Local Global Health Electives
Office of Global Health
Schulich School of Medicine and Dentistry
In addition to international global health electives, the Office of Global Health (OGH) at Schulich Medicine & Dentistry includes local global health electives for undergraduate medicine and dentistry students and postgraduate residents as part of its overall programming. Local global health electives provide learners with opportunities to work with preceptors at various sites in Southwestern Ontario who practice medicine with global health awareness. In the past, these sites were limited to and defined by the concept of “marginalized groups.” However there is a shift towards a broader understanding of global health experiential learning with emphasis placed on the fundamental outcome of global health awareness, which can be defined as “an ability of the health workforce to link and transfer local issues to global contexts and vice versa.” (Bozorgmehr et al, 2011)
Local Global Health electives are an opportunity for those who are interested in exploring Global Health Issues outside the realm of an international experience. They are also an excellent opportunity to prepare students for future international experiences, by providing a sound foundation through applying common practices in Global Health (e.g. cultural competencies, language competencies, ethics, work in low resource settings etc).
Local Global Health electives organized through family medicine were formerly called “Marginalized Communities Elective.”
Overall Program Objectives and Values
Global Health Experiential Learning is guided by several philosophical frameworks.
The approach of the OGH is based on guidance from the Canadian Academy of Health Sciences, emphasizing:
1. Equity in access to appropriate healthcare
2. Effectiveness of resource investments for greatest impact
3. Engagement with partnerships that result in shared or mutual learning and development of common solutions.
Core Values and Principles of the OGH abstracted from research by Redwood-Campbell et al, 2011 include the following:
- social responsibility (fairness, responsibility and promotion of the just distribution of resources and access)
- cultural humility (respect for history, context and humility in recognizing our own values, limitations, biases and abilities)
- ethical practice and professionalism (maintaining responsiveness, accountability and holding our students to the highest ethical standards)
- sustainability (promotion of life-long learning and pursuit of sustainable knowledge, skills and attitudes)
- reciprocity (multidirectional sharing and exchange of experience and knowledge among collaborating partners)
As guided by Canadian Consensus Global Health Competencies, the program objectives for local global health electives include:
- Improve understanding of the global burden of disease and how it applies to local populations in Southwestern Ontario.
- Provide experiential learning that enhances knowledge of the social and environmental determinants of health and how they relate to communities in Southwestern Ontario.
- Understand the health implications of migration, travel and displacement through working with immigrant and refugee populations in Southwestern Ontario.
- Learn and define the concepts of health disparities and health equity and how they apply to the provision and organization of health care delivery in Southwestern Ontario.
- Gain an understanding of the structure and function of the healthcare system and community resources in Southwestern Ontario.
- Expose learners to experiences that include linguistic, cultural and ethical complexity to foster a mature understanding regarding the CanMEDS roles and how they apply to underserved populations.
- Foster a mature understanding of ones own personal values, beliefs and biases and how they relate to patients and communities who have differing beliefs, values and cultural practices.
Learners are advised to develop their own learning objectives based on the application of the CanMEDS framework to a local global health experience and based on the scope of their elective and the specifics sites and preceptors they wish to work with
Understand how to perform a community needs assessment in a resource-poor setting and be able to make suggestions towards creating an action plan for improving health in that community.
Apply skills that demonstrate the cultural context of well-being, illness and disease, and use these to strengthen the doctor-patient relationship.
Engage in respectful and sustainable relationships with non-health care disciplines towards cooperative action.
Describe the advantages and challenges of a range of healthcare delivery systems and their relevance in various contexts e.g., primary healthcare model, community-based care models, public health models.
Identify and describe interventions which will have the most impact in a resource-constrained environment e.g., immunizations, nutritional supplements, education.
Develop culturally appropriate educational models and resources for dissemination to populations in need
Model the importance of self-care, self-reflection, personal awareness and physician well-being in professional practice, particularly in unfamiliar environments.
List of Sites and Preceptors*
A preliminary list of sites and preceptors is available based upon existing relationships, however the list is being reviewed and expanded over the course of 2013-2014. Future sites include community clinics and experiences with Southwestern Ontario’s diverse population (i.e. Mennonite, Aboriginal and other communities)
- The Southwest Ontario Aboriginal Health Access Centre
- offers primary health care, traditional healing, mental health/crisis programs, nutrition and healthy lifestyles program, diabetes and primary prevention, and the maternal and child health nutrition program to aboriginal populations.
- Contact: Dr. Phil McCabe
- Middlesex-London Health Unit
- provides public health services in London and Middlesex County.
- Contact: Cynthia Bos [Cynthia.firstname.lastname@example.org]
- London Cross Cultural Learner Centre
- a multi-service support network designed to welcome newcomers into the London and region area. Provides medical intake and follow-up for Government Assisted Refugees.
- Contact: Dr. Bhooma Bhayana [email@example.com]
- London Intercommunity Health Centre
- offers health and social services to those experiencing barriers to care (including poverty, homelessness, chronic health conditions, mental health and addictions).
- Contact: Stephanie McCulligh [firstname.lastname@example.org]
*this list is being updated regularly and is current as of February 27 2014
Logistics and Scheduling
The Office of Global Health has approved each current placement and will evaluate any new sites and preceptors to ensure that they meet the desired learning objectives and opportunities. Most placements will be 4 weeks, which include partnership and contact with a primary preceptor at least 40% of time and/or as required by accreditation standards. Placement timings and locations will vary depending on availability as well as trainee requests in areas of special interest.
It is the responsibility of the student/learner to follow the procedure below:
- Review information on Local Global Health Electives on the Office of Global Health Website
- Register with the Department of Family Medicine
- Contact the Office of Global Health and meet with the Academic Director Global Health Curriculum at least 90 days prior to the scheduled start of the elective
- Develop individualized learning objectives
- Contact approved sites and preceptors to build schedule. Begin at least 60 days prior to the start of your elective.
- Provide learning objectives and schedule to Office of Global Health at least 10 days prior to the start of your elective
- Complete pre-experience questionnaire
- Once elective is completed, obtain evaluation forms and complete post-experience questionnaire