In this article 5
Anette Wu, Geoffroy PJC Noel, Betty Leask, Lisa Unangst, Edward Choi and Hans de Wit
The COVID-19 pandemic has demonstrated the need for efficient international collaboration in biomedical research, education and patient care. Such global health emergencies require efficiency in international communication, expert, culturally competent healthcare leadership and practice (locally, nationally and internationally), rapid international public health action and collaborative international biotechnology and medical science research.
Today more than ever before, these elements are not optional choices but rather represent essential components that should be included in medical education curricula globally.
Different definitions
Currently, internationalisation of medical education is a broad term that is understood in different ways. Our research showed that in the United States, for example, it is frequently delivered primarily through Global Health programmes that largely represent Global North-South initiatives or by addressing issues around social determinants of health locally.
However, internationalisation of medical education should include consideration of all aspects of internationalisation; of how intercultural and international issues might impact professional practice and medical education – locally as well as globally.
Internationalisation of medical education needs to include bilateral exposure to both high-income and low-middle income countries.
Particularly, given the current healthcare environment, internationalisation of medical education can help in building awareness of international health challenges, create the foundation for international collaboration and exchange and introduce a global perspective on medical practice to students so that the next generation of medical professionals can work efficiently and collaboratively on world health issues.
Internationalisation and global health
In today’s world it is no longer appropriate to use the terms ‘Internationalisation of Medical Education’, ‘Global Health’ or ‘Global Health education’ interchangeably. While there is overlap between internationalisation of medical education and Global Health, these two areas are distinct.
Internationalisation of medical education is understood as an educational concept, a framework and a means to achieve an international educational goal in medical education – not a goal in and of itself.
International medical competencies achieved via internationalisation of medical education can ultimately improve Global Health.
Although often understood as an area of social justice in healthcare, the classical definition of Global Health includes improving aspects of health for all people worldwide. While the ultimate educational goals of Global Health and internationalisation of medical education overlap (ie, cultural competency), internationalisation of medical education focuses on the comparative aspects and analysis of differences between nations in regard to healthcare (for instance, international health systems, economics, law, ethics and outcomes measures) and on international understanding.
In this context, internationalisation of medical education highlights learning about meaningful differences between individual nations, whereas Global Health issues transcend individual nations.
Goals and outcomes
Internationalisation of medical education is important in ensuring that future physicians practise medicine within a global frame of reference. Furthermore, it can provide the foundation and framework for international leadership and collaboration and provide physicians with skills in cultural competencies, ultimately improving healthcare worldwide and thereby enhancing Global Health.
Goals and outcomes associated with internationalisation of medical education include, but are not limited to, improvement of sensitivity to social, intercultural and ethical differences, knowledge and appreciation of differences between healthcare delivery systems, understanding of global Public Health challenges, in-depth understanding of global biomedical research and international networking, leadership and collaboration competencies, resulting in physicians and medical leaders who are subsequently able to practise medicine as globally minded and socially accountable medical practitioners.
International educators need to see the importance of focusing on developing all medical students’ understanding of the social, cultural and ethical issues associated with medical research and practice. However, despite the potential positive impact on global healthcare, how to achieve the previously mentioned goals and outcomes has not been a shared priority of study worldwide.
The call for internationalization
To date, international education in medical schools is fragmented, competencies are not agreed upon and internationalisation programmes vary in the absence of official guidelines or agreed upon formats. Published work is mainly found within periodicals of other health professions (ie, Nursing and Public Health), with few examples in medical journals.
In order to bring awareness of global aspects to medicine, internationalisation of medical education needs to find its place in standard medical school curricula and has to be established as an investigational area of educational research.
Internationalisation elements should be an essential part of medical education and not an optional extracurricular part of medical school. And internationalisation elements should not be considered as being in competition with other subject matters.
For many institutions extracurricular student outbound mobility currently serves as a synonym for internationalisation of medical education. However, these programmes are accessible only to a small percentage of students. We argue that this approach is insufficient and call for an internationally informed approach that focuses on all students and medical educators.
Internationalisation of medical education can be achieved on many levels in academia – including governmental and institutional levels within a university and at faculty and student level – at home and abroad.
There is no ‘one size fits all’ approach. Healthcare professionals, medical educators, Global Health educators and scientists in the social sciences need to come together to work out best formats and practices regarding what fits best for each school and country – adopting an interdisciplinary and international approach. We argue that this is a high priority area of educational research and professional practice given the current environment.
Medical school curricula designed and delivered in ways that are informed by research into curriculum design, teaching, learning and internationalisation are urgently required. This will, in turn, require internationally minded and interculturally competent medical educators.
As we have learned in 2020 – the future of our global healthcare world lies in the collaborative competencies of the next generation of internationally competent medical leaders.
Failure to incorporate internationalisation of medical education into medical education will limit the full potential of developing all medical students’ understanding of the global social, cultural and ethical issues associated with medical practice and research – impeding what higher medical education can contribute to shaping a global medical world and improving Global Health.
Anette Wu is an assistant professor, department of pathology and cell biology and founder and director of ‘International Collaboration and Exchange Program – Preparing Global Leaders for Healthcare’, Vagelos College of Physicians and Surgeons, Columbia University, New York, United States.
Geoffroy Noel is associate professor and director of the anatomical sciences division, department of anatomy at McGill University, Montreal, Canada.
Betty Leask is a visiting professor at the Center for International Higher Education, Boston College, United States, and professor emerita at La Trobe University, Melbourne, Australia.
Lisa Unangst is a PhD graduate in international higher education, Boston College, and incoming postdoctoral fellow at Ghent University in Belgium.
Edward Choi is a PhD graduate in international higher education, Boston College.
Hans de Wit is director of the Center for International Higher Education, Boston College, United States.
This article was originally published on University World News.
Views in this article are author’s own and do not necessarily reflect CGS policy.
