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Identify programs that may exhibit the potential for “multichannel” reciprocity with an equity focus.
Commenting is closed.
Identify those programs in which an established relationship with UCSF already exists or is under development, and in which there is broad campus interest in developing a partner relationship. You may also want to include programs that have existing partnerships with outside universities or organizations and at what capacity.
IGOT has strong relationships with GHS leadership & across the greater surgical/trauma sub-specialties.
As part of our Global Advocacy & Leadership pillar we are involved in leadership roles across the AAOS-American Academy of Orthopaedic Surgeons, OTA-Orthopaedic Trauma Association, HVO-OO Health Volunteers Overseas/Orthopaedics Overseas, MSF, ICRC, AO & Operation Rainbow.
We collaborate with SIGN-Fracture Care International (NGO in WA) for our annual Summit & SMART Course. We work with Stanford & the ACS anually for their Humanitraian Skills Course.
As a Department we have strong relationships with industry & have successful track record with obtaining industry grants for our programs.
On an international scale we are active at the World Congress of Surgery, Anaethesia & Trauma, WHO, SICOT, WACS.
The Roatan Interprofessional Program began its relationship with UCSF at the time of its founding in 2002 by UCSF alumni/current faculty Arup Roy-Burman (Pediatrics) and Sheila Jenkins (Neurology); much of the program’s first decade of clinical development was coordinated through Children’s Hospital Oakland (CHO), which is now acquired as the newest campus of UCSF. The Program’s resident clinical elective has attracted >100 residents from training programs across the US, stretching from Boston to Miami to Seattle and San Diego. Dozens of residents have come from UCSF, CHO (now also UCSF), and Stanford. Many alumni are now current UCSF Faculty (e.g., Datar, Fiore, Shimano). Since FY12, there has been much progress with more formal integration with the UCSF academic mission, across all four professional schools, from senior faculty to various learner levels. SOD Faculty: Greenspan, Zhan, Den Besten. SON: Lynch, Baltzell, Rankin. SOM: Rutherford, Dandu, Stewart. SOP: Brock, Stofella, Scarspace. In FY14, the Program has hosted 5 Clinical Scholars, 3 Pathways students, and 1MS student, representing all four schools. Current academic partnerships extend to BSRI (Busch, Bloch), UCB (Sokal-Gutierrez; E. Harris), UCSB (Loprez-Carr, Geography), UCD (Chantry and Herlihy, Pediatrics and Demography); UCM (Roussos, Blum Center for Developing Economies).
The International Training and Education Center for Health (I-TECH) collaboration between UCSF and University of Washington has developed a variety of products that are innovative and of potential use to UCSF learners.
They include:
All resources can be found on the I-TECH website here: http://www.go2itech.org/resources
Great resources as we move forward. I-TECH has been a great leader in developing tools and information sources.
The University of Namibia Schools of Medicine, Nursing, and Pharmacy offer a wonderful opportunity for enhanced collaboration with UCSF. UCSF already has some partnerships in the country (eg, http://www.ucsf.edu/news/2014/04/113841/ucsf-work-namibia-contributes-sh...) both as standalone work and in partmership with ITECH. Their leaders have been to UCSF and some of ours have been to Windhoek. These are relatively young training programs with good facilities and access to supplies. For trainees, there are good roads and decent wifi. What they don't have is enough trained preceptors - across the professions - as well as models for interprofessionalism. There are a lot of NGOs that are interested in working with UNAM (including some nice educational support funding from the CDC) - but not a lot of ears that are listening to what they say they need. Developing a coordinated and locally responsive collaboration effort to support them as they grow and mature could improve health in Namibia and also provide a UCSF template for collaboration (not colonization).
Do we have any formal agreements active in Namibia?
The pharmacy work is done via a USAID contract; so the SOP does not have a TAA for learner as yet. In a GH meeting of Namibia consultants last year, we had a full room so I expect there are some TAAs in place... just don't have access to this info.
FYI, the University of California Committee on International Education (UCIE) is proposing important bylaw changes relevant to Global Health Education.
for example proposed changes are in bold italic:
"B. Duties. Consistent with Bylaw 40, the Committee shall: (Am 28 May 2003)
1. Consider and report on matters of international education and research referred to the Committee by the President of the University, the Academic Council, the Assembly, a Divisional or any Senate Committee (Am 28 May 2003).
2. Report to the Academic Council and other agencies of the Senate and confer with and advise the President and agencies of the University Administration on matters concerning international engagement, including:
i. International research in which UC students and/or faculty participate.
ii. Participation of UC faculty and/or students in international exchange agreements.
iii. The status and welfare of international students and scholars on the UC campuses.
iv. Educational Centers run by UC campuses abroad (other than UCEAP)."
http://senate.universityofcalifornia.edu/underreview/documents/ReviewofSB1823-15.pdf
Jyu-Lin Chen (Jyu-Lin.Chen@ucsf.edu) is the UCSF rep to UCIE.
send comments to UCSF Academic Senate Chair Farid Chehab (Farid.Chehab@ucsf.edu).
Thank you for bringing this to the attention the global health researchers and educators! Will take some time to review and digest!
