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Global Health-related Training Opportunities: A National Survey of Pulmonary and Critical Care Medicine Fellowship Programs.

RATIONALE
Clinical and research training opportunities in global health are of increasing interest to medical trainees, but little is known about such opportunities in U.S.-based pulmonary and pulmonary/critical care medicine (PCCM) fellowship programs.


OBJECTIVES
Summarize currently available global health-related training opportunities and identify potential barriers to implementing global health curricula among U.S.-based PCCM fellowship programs.


METHODS
We sent a confidential, online, targeted needs assessment to PCCM fellowship program directors and associate program directors. Data collected included program demographics, currently available global health-related clinical and research training opportunities, potential barriers to the implementation of global health-related programmatic content, and perceived interest in global health-related training opportunities by current and/or prospective trainees. To evaluate for non-response bias, we performed an online search to identify global health-related training opportunities offered by non-responding programs.


RESULTS
Out of 171 surveyed programs, 63 PCCM fellowship programs (37%) provided survey responses. Most responses (n=56, 89%) were from combined PCCM training programs; 66% (n=40) of programs offered at least one component of global health-related clinical or research training. Overall, 27% (n=17) had a Ruth L. Kirschstein National Research Service Award Institutional Research Training Grant (NIH T32), 73% (n=46) had fewer than 35 faculty members, and 51% (n=32) had at least one faculty member conducting global health-focused research. Most responding programs (66%, n=40) offered at least one global health-related educational component. Among programs that would like to offer global health-related training components, the most common barriers included competing priorities for lecture content and a lack of in-division mentors with global health experience, a champion for global health-related activities, and established partnerships outside the U.S.


CONCLUSIONS
PCCM program leaders are interested in offering global health-related training opportunities, but important barriers include lack of mentorship, dedicated fellowship time, and established global partnerships. Future research is needed to better understand global health-related interests and training needs of incoming fellows, and to design creative solutions for providing global health-related training across academic institutions with variable global health-related training capacities.