u.s. residencies promoting international training

U.S. Residencies Promoting International Training

Brad H. Feldman, Wills Eye HospitalJanuary 28, 2016

U.S. Residencies Promoting International Training

• Resident interest as the driving force• What’s being offered?• Is residency the right time for this?• The Wills Eye Int’l Residency

Experience

References: Surveys from 2005, 2011,

2012, 20141. Gattey DM, Lauer AK. International Ophthalmology in Training Programs. Ophthalmology. 2006; 113(12): 2379-2380.2. Tibbetts MD, Feldman BH. Wills Eye International Elective Survey. July 2011. 3. Coombs PG et al. Global Health Training in Ophthalmology Training Programs. J Surg Educ. 2015 July-Aug; 72(4): e52 – e59. 4. Welling J et al. Global Ophthalmology Training Opportunities in US Residency Programs: A Survey of Program Directors. 2015. Submitted for Publication.

Resident Interest as the Driving Force

Nearly all residents are interested these electivesFrom Wills Eye survey2:

24/24 interested, even if no credit awarded21/24 would prioritize over another elective18/24 felt offering an int’l program makes the residency more desirable

Resident Interest as the Driving Force

• 63% of PDs believe int’l electives influence medical students’ match choices3

• Multiple residents tell me that our int’l offerings played an outsized role in their match list decision-making

What’s Being Offered? 3

2005

(out of 43)

2012

6 9

34

5

,1

What’s Being Offered? 3,4

PGY-3 or PGY-4 in good standing 4

2 weeks long (range 7 – 35 days) 4

Financial support given 3

Academic time allotted 4

Surgical & clinical experience 4

Barriers cited by PDs 3: Financial Coverage/time Lack/hassle of ACGME credit Difficulty arranging experience Safety & liability

Is Residency The “Right Time”

For This?

This should be a positively disruptive experience for our residents Significantly alter the path they choose and how they

practice Create awareness & perspective Ignite a passion for global health Establish a new network for continued global pursuits


For This?

This should not be a negatively disruptive experience for the visited communities Drain on local resources or eye care network Creation of dependency on charity Surgical complications and subsequent mistrust Real or perceived exploitation


For This?


For This? If in residency, allows for proper instruction on:

Effects of foreign intervention on community

Ethical issues while working abroad Critical safety, legal & logistical

considerations Enables graduates to more effectively

participate in global ophthalmology

2012 launch Demonstrated demand -> Faculty buy-in Created MoUs with 2 int’l partnering sites

2013 funded by alumni society Enthusiasm & knowledge of returning

residents convinced society leaders of value

Wills Eye International Residency Experience

Structure: 1-2 weeks (vacation matched by academic) PGY-4 must apply for the privilege 2K reimbursed (above that resident pays) Travel to pre-approved partnering sites Pre-travel orientation, didactics, health exams,

licensing/documentation review


20 resident participants Kenya, Peru, Haiti, Rwanda, Dominican Republic,

Swaziland, Japan All complete extensive post-experience evaluation &

present to faculty during special VP End of year review of residents by partnering sites Annual assessment of partnerships



• All 6 AGME core competencies consistently met• Residents’ point to these 1-2 weeks as the best of their PG

training and say it reminds them why they wanted to be docs:

This experience galvanized my desire to serve others who are in great need.I saw new pathology I had only read about. This experience expanded my horizons.This kind of experience highlights what really matters in medicine.

Ehrlich JR, Hannush SB, Feldman BH. Opportunity for surgical education and fulfillment of ACGME core competencies: Wills International Residency Experience. Poster presentation. ASCRS 2015. San Diego.

Thank youwww.aupo.org

u.s. residencies promoting international training

Education