Very helpful information, Stuart. Thanks
Global Partners in Anesthesia & Surgery (www.globalsurgery.org)
The number of global health initiatives focusing on surgical disease has increased signficiantly in recent years. Since formation, GPAS has created partnerships with numerous faculty from multiple disciplines not only at UCSF but also with a number of other universities and non-academic partners (UBC, Duke, UW, Harvard, Stanford, Makerere University, Mbarara University, The Red Cross, iGOT...). These partnerships have included MOUs, collaborative fundraising, shared mentorship, and collaborative project design and implementation.
Our mission is dependent on a multidisciplinary team with leadership from all partners (as reflected in our board of directors).
As international and campus-wide interest in global surgery increases, the critical mass of surgery-focused global health groups has potential to make UCSF a leader in this burgeoning area of public health.
...also significant new projects and partnership underway with the new Center for Global Surgical Studies.
Center for Global Surgical Studies (CGSS)
Much of the work of CGSS is made possible by its strong partnerships across UCSF and abroad. With a history of injury surveillance research in Cameroon, CGSS maintains a strong relationship with the Ministry of Public Health of Cameroon, collaboratively implementing and evaluating a national trauma surveillance system. CGSS also works in partnership with the leadership and staff of Soroti Regional Referral Hospital in rural Uganda. CGSS also has an ongoing collaboration with Lokmanya Tilak Municipal Hospital to investigate patterns of injury in Mumbai, India. New and ongoing projects are also being developed in partnership with GPAS and CGSS works closely with GHS and IGOT to define goals and develop content for focused educational opportunities surrounding global surgery. Given our areas of common interest and research, there is potential for greater partnership across surgical specialties at UCSF.
Commenting is closed.
Identify UCSF programs which appear to demonstrate sustainability over a period of time.
Such programs are likely to have broad campus support and a commitment beyond an individual person.
IGOT has grown steadily since it's inception (2006) considering limited funding & administrative/organizational infrastructure. IGOT has 4 programmatic pillars: Global Research Initiative, Global Knowledge Exchange, Global Surgical Education & Global Advocacy & Leadership. Within each pillar there are "gems" that are scalable such as the SMART Course SF & in-country with an interest for IGOT to co-host the SMART Course in at least 4 additional countries in the coming year (pending financial support). Research initiatives are sustained by our fellow & annually IGOT is approached by learners within & outside of UCSF interested in suporting these efforts. The Exchange Program is popular with housing & travel expenses being the limiting factor for expanding the program.
In general terms the greater UCSF "Global Surgical" community is strong with longstanding faculty support across the subspecialties. Some efforts overlap in country (such as Uganda & Tanzania) across the groups. Offering resident global electives, research support, exchange programs & education are common interests. As a collective we offer a unique strength compared to other universities.
Collective fundraising, communication tools (such as registries, open source portal to discuss/consult on cases from our partners abroad) & administartive support are common needs to ensure further scalability & sustainability.
Twelve years of productivity attests to the Roatan Program’s sustainability and growth. Expansion through new research initiatives is already underway. Since its founding by UCSF faculty in 2003, the Program has provided over 35,000 patient-visits. The Program hosts one of the largest Pediatric Residency International Electives available to US trainees (>100 pediatric residents); the undergraduate Health Education and Advocacy Liaisons (HEAL) internship, developed with Stanford (>80 students) and a local Pediatric “Fellowship” to train a Honduran physician in Pediatrics (5 fellows). Several student alumni have pursued advanced training in global health and several Pediatric “Fellowship” graduates have assumed healthcare leadership positions in Roatán. Importantly, local leadership remains strongly supportive of the UCSF-Roatán Program. Both Drs. Omar Brito (current Ministry of Health Bay Islands Director) and Dr. Raymond Cherington (former Roatán program fellow and current PHR Medical Director) continue to advocate for growth in the UCSF partnership, including expansion of training and research. The Roatán projects have accelerated interprofessional collaboration at UCSF with nearly 200 clinical trainees hosted to date. The Program hosted two Clinical Scholars (SOM, SOD) in 2012-2013 and five Clinical Scholars (SOM, SOP, SOD), three Pathways students (SON), and one MS student (GHS) in 2013-2014.
Since the Student Training Education Program (STEP) is based out of the Family AIDS Care and Education Services (FACES) project in western Kenya, STEP has enjoyed relatively steady participation since 2006, with over 200 electives conducted during the 2006-2014 period. Furthermore, multiple participants in the program have continued on to mentor students in the program in research, thus reinvesting in the sustainability of the program.
Global Partners in Anesthesia & Surgery (GPAS - www.globalsurgery.org)
For the past 8 years this initiative has focused on building local capacity for surgery and anesthesia research, education and clinical service. Most of the program is run by partners based in Uganda, and plans are moving forward to scale our initiatives to a rural hospital in Uganda and an additional training hospital in Tanzania. These efforts are being led by faculty who have graduated from the training program with GPAS support.
