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, social medicine, and caring for the underserved. 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). Any resident interested in global health can apply after they match with the program.
OHSU IM Global Health residents will (1) participate in local interdisciplinary lectures and journal clubs, (2) learn from selected readings and didactics with faculty, and (3) rotate through local and international clinical sites during the second and third year of residency.
In addition to curated independent study materials, residents in our program are exposed to a robust didactic curriculum covering core concepts in global health, such as structural violence/competency, systemic racism, native health, infectious diseases, social justice, advocacy, and more. These take place in the following settings:
- Quarterly in-person global health didactic series
- Four global health themed noon conferences per year
- Bi-monthly resident-led journal club
- One-on-one discussions during local global health rotation
- Prebrief and debrief sessions before/after international travel
Several of our clinical sites were previously unavailable due to the global COVID-19 pandemic. As of May 2022, all global health rotations are currently active, including Botswana. We are continually evaluating the state of the pandemic to ensure the safety of our residents.
Local Global Health Clinical Electives
Global health encompasses more than just international service. Our program provides residents with skills to care for underserved and vulnerable populations within their local community. Starting in their second year, OHSU global health residents may select from diverse clinical opportunities both within the Portland metropolitan area or across the country.
See below for clinical sites.
During their local global health elective, residents may select to rotate through a combination of clinics in the Portland Metropolitan Area, or in one of several clinics caring for AI/AN populations.
Portland Metro Area Clinics:
- Virginia Garcia Memorial Health Center (an FQHC providing medical care to migrant and farm workers, and those with barriers to care)
- Multnomah County Health Department (including a refugee intake clinic)
- Bridges Clinic (an OHSU student run free clinic)
- Corrections Medicine
- Community Resource and Referral Center (caring for Veterans without housing)
American Indian/Alaskan Native Medical Centers:
During their local global health elective, residents have 1:1 didactic sessions with faculty to review core concepts in global heatlh, including structural violence/competency, colonialism, advocacy, and more.
Global Health Partnership in Botswana
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 Beth Israel Deaconess Medical Center. 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.