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Global Health Pathway Curriculum

The goal of the Global Health pathway at SUNY Downstate’s College of Medicine is to provide a longitudinal curricular pathway for medical students interested in Global Health to identify, engage in and advance innovative and sustainable solutions in health care worldwide. The pathway will achieve that mission through integrating collaborative, inter-professional approaches to education, researchand servicefor GH populations and individuals into the four-year medical school curriculum.

The GH Pathway specific goals are

  • To create awareness, understanding and a vibrant dialogue around global health issues within Downstate and our larger communities.
  • To specifically integrate knowledge of global health issues in the context of historical, geo-political, economic, environmental, and social factors into the practice of Medicine at home and abroad.
  • To develop and advance scientific research and learning concerning global health problems.
  • To develop and promote student leaders as champions for solutions to global health problems in collaboration with international partners through service learning opportunities.
  • To tap SUNY faculty leaders as supporters for direct engagement with international partners to find interdisciplinary solutions to global health problems.

Pathway Curriculum

MS year Activity Detail / Requirement

MS I

Global Health Lecture Series
  • Attend 8 of 10 scheduled GH Lectures

MS II

Seminar Series
  • September through January
  • Small group seminars on specific case studies (5 cases total)
  • Based on Case Studies in GH by Ruth Levine

 

MS III

Online Clinical Case Studies
  • Global Health clinical case studies

MS IV

Supervised Culminating Experience
  • Global health service experience
  • Local GH experience
  • International experience
  • Research project
  • GH competition

Detailed Pathway Outline

MS I

Topics in Global Health Course

The purpose of this course is to introduce future healthcare providers to a selection of issues affecting the health of populations in developing countries. The focus is on major contributions to the burden of disease in the developing world. However rather than attempting to cover every area with the purview of global health, we seek to expose students to topics in research and practice that will provoke discussion and insight into this diverse and growing field. For students who are interested in conducting work or research abroad, this course may aid in gaining knowledge for future career options as well as improve critical thinking on the role of the clinicians in global health. Additionally, students who attend and participate actively in the course should gain insight into global health issues affecting patients in increasingly diverse domestic communities.

The course consists of 10 evening classes

Course Objectives:

At the completion of this course students should be able to:

  • Describe the major stakeholders involved in implementation of global health initiatives
  • Identify communicable & non-communicable illnesses that contribute to the global burden of disease
  • Identify mechanisms of which physicians can contribute to sustainable global health solutions
  • Identify barriers in providing primary care and long-term care in the global community.

Course Structure:

Part I: Defining Global Health and Discussion of Key Issues

  1. Overview of Global Health: Why is the third world the third world?
  2. Health Systems and Management

Part II: Role of Physicians in contributing to Global Health Solutions

  1. Infectious Disease
  2. Disaster Management and Emergency Medicine
  3. Maternal Health
  4. Reproductive Health
  5. Mental Health
  6. Surgery
  7. Humanitarian response
  8. Careers in Global Health

Course Requirements:

  • Attendance (8/10 sessions)
  • Active participation

MS II

Global Health Seminar Series

The seminar series will provide case-based learning focused on logistical and ethical concerns within the global health arena. This five-case series will take place during the 2nd year of medical school from September until January. Monthly meetings will allow for a review and study of five cases from Case Studies in Global Health: Millions Savedby Ruth Levine. Each case will culminate in an assignment (approximately 2 pages) designed to provide written analysis and address lessons learned.

Objectives:

  • Provide case-based learning that illustrates real-life examples of global public health.
  • Provide a foundation in social and global awareness through ethical engagement.
  • Identify some of the strategies used in successful community health interventions to prevent or treat disease.
  • Understand the major benefits and limitations of various global health intervention strategies.

Course Structure:

  • Case #1: Preventing HIV/AIDS and Sexually Transmitted Infections in Thailand
  • Case #2: Eliminating Polio in Latin America and the Caribbean
  • Case #3: Improving the Health of the Poor in Mexico
  • Case #4: Reducing Guinea Worm in Asia and Sub-Saharan Africa
  • Case #5: Preventing Neural-Tube Defects in Chile

Course Requirements:

  • Attendance at 4/5 seminar sessions
  • Completion of 3/5 course assignments
  • Active participation

MS III

Reasoning Without Resources: Clinical Case Series

This case-based clinical series from the district hospital of Kisoro, Uganda, provides clinical education around common diseases encountered in rural Uganda while modeling an approach grounded in clinical reasoning, practical epidemiology, and physical diagnosis skills. This series will take place during the 3rdyear of medical school and is designed to be held as a group learning session with a facilitator but can also be done as a group online activity. Each session will have 2 to 4 cases and will be organized in themes that can be completed every month.