MU-UCSF collaborators in Uganda started studying malaria in 1998 and today, also includes research in the areas of TB, HIV, pulmonary disease, non-communicable diseases, immunology, parasite and drug resistance with over 20 collaborating principal investigators primarily in Uganda and at UCSF (www.muucsf.org). The goals of this collaboration are: 1) conduct high-quality research in infectious diseases; 2) build capacity through training; and 3) strengthen infrastructure to help integrate research into policy by linking researchers and policy makers. Infectious Diseases Research Collaboration (IDRC), an NGO, formed in May 2008 with the support of MU-UCSF collaborating investigators and founder members of Ugandan health scientists from MU and Ministry of Health (www.idrc-uganda.org). A Collaboration Executive Committee with members from MU, UCSF, IDRC, and LSHTM to direct and monitor goals for the scientific direction of the research collaboration. To date the collaboration accomplishments include: malaria and TB surveillance of over 750,000 patients throughout Uganda; enrolling ~230,000 persons in research studies; contribution of 250-300 publications; carrying out annual MOH dissemination meetings on malaria and HIV findings to policy makers; maintaining two high functioning research laboratories in Kampala and Tororo; and support for internal and external training programs and research symposiums for U.S. and Uganda students.
Commenting is closed.
Identify those programs that in your opinion exhibit an enthusiasm for high-impact and distinctive initiatives.
In general IGOT is innovative in its academic approach to global orthoapedics & trauma. Specifically IGOT’s SMART Course is an example of cross training orthopaedic surgeons “plastic surgery” limb salvaging principles. This model has expanded to in-country courses which are more costs effective & yield a higher impact reaching >100 regional attendees annually as opposed to 2-3 per region at our local SF course. The SMART Course is scalable yet defined in its scope. IGOT’s “Bay Area Global Health Film Festival” is an advocacy & awareness program that has potential to be expanded across the UCSF campus to highlight our efforts.
IGOT's ability to focus on specific training applicable to resource constrained settings allows it to work at the forefront of its field in GH. The program has been innovative in its fundraising and outreach, the integrated approach to surgical and research training, and now in how it is "flipping" its class to be taught abroad.
Having participated in a Global Health rotation during my pharmacy residency year at UCSF, I was able to further enhance my skills and knowledge on barriers to medication supply chain management. The project looked at identifying these barriers to medication supply chain management at a Public Hospital in Roatan, Honduras in collaboration with UCSF SOM, SOP, & SON. Future innovative projects may include developing rotation sites for multidisciplinary students/residents to round with physicians, prepare medications, and counsel patients on high risk medications; assisting with developing and revising a medication administration record (MAR) for nurses; and creating standard treatment guidelines (i.e. adapted algorithms based on available medications, video prompts with smartphones - Medic Mobile).
The island of Roatan, Honduras, has a population of >>60,000, with a diverse race/ethnic mix (African, Garifuna, Latino) and dual languages (English and Spanish) matching well with our learners. Taken together with geographic isolation, a resource-limited public health capacity (one public hospital/birthing center, four public health clinics, and no EMS system), and a high burden of disease (dengue/HIV/ malaria; trauma and infant mortality; early childhood caries and malnutrition), Roatan itself is a microcosm of developing world challenges. This locale provides an ideal model for the development and vetting of scalable global health solutions.
We piloted a novel immunization clinic-based early childhood fluoride varnish program, which appears to have reduced childhood caries, as measured on preliminary assessment by investigators from UCSF SOD. As the project paired with one of Hondura’s strengths (immunization), the MoH has considered nationalization. Roatan has strong cellular network and many staff have smart phones. SON is pursuing “microlearning” video training for local staff. SOM and SON are partnering in SMS-based maternal education/tracking to enhance breast-feeding compliance. SOM, GHS, BSRI, UCSB and UCB are exploring dengue epidemiology and extending a rapid-diagnostic developed in collaboration with Nicaragua. All projects have a goal of ultimate implementation throughout Mesoamerica and beyond.
The program has already received wide interest from across UC given the ability to harness the collective cross-campus expertise in one manageable location. This would prove innovative in global health education whereby seemingly disparate disciplines (e.g. geography and medicine) can develop joint studies, thereby tackling health needs in a multifaceted way (e.g. mapping breeding sites to target malaria and arbovirus [Dengue and Chikungunya] infection). In short this holds enormous promise for both faculty and students alike, who can participate in transdisciplinary initiatives in a real world “global health laboratory”.
As a pharmacy student at UCSF who is also interested in becoming involved in Global Health, I think that having the opportunities to build upon my skills and knowledge on medication supply chain management and its barriers through innovative rotation sites would be very valuable. With a dense curriculum, pharmacy students do not get very many opportunities to learn about these crucial topics that are important for Global Health involvements. With this basic knowledge and skill set, Global Health students can perform studies and projects to break down the barriers to medication supply chain management.
Early childhood caries (ECC) is the most prevalent and neglected chronic diseases worldwide. In addition to its common negative consequences, including higher risk of caries in subsequent permanent teeth, pain, chronic infections, inability to eat, and impaired growth/development and education potential, ECC share defiencient dietary habits that are associated with future non-infectious disease such as diabetes, obesity and cadiovascular diseases. ECC is preventable by early intervention—beginning by 1 year of age—with oral health and nutrition education and fluoride varnish application. However, worldwide shortages of dental services have prevented the optimum oral health promotion for young children.
