be a very busy and critical time for Year I students in the Global Health Scholarly Concentration. In spring semester of Year I, after entry into the global health concentration and proceeding the summer, Year I students will be required to work closely with their faculty mentor to prepare. From March through early May, Year I students and faculty mentors should meet every 2 weeks. The faculty leaders of the concentration will meet with students as a group (and individually as needed) prior to summer departure to review progress, address concerns, and more fully outline plans for the summer experience. Students may also use this time to apply for additional funding of the summer experience if necessary.

During this planning period, possible discussion topics with concentration leaders and/or mentors include:

1.         Clinical Science and Practice

  1. Clinical Care challenges in LMICs
  2. Ethical dilemmas in delivery of clinical care in LMICs for US medical students & faculty
  3. Understanding cultural barriers to adherence
  4. Clinical translational and implementation issues in communities

2.         Research Concepts, Methods and Conduct:

  1. Demonstrate understanding of fundamental epidemiological and clinical research concepts and methods: study designs, rates and proportions, definition of populations and sampling, bias, and confounding.
  2. Demonstrate understanding of screening and surveillance concepts and methods.
  3. Understand purpose, design, and conduct of experimental trials at community and individual levels.
  4. Understand qualitative methods and utility in global health research.
  5. Identify a medical or public health problem with a defined population deserving of further study.
  6. For a specific health problem, contrast generalizability and limitations of data from different sources.
  7. Discuss ethical issues related to human research participants.
  8. Discuss ethical issues related to the conduct of global health research.
  9. Read and critique medical and public health research literature.
  10. State a global health research problem in terms of a research hypothesis.
  11. Develop research methods for study of a particular public health problem.

Year II Global Health Seminars

Students should continue meeting regularly with their faculty mentors to make progress on their projects and plan for the scholarly product. During Year II, the Global Health Scholarly Concentration will meet regularly as a group with faculty leaders approximately twice a month at lunch time from August to February. Students will be required to attend these meetings. The structure and format of the meetings will be a combination of small group discussions and presentations, faculty panels on global health careers, and seminars on selected global health topics. In the past, seminars have included guest faculty working in global health in the areas of public health, clinical research, clinical education, and medical anthropology. These meetings will end in February due to Year II students’ need to prepare for the USMLE Step 1 exam. 

Students in Year II will be expected to submit an abstract and present a poster at the Brown Global Health Poster Session in the Fall.

Year III Activities

Although Year III will be very busy with clinical training rotations, it is essential that students maintain contact with their faculty mentors and discuss the progress on their scholarly product. Year III students will submit two brief cases/reflections from their clinical experiences that have global health relevance. These may include cases of less common infectious diseases, experiences with refugee or immigrant patients, cultural or interpretation challenges, or reflections on specific differences seen in health care utilization here and in previous global health experiences. In addition, most students have more optional time in Year IV, so it is wise to plan far ahead for global health activities in the last year.

Year IV Scholarly Product and Elective

The final component of the Scholarly Concentration consists of the submission of a scholarly product and a relevant clinical elective. Although well over half of the students in this Scholarly Concentration go overseas in Year IV to participate in an international elective, overseas travel is not required. Students also have the ability to pursue an elective in the United States that is pertinent to global health. Relevant electives include working in clinics with large immigrant or refugee patient populations. The fourth year elective must include a clinical component requiring students to interact in a meaningful fashion utilizing their clinical skills.

Students will be required to submit a scholarly product for review by their faculty mentor and the concentration leadership by April of Year IV. Approval of this product will indicate successful completion of the global health scholarly concentration.

Concentration-Related Electives

This website, put together by Global Health Scholarly Concentration graduate Evan Stern (class of 2020), provides a comprehensive overview of international electives.

Maximum Number of Students

We anticipate that the concentration leaders will be able to provide adequate guidance and mentorship to 7-8 students per year.

Faculty Mentors and Advisors

A critical goal of the scholarly concentration will be to match students with faculty mentors in Year I of medical school. The application for joining the concentration, which is generally due in February of Year I, requires the commitment of a mentor to the applicant. We recognize that changes in students’ interests, faculty resources, and other factors may lead to students seeking out additional mentors as they progress through the concentration. Nonetheless, it is crucial that faculty mentors who commit to applicants understand the need to provide ongoing mentorship beyond the first summer experience. This includes assurance of safety and adequate supervision at the field site, as well as continued mentorship in creation of the scholarly product. The faculty mentor is primarily responsible for overseeing the work related to the scholarly product. The concentration directors will work hard to provide guidance and counseling and assess the quality of the student and mentor fit. The concentration leaders will also attend and oversee didactic and other educational opportunities in the concentration.

Funding Opportunities
(Alternatives to Summer Assistantships)

There are several internal sources of funds that could provide financial support for overseas experiences. The International Health Institute also provides useful information on its web site about outside funding sources.

Brown University offers international research grants for students and clinical trainees through the Framework in Global Health program, led by Dr. Susan Cu-Uvin. Please visit the Framework in Global Health page for more information and an application.

The Infectious Disease Society of America also offers funding through its Medical Scholars Program.