Global Health Program
The mission of the OHSU Internal Medicine (IM) Global Health Program is to supplement and enrich a robust internal medicine curriculum with opportunities in global health. In this regard, the OHSU IM Global Health Program endorses a broad definition of Global Health rooted in interdisciplinary collaboration to promote better health for all (Koplan, et al. June 2009).
OHSU IM Global Health residents will (1) participate in local interdisciplinary lectures and journal clubs, (2) learn from selected readings, and (3) rotate through local and international clinical sites during the second and third year of residency. The IM Global Health Program is an optional supplement to OHSU's Internal Medicine residency curriculum for those residents with an interest in Global Health.
Global Health Partnership in Botswana
The Botswana Harvard AIDS Institute Partnership (BHP) was founded in 1996 in response to the extraordinarily high rates of HIV affecting the nation. As a research and training collaborative between the Harvard AIDS Initiative and the Government of Botswana, BHP has since focused on both epidemiological and lab-based research and made seminal contributions to the international fight against HIV/AIDS. Several members of BIDMC's Infectious Disease department, including Dr. Roger Shapiro, carried out clinical and research work at Scottish Livingstone Hospital and laid the foundations for today's Botswana Global Health Program.
The OHSU IM Global Health Program offers exciting resident rotation opportunities for those interested in a unique global health learning experience. The program was launched in 2014 in partnership with Scottish Livingstone Hospital (SLH), the Botswana Ministry of Health, and the Botswana-Harvard AIDS Institute Partnership and BIDMC. This interdisciplinary program is the primary global health training site for OHSU. Several departments participate, sending trainees for rotations. The departments of Medicine, Anesthesia, and Obstetrics & Gynecology each have full-time faculty in Botswana that allow for this experience to be robust, sustainable, and meet institutional and ACGME guidelines. OHSU sends approximately 10 residents per year, and have had over 50 IM residents participate so far.
The OHSU Global Health Program is dedicated to building healthcare capacity in Botswana through clinical stewardship, medical education, and collaborative quality improvement. The program offers OHSU medical residents, and other U.S. training programs, the opportunity to contribute to these efforts by working in Botswana alongside local medical students, interns, medical officers, and nursing staff.
The IM Global Health Partnership in Botswana aims to promote health equity by contributing to healthcare delivery and clinical capacity in Botswana. We strive to fulfill our mission by working with local partners to support medical education, clinical training, care delivery and quality improvement in the local healthcare setting.
Our activities in Botswana include:
- Stewardship of internal medicine inpatient and outpatient clinical services at SLH
- Clinical training in internal medicine for University of Botswana medical students, interns, and residents
- Contribution to continuing medical education activities for healthcare staff at SLH and the surrounding district
- Outreach and clinical mentorship at outlying district healthcare facilities
- Promotion of quality and system improvement initiatives
- Leadership of quality improvement- and medical education-focused research
There have been a plethora of significant QI initiatives that have led to improvement in clinical care and allowed for publications and QI experience for our residents (an ACGME requirement). Below are a sample of the initiatives that have occurred over the past few years.
- Recognizing and Utilizing EBM in Management of Sepsis
- HTN/DM education and outreach in the hospital and surrounding district clinics
- Preventing CAUTI
- Starting Anticoagulation Clinic
- Creation of a CME curriculum
- Development of a Structured Internship Training Curriculum
- Patient Care Delivery and Clinical Outcomes at SLH: Characterization and Identification of QI Opportunities
- The SLH On-Call Radio Communication System: improving early communication between ER/Wards/ICU/OR physicians and nurses
- Development of a Nursing Education Curriculum
Scholarship is a key component of the rotation. Residents have been part of multiple presentations and publications. There is qualitative and quantitative research. The culmination of one of the research studies was published in the New England Journal of Medicine.
Local Global Health Clinical Electives
Global Health Residents, in their second year, may select an Indian Health Service clinical rotation (options include sites in Round Valley, California, Chemawa Health Center, in Salem, Oregon; or Alaska Native Medical Center in Anchorage, Alaska) or stay locally in Portland and rotate through corrections medicine, Virginia Garcia Memorial Health Center (provides medical care to migrant and farm workers and those with barriers to care), Bridges Clinic (an OHSU student run free clinic), and Community Resource and Referral Center (focused on homeless Veterans).