In contrast, medical care and vaccination clinics worldwide have excellent population-wide coverage of children from birth to 5 years of age even in developing countries. Over the years, the Roatan project has been well integrated into local health care and established trusting relationships with the island community (patients, families, providers and national medical/political/business leaders). The UCSF director initiated a novel project to include oral health education and FV application for 18 to 60 month old children to improve early childhood oral health at four public health vaccination clinics in Roatan in 2009. With the collective effort of the students and faculty from all 4 schools of UCSF, the public health department of UC Berkely and local health community of Roatan island, we will able to conduct research projects on the severity of ECC, the effectiveness, feasibility, coverage, best practices, and implementation barriers of oral health program; and make scientific-based recommendations for program improvement.We hope that
understanding the strength and obstacles of this new approach in a full study of its implementation, outcome effectiveness and attitudes and opinion towards the program from key stakeholders (administrator’s providers and parents) would provide critical information needed to build strong, efficient, and sustainable oral health education and prevention programs that can be expended to other regions in the future. This appoach has recently been put as a potential model by WHO to improve oral health globally.
Cascade Tuholske, commenting above, is a PhD student in the Dept of Geography at UCSB, under the mentorship of David López-Carr, Director, Latin American and Iberian Studies, and Professor, Department of Geography. His work in Roatan collaborates with both UCSF and UC Berkeley.
Center for Global Surgical Studies (CGSS, global.surgery.ucsf.edu)
As low- and middle-income countries move through the epidemiological transition, surgical disease and injury have become a leading cause of morbidity and mortality. As a result, initiatives working in the area of prevention of surgical disease and injury have the potential to make significant impact.
Our projects to establish surgical and trauma surveillance systems in Cameroon and Uganda lay the groundwork for such efforts, allowing us to understand the burden of disease and injury, and to highlight optimal resource allocation as well as map problem areas in communities with respect to disease onset and injury location and mechanism. These efforts have been shown to have local, regional, and national impact in the formation of specialized task forces and through policy development and implementation.
Commenting is closed.
Identify those programs that are actively validating measurable change as a result of their efforts.
IGOT’s “International Summit & SMART (Surgical Management & Reconstructive Training) Course” has a 5-year track record of pre/post course evaluations & 1-year self-reported clinical outcomes of skills gained by international attendees (orthopaedic surgeons from developing countries). IGOT has measured the impact of the global elective program showing significant likelihood of participants to continue international volunteer opportunities & or serve under served communities in their professional careers compared to a similar cohort that did not have an elective opportunity. (*http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780923/).
IGOT has implemented Sales Force as a pilot database for learners, research, educational programs & donors but without operational support to maintain it has proven to be inefficient. Having website support to maintain a “live map” of activities & or establish an open source database of tools, including a registry for research is a long-term goal.
The UCSF Roatan Inter-professional Program’s pediatric clinic has had >35,000 patient-visits to date. The resident elective has hosted >100 residents (primarily pediatric, but also emergency and family medicine) from across the US, from Boston to Miami to Seattle to San Diego. The HEAL student internship developed out of partnership with Stanford; over 80 undergraduate/post-baccalaureate students have rotated have rotated through to date. Attending physician volunteers have numbered >120. With a goal of bilateral training, the Program initiated a Pediatric “fellowship” for local Honduran general practitioners. The 1-3yr “fellowship” has supported pediatric training in Roatan, with mentorship from our rotating volunteer attendings. Of 5 fellows to date, one is Medical Director of the Public Hospital Roatan and another is director at one of the island’s other four public health clinics. The fifth fellow, who received formal pediatric training in Honduras, is our current Roatan site director.
The Program has created a culture of continuing education. The Program brought internet to the Public Hospital and access to best-practices through UpToDate. Rotating residents and attendings often host case-conferences and formal lectures. The Program has sponsored focused training (e.g., ultrasound, NRP) for local providers, biomedical maintenance training, and island-wide trauma/disaster conferences.
An interesting and timely contribution by Dr. Eichbaum at Vanderbilt University: The Problem With Competencies in Global Health Education. E-published ahead of print in the Acad of Med. He seems to be calling for just this type of exercise in assessing GH training programs.
In the GHS masters program our students are located in many different sites. This puts us at a disadvantage for measuring impact as we do not place students in the same locations years after year. I am most interested in how we can measure our impact on the ground, e.g how the work our students participate in results in better health outcomes ultimately. We track our alumni to see if they stay in global health careers or higher ed degrees, but for me the marker of success is what our sites gain for our students participation. Perhaps dissemination of work is a good metric in this case? I would be interested in what others have to say about tracking the impact of shorter term projects or how we might consider continuing in a set number of sites each year. To do this, we need to also consider the varied interests of our incoming students.
Center for Global Surgical Studies (CGSS)
Primarily focused on public health research, CGSS projects regularly track metrics on measurable change as a result of research efforts. For example, in Cameroon, the implementation of trauma surveillance includes follow-up arms examining health outcomes as well as resulting policy development. This allows for CGSS to understand the extent of the impact of the trauma surveillance system on health outcomes, disability, quality improvement interventions, and injury prevention programs as well as policy and intervention development as a result of dissemination of findings.
A similar project at Soroti Regional Referral Hospital, a rural hospital in northeastern Uganda where CGSS is designing and implementing surgical and trauma registries, will track similar follow-up metrics to evaluate the impact of ongoing surgical and trauma surveillance on the health system.
