The Chronicle of Higher Education published a timely article, “Some Health Programs Overseas Let Students Do Too Much, Too Soon”, about the ethics of undergraduate health science field students and their clinical experiences abroad. The article raises concern about the ethics of treating patients before certification, especially at-risk populations, and the global health spectrum of care providing services. Students write about their clinical experiences abroad in their medical school applications, causing concern for educators and global health practitioners.
Far too often, experts say, students are providing patient care—conducting examinations, suturing wounds, even delivering babies—for which they have little or no training. Indeed, as competition intensifies for medical-school slots, some students may actually be going overseas for hands-on experience they could not get in the United States, in hopes of giving their applications a competitive edge.
Instead, they could be putting their own health and that of foreign patients at risk, and putting colleges and study-abroad providers at risk of legal liability.
And they may end up hurting, not helping, their graduate applications, because many medical, dental, and nursing schools view such behavior as unethical and irresponsible. (Chronicle of Higher Education, 2013)
Non-profit organizations which support global health community projects, such as Child Family Health International, have seen a rise in applicants hoping to treat patients during their experience. CFHI Executive Director Dr. Chris Evert says “professional schools need to become better aware of the problem” of unprepared students’ engaging in patient care abroad, and also recommends that “such activities will count against applicants”, stressing that professional schools have to make it clear that this practice is unacceptable (Chronicle of Higher Education) .
The University of Minnesota’s efforts to dissuade unlicensed students practicing on patients overseas is highlighted in the article. The University of Minnesota’s Academic Health Center created a course to guide their students participating in health sciences focused study abroad programs about medically ethic practices to protect patients and themselves. The online workshop “Global Ambassadors for Patient Safety” is available free of charge to students from other campuses.
The University of Michigan Medical School supports a model of bidirectional practice in its global health initiatives and programs. The GlobalREACH program supports educational services for UMMS students, M1-M4, who want to participate in an international experience. GlobalREACH activities include students designing international experiences for their M1 summer or choosing to conduct health-related research with U-M faculty and international partners while in Ann Arbor through the Summer Biomedical Research Program (SBRP).
Opportunities facilitated through GlobalREACH include participating in an M4 clinical elective at an international partner institute or overseas research elective or applying to participate in Global Health and Disparities Path of Excellence. This co-curricular program was created to “provide students an opportunity to integrate foundational, investigative, and experiential learning to become agents of sustainable change to reduce domestic and global health disparities” (http://globalreach.med.umich.edu/education/students/ghd). The second Path of Excellence to be made available to UMMS students will be Medical Ethics (website under construction).
If you have specific information resource questions about global health, I’d encourage you to visit the Global Health and Disparities Path of Excellence Information Resource Starter Kit created by Taubman Health Sciences Informationist Gupreet Rana.