Objectives:

  • Introduce students to commonly encountered diseases and disease patterns from rural Uganda with an emphasis on clinical manifestations and its relation to disease severity
  • Provide practical approaches to diagnosis in resource-limited settings
  • Learning to apply clinical prediction rules to improve diagnostic suspicion of diseases as well as disease states
  • Applying critical analysis of physical exam findings and maneuvers
  • Understanding the intersection of disease prevalence, disease severity and geo-social factors

Course Structure:

  • Session 1: Fevers (Malaria, Dengue, Typhoid)
  • Session 2: Fevers II (Borrelia, Leptospirosis, post-viral CAP)
  • Session 3: Fevers III (Brucella, TB/HIV)
  • Session 4: CNS Syndromes (Cerebral Malaria, Bacterial Meningitis, Sleeping Sickness, TB Meningitis)
  • Session 6: Abdominal Pain (HCC, Hepatic Abscess, TB peritoneum, Amoebic Abscess)
  • Session 7: Cardiac (EMF, Mitral Stenosis/Pregnancy, Purulent Pericarditis, RHD)
  • Session 8: Renal Vignettes

Course Requirements:

  • Attendance and participation in group sessions or online sessions
  • Submission of answers for feedback (not graded)

MS IV

Supervised Culminating /Practical experience

The final year will give student the opportunity to apply the acquired knowledge in the context of an actual Global health experience. Due to differing financial and logistical circumstances these experiences may vary considerably in their make-up and execution. However, 4thyear students are required to write a well-researched proposal for their experience, seek out personal mentorship, make the necessary preparations and finally engage in the specific activity.

Objectives:

  • Apply GH knowledge in a real-world environment by selecting from one of the following:
  • International experience
    • National or Local experience with a GH organization
    • GH research project
    • GH case competition at Emory University
  • Be able to outline goals and objectives as well as define outcome measures
  • Understand the inherent structures and barriers in the implementation of GH projects
  • Observe, analyze and learn
  • Critically evaluate GH interventions

Course structure:

Students in conjunction with the course directors will identify a GH project that fits their circumstances. Several opportunities have been already identified by the course directors internationally or locally. Students may wish to undertake a research project with one of the course directors. Finally, if selected through the application process, students can participate in a national GH competition at Emory University as their chosen activity to meet their fourth-year pathway requirement.

Either way, students will write a proposal outlining the need, the planned intervention, and the expected outcome parameters. Following their practical experience, the student will write a comprehensive and critical analysis of their project and submit to the course directors.

Course Requirements:

Completion of a pre-approved project, including the project proposal and the outcome evaluation.;

Admission to the Global Health Pathway

The GH pathway is open to all students with strong interest in GH regardless of previous GH experience. However, admission to the pathway is limited to 20 students who will write a formal application, outlining their interest, expectation, experience, and reason for wanting to choose that pathway

Mentoring

Students will be assigned to GH mentors with whom they will communicate on a regular basis and who will work on specific projects. This becomes particularly important in the Fourth Year.

Evaluation

The Pathway directors will record attendance and fulfillment of required tasks. Minimal criteria for completion will be distributed to the students prior to signing up for this pathway.

Minimal Passing Criteria:

  • MS I: Attendance of 8 of 10 lectures
  • MS II: Attendance and participation in 4 of 5 seminars
  • MS III: Well researched answers to 8 of 10 case study questions
  • MS IV: Successful completion of research project or local GH service experience or International GH service experience or other

Participation in this program and its activities is not mandatory and students may drop out at any time, however students should be aware of the additional time commitment before applying to this pathway.

Faculty

  • Dr. Jack DeHovitz
  • Dr. Stephan Rinnert
  • Dr. Christina Bloem
  • Dr. Rikki Morris
  • Dr. Noriyuki Murakami
  • Dr. Cameron Page

References

Global Health Pathway Examples