Lastly, for the Kampala Advanced Trauma Training conducted quarterly in collaboration with GPAS, pre- and post-testing as well as course surveys are administered to evaluate the impact and efficacy of the course. Knowledge and retention as well as outcome metrics are collected to contribute to ongoing development and improvement of the course for the Ugandan setting.
Commenting is closed.
Identify programs that demonstrate strong in-country educational and administrative infrastructure (i.e.; in-country mentorship, administrative support, telecommunications, internet access, etc.).
IGOT has 5 established institutional partnerships (Managua-Nicaragua, Kumasi-Ghana, Dar es Salaam-Tanzania, Blantyre-Malawi, Kantmandu-Nepal) where there are designated senior mentors, residency training programs & research coordinators. IGOT has found that fiscally sponsoring local research/volunteer coordinators has been cost effective (<$1K a year) and led to improved efficiency in communications with sites. Partnering with academic institutions that have an interest in research & training has proved to enhance these partnerships. IGOT encourages & supports bilateral exchange hosting learners in SF but travel expenses & housing is a moving target & in some sites is expensive. Centralizing the logistics of coordinating travel & housing, ideally bilaterally would be an invaluable resource for IGOT.
The UCSF Roatan Interprofessional Program is supported by Bay Area and in-country administration/leadership. Learners receive orientation materials in advance of travel. Non-stop air from Houston, and multiple connections to San Salvador and mainland Honduras. Standard guest apartments house learners at one consistent site in West End, Roatan. The apartment owner lives locally and communicates regularly with program administration. As a small tourist town, West End provides a comfortable home for our learners, with easily accessible transit and food/supplies. Given the tourist economy, and the importance of tourism to Roatan, there is strong local attention to safety and security. The Program itself is based in the Public Hospital Roatan, a 20 minute shuttle ride away in Coxen Hole, the major urban center of the island. On-site internet access and VOIP, together with a 2h time difference, simplifies communication with stateside leadership/administration. The Program supports a local physician site director jointly with the Honduran MoH; Dra. Karla Cerritos staffs the pediatric clinic and provides mentorship to rotating residents. As faculty of the Public Hospital, she also serves as a key liaison between visiting learners and other faculty or staff with whom they may collaborate—whether for clinical practice, research, or education.
Thanks for your thoughts about potential useful additions.
In reference to Amber Caldwell's IGOT comment:
Looking at the 5 sites you are currently most active, I'm wondering if efficiencies might be garnered by working with Berkeley (lots of work in Nicaragua), UCSF SON (works in Malawi), and the Bixby Ctr (in Nepal) in creating the kind of centarlized support you mention. How did you end up at these specific sites? Was there a specific need that motivated you, or a specific resource that helped you get traction at that site?
The UCSF-Gladstone CFAR supported the infrastructure and development of the new Translational Research Lab based in Kampala, Uganda, and managed by the Infectious Diseases Institute in conjunction with Makerere University Medical School’s Department of Obstetrics and Gynecology. The in-country lab director is Steffi Sowinski, a Gladstone Instittue of Virology and Immunology staff scientist, who leads a team of 5 lab scientists. This not only serves as a major capacity building endeavor for increasing the number of Ugandan trained East African researchers, but allows for speedier lab analyses for PIs of projects taking place in East Africa and is revenue generating. The UCSF-Gladstone-IDI-Makerere relationship continues to grow with this investment and the presence of Dr. Sowinski. Partnerships have already been forged with other European and American universities based on the presence of the lab.
Recipients of the CFAR developmental pilot awards, generally early career investigators or postdocs at UCSF, frequently subcontract projects with Makerere University. They can utilize the IDI-administered and UCSF-Gladstone CFAR supported Translational Research Lab for any needed analyses. They frequently hire in-country research staff, which is both capacity-building and supportive of existing research collaborations. Investigators based abroad also have benefitted from the CFAR Developmental Awards in the International Mentored Scientist category, in which they partner with a senior UCSF or UCSF-affiliated researcher for their study, which has frequently led to the development of more robustly funded projects that they manage on their own or with their new American based collaborators.
The lab resource is invaluable, and amazing. I think it will take some time for programs to transition protocols, so be patient! Im wondering what kind of outreach is being undertaken so that researchers at UCSF and other universities can capture capability in their grant proposals. Is there a website describing current capabilities and capacity?
Since the Student Training Education Program (STEP) is based out of the Family AIDS Care and Education Services (FACES) program in western Kenya, participants enjoy access to the facilities employed by the project. Participants are able to work in the office spaces used by FACES – including fast internet connection – and have access to vehicles, administrative support, county-level coordinators, and many other resources afforded by the multi-million dollar HIV care project. The participants are connected to a district-level clinical officer (a level of training between a nurse and a doctor), who then coordinates connecting them to a medical professional in the facility.
GPAS – Global Partners in Anesthesia & Surgery (www.globalsurgery.org)
The GPAS collaboration has maintained a continuous presence in Uganda since formation in 2007. More than half of the GPAS leadership is from Uganda and based in-country at our project sites. In addition, our faculty from North America are in Uganda nearly each month. GPAS maintains an office at Makerere University College of Health Sciecnes and supports a full-time, research and education coordinator who is based in Kampala. Through this office we arrange logistics for our visiting trainees and collaborators. This office is also home base for our in country GPAS Senior Scholars (~akin to Chief Residents) in surgery, anesthesia, obstetrics & gynecology and orthopedics. These Senior Scholars provide additional in-country mentorship for visiting faculty and trainees.
Great information, I was not aware that GPAS had a stff member in Kampala. What is their relationship with CFARs lab director in Kampala?
The MU-UCSF/IDRC collaboration has strong administrative infrastructure for both primary research and training projects with established policies for local hiring, management of over 40 subcontracts totaling ~$11,000,000 in funds annually including U.S. federal funds, and local Grants Management Office qualified for U.S. SAM direct funding. A centralized regulatory department for both investigators and trainees for human subjects research studies. In-house data management center that designs and develops custom adaptable software for administering questionnaires and capturing gps and fingerprints as well as capacity for multi-country data merging and coordination with custom made web-based secured access to databases. Research laboratory infrastructure including: Molecular Research Laboratory (MOLAB) located in Kampala has routine capability (including PCR, RFLP analysis, and gel imaging and documentation) to genotype parasites for clinical outcome assessments and to characterize molecular markers of parasite drug resistance and capacity for the culturing of malaria parasites; Tororo Research Laboratory (TOLAB) located in Tororo Hospital has capacity for molecular studies, culture of malaria parasites, and the harvesting of peripheral blood mononuclear cells to support translational molecular, parasitology, and immunology studies. Additionally both laboratories have capacity for long-term banked storage of samples at -80 °C and in liquid nitrogen for future research projects.
How many UCSF trainees are in the program each year? I know that there is a strong drive to develop local capacity, including community outreach and lab capacity. Do you have a sense of how many local trainees are involved?
Contra Costa County Family Medicine Global Health Fellowship
The mission of the Contra Costa/UCSF Family Medicine global health fellowship is to train physicians to provide and promote high quality and culturally relevant care imbued with the principles of Family Medicine in the global health setting. The fellowship is sponsored by the Contra Costa Family Medicine Residency, a UCSF affiliate.The one year fellowship will provide the fellow with: advanced clinical training in Inpatient Medicine, Obstetrics (dependent on experience) and/or Emergency Medicine with teaching opportunities at Contra Costa Regional Medical Center, advanced global health fieldwork at a vetted site with a focus on building local capacity and Family Medicine/Primary Care medical education, point of care ultrasound training, faculty development and enrollment in UCSF sponsored global health courses such as GHS 101 and Clinical Scholar Program (see UCSF Global Health Science web page) and the UCSF Heal Initiative Global Health Boot Camp. If you have any questions about the fellowship please contact Neil.Jayasekera@hsd.cccounty.us.
Could you describe the sites where the CCC Family Medicine GH Fellowship has placed fellows a bit?
Center for Global Surgical Studies (CGSS, global.surgery.ucsf.edu)
Long-term CGSS projects in Uganda and Cameroon demonstrate strong relationships with in-country partners. For this reason, there has consistently been strong, stable infrastructure for UCSF learners to productively impact research and program progress. Local partners have been key to appropriately introducing UCSF learners to study sites and research participants and helping with any potential language and/or cultural barriers.
GAIA was founded in 2000 in response to the global HIV/AIDS epidemic; this response has 3 primary programs: the GAIA Villages intervention, which to date has served over 200,000 rural Malawians in 180 villages and has employed more than 720 Community Caregivers. A second program is the Nursing Scholars Program that nursing students who are deployed to work for the Ministry of Health following graduation; more than 150 graduates are now working in 24 of 28 Malawi districts. The third program is the Mobile Health Clinics program in which seven Toyota Land Cruisers loaded with medical supplies and each staffed by a clinical officer (similar to a physician’s assistant), a registered nurse, a nurse’s aide, and a driver to Malawi’s most remote villages Monday through Friday; each mobile clinic serves 100-225 patients daily with care for acute and chronic conditions, providing diagnosis and treatment for life-threatening illnesses, such as malaria and pneumonia. GAIA has more than 55 full time employees in southern Malawi and the infrastructure provided by Malawi and US staff have provided infrastructure for doctoral dissertations, 10 GHS capstone projects, numerous Clinical Scholar projects, and a NIH funded R01.
Commenting is closed.
Identify programs which demonstrate an ability to accommodate UCSF learners of diverse areas of study and level of training. Reference programs that provide notable learner support (i.e.; pre- and post-travel support, student orientation and debrief, etc.).
Researchers (Medical Students): Institute for Global Orthopaedics and Traumatology (IGOT) supports a 1-year Research Fellowship (funded) for MS3/4. Fellow is incorporated into the Orthopaedic Trauma Institute (OTI) Clinical Research Center, which includes mentorship & access to projects spanning basic, translational & clinical research.
Residents: The Orthopaedic Department supports a 4-wk global elective resident rotation (funded) for PGY-4’s across 5 international sites. A formal required reading list for learners & access to audit either the UCSF Global Health Scholar or GHS MS intro courses would be beneficial to learners.
Interns/Other learners: IGOT annually accommodates interns (undergrad-MS1/2’s) for shorter-term projects but funding/HR limitations limit the expansion of these opportunities.
International Learners: in collaboration with national societies (AAOS & OTA) we support observerhsip scholarships (up to 1 month) where learners are weaved into our clinical didactics, research curriculum & training activites per their interests.
All of the above have informal orientations, pre/post program debrief. Adminitartive uspport to organize & catalog these opportunties, manage the logistics & measure impact is needed.
The UCSF Roatan Interprofessional Program’s pediatric clinic has had >35,000 patient-visits to date. The resident elective has hosted >100 residents (primarily pediatric, but also emergency and family medicine) from across the US, from Boston to Miami to Seattle to San Diego. The HEAL student internship developed out of partnership with Stanford; over 80 undergraduate/post-baccalaureate students have rotated have rotated through to date. Attending physician volunteers have numbered >120. With a goal of bilateral training, the Program initiated a Pediatric “fellowship” for local Honduran general practitioners. The 1-3yr “fellowship” has supported pediatric training in Roatan, with mentorship from our rotating volunteer attendings. Of 5 fellows to date, one is Medical Director of the Public Hospital Roatan and another is director at one of the island’s other four public health clinics. The fifth fellow, who received formal pediatric training in Honduras, is our current Roatan site director.
The Program has created a culture of continuing education. The Program brought internet to the Public Hospital and access to best-practices through UpToDate. Rotating residents and attendings often host case-conferences and formal lectures. The Program has sponsored focused training (e.g., ultrasound, NRP) for local providers, biomedical maintenance training, and island-wide trauma/disaster conferences.
Here is correct post for Multi-Learner Capacity:
The UCSF Roatan Inter-professional Program has grown from a pediatric clinic founded in 2003 (by UCSF faculty, plus the Public Hospital Roatan and Berkeley NGO Global Healing) to touch on perinatal care, OB, EM, family medicine, and surgery, as well as nursing, dentistry, and pharmacy related educational/clinical initiatives. The Program has hosted resident learners from multiple specialties, with >100 residents from across the US (largest groups UCSF, Children’s Hospital Oakland, Stanford). Our Health Education and Advocacy Liaisons (HEAL) internship has hosted >80 undergraduates (primarily Stanford). The Program has expanded to include Dentistry, Nursing, Pharmacy, and GHS, hosting in FY14 3 Pathways to Discovery students (SON), 5 Global Health Scholars (SOD/SOM/SOD/SOP), and our first GHS MS candidate. An established housing and orientation system facilitates learner travel and acclimatization—thereby maximizing clinical/project time. Current capacity: 3+ learners simultaneously. Non-stop air from Houston, and multiple connections to San Salvador and mainland Honduras. On-site internet access and VOIP with Bay Area phone number, together with a 2h time difference, simplifies communication with Bay Area leadership/administration. A designated Public Hospital Roatan faculty member works full time in the pediatric clinic as our local Program director; she serves as on-site liaison and mentor for our learners.
As a pediatric pharmacy resident last year through the SOP, I had the opportunity to collaborate with SOM & SON to complete a research project through the GHS Program at Public Hospital Roatan (PHR). The opportunity had expanded my clinical knowledge and enhanced my communication, research, and global health skills. In addition to working with the multidisciplinary team (UCSF Faculty), the PHR faculty member also provided guidance and assistance during our time conducting research at PHR.
One of the best things about the UCSF Roatan collaboration is the interprofessional nature. Last year's pharmacy residents were able to work with medicine and nursing; this year, the opportunity was dentistry. Each profession has something to teach and something to learn in this environment.
It has been a great opportunity to work in important interprofessional research and clinical interventions to improve health care service delivery for vulnerable infants and children from impoversihed families in Roatan. This unique faculty collaboration at UCSF has also supported collaboration between many students from nursing, medicine dentistry, pharmacy both at UCSF and in Roatan. As a School of Nursing faculty, our interprofessional faculty work in Roatan has also supported me to mentor eight Global Scholar nursing students to develop innovative nursing educational projects for nurses in Roatan.
The partnership of UCSF and Public Hospital Roatan has provided a unique experience for myself and other colleagues to work intimately with health professionals internationally. I am especially grateful for this experience in the opportunity it has provided to me to complete work for the global health scholars program in conjunction with a project planning class. It is a wonderful opportunity to collaborate with so many different faculty and classes in order to contribute to one goal.
This partnership is working to create a working knowledge base of pediatrics and emergency care through educational projects that have far reaching implications for the future both through immediate implementation and further education and training in the long run and for future students, faculty and hospital personel in public hospital Roatan.
I feel honored and very grateful to have been the first Global Health Sciences MS candidate to complete part of my Capstone Project with the UCSF Roatan Inter-Professional Program.
My duties with the program consisted of drafting a clinical research protocol, as well as conducting informal interviews with different medical staff members at the Public Hospital of Roatan. The goal was to gain an improved understanding of the major challenges involving dengue diagnosis and its management in resource-poor settings.
In addition to gaining experience with research and learning more about issues concerning global health, I also had the opportunity to shadow physicians and conduct educational talks with patients regarding HIV, dengue, and malaria prevention.
My experience with the program truly amplified my knowledge and passion for global health.
What is the cacpacity of your five international sites to accommodate learners from other disciplines: pharmacy, nursing for example?
Would it be beneficial to integrate these ortho placements with other placements? I'm thinking dental- reconstuctive? Pharm? nursing? There is an intrinsic support and team building aspect to that type of placement. There is a push amoung many at UCSF to develop supportive & rehab development placements. That seems like a great overlapping way to place trainees...
IGOT has been very successful in its international learner program and I am thrilled that you are now taking the program to the learners. In particular, the emphasis on research for best implementation in specific settings, with a follow-thru in grant writing and submission is an outstanding model for international scholars. It strikes me as similar to Eva Harris' SSI program. Definitely a model in fostering sustained capacity in the sites we impact.
In the 5 international sites that you most heavily impact, are you doing any combined placements? team or multi-discipline?
The UCSF Roatan project provides a unique place to graduate and predoctoral dental students to interdisplinary learning and research projects that incorporating oral health as a part of the global health of children. These projects brought a whole new field of learning opportunities and open the eyes of students and faculty for novel models to promote oral health in underserved community and countries. The oral health project in Roatan started with a close collaboration between a pediatric dental resident with pediatric resident involving crossing training and research designing and close collaboration between faculties in SOD, SOM and public health in UC Berkley. Currently, we have had 3 pediatric dental residents and 3 predoctoral dental students, 1 pediatric resident, 1 pharmacy resident, 1 global health resident and 1 premedical students involved in the oral health project with mentors from all 4 schools within UCSF and mentors from UC Berkley. These projects has provide them the opportunity to learn and work with students, faculty and local health providers and administrators on different aspects that are needed to build a sustainable interdisplinary oral health program. They work as a team and start from assessing local oral health condition needs; assessing the outcomes of the program on children’s dental caries, nutrition, and parental oral-health literacy; evaluating program feasibility, coverage, best practices, and implementation barriers; and working with other medical professions to build a sustainable interdisplinary oral health program that can be used as a model globally to improve oral health for children in underserved area or countries. As a faculty in School of Dentistry, I am very excited to be included in this group. The strong bond and trust of the Roatan project and its unique location and population can serve as a unique place to build novel interdisplinary health models that can be scaled up globally.
Helpful description - Thanks!
I'm interested in the UCSF-UCB collaborative aspect. Are your learners from Berkeley also UCSF affiliates (thru a joint program?) I am aware that you also accomadte undergrads- is that done through an independent NGO? Child Family Health International? or UC Study Abroad? My sense is that developing tighter relationships with GH workes on the East Bay is a good thing, and that seems to be a strength in this program. What advice would you give to other UCSF GH programs about cross-bay collaborations?
The UCSF Roatan project provides a unique place to graduate and predoctoral dental students to interdisplinary learning and research projects that incorporating oral health as a part of the global health of children. These projects brought a whole new field of learning opportunities and open the eyes of students and faculty for novel models to promote oral health in underserved community and countries. The oral health project in Roatan started with a close collaboration between a pediatric dental resident with pediatric resident involving crossing training and research designing and close collaboration between faculties in SOD, SOM and public health in UC Berkley.
Up to date, we have had 3 pediatric dental residents and 3 predoctoral dental students, 1 pediatric resident, 1 pharmacy resident, 1 global health resident and 1 premedical students involved in the oral health project with mentors from all 4 schools within UCSF and mentors from UC Berkley.They have received 5 campus and regional funding for their research projects, presented their projects in 6 campus wide, 3 regeinal, 5 national conferences and 1 international conferences, and won research 8 awards from UCSF SOD Research and Clinic Excellence Day (3), California Society of Pediatric Dentistry and American Association of Pediatric Dentistry.
These projects has provide them the opportunity to learn and work with students, faculty and local health providers and administrators on different aspects that are needed to build a sustainable interdisplinary oral health program. They work as a team and start from assessing local oral health condition needs; assessing the outcomes of the program on children’s dental caries, nutrition, and parental oral-health literacy; evaluating program feasibility, coverage, best practices, and implementation barriers; and working with other medical professions to build a sustainable interdisplinary oral health program that can be used as a model globally to improve oral health for children in underserved area or countries.
As a faculty in School of Dentistry, I am very excited to be included in this group. The strong bond and trust of the Roatan project and its unique location and population can serve as a unique place to build novel interdisplinary health models that can be scaled up globally.
Hi Ling! So excited to see dentistry represented! What other programs have you done dental placements with? I think that would help this conversation a lot- knowing where placements are happening. Are you only placing thru NGO's? Did Roatan help you with that aspect? I remember Chris stuart used to have a very robust "team placement" program. Does anyone know if that is slated to be re-surrected?
We have had an outstanding experience with both IGOT and with Roatan. Masters studens, medical students, nursing students, pharmacy students and residents in the programs with which I have been involved have universally commented on the strength of the multi-learner capacity of these programs. In addition, all of them have been struck by the interprofessional mentors.
The Student Training Education Program (STEP) is based out of the Family AIDS Care and Education Services (FACES) program in western Kenya and has hosted more than 100 UCSF learners in both clinical and research capacities since its inception nine years ago. Participants in STEP were affiliated with the following UCSF schools: School of Medicine (MS1, MS3, MS4), Nursing, Pharmacy, Global Health Masters, PhD programs, and Internal Medicine, Pediatrics and Ob/Gyn Residents. STEP also allows medical students and residents at other institutions to participate. From 2006 to 2014, staff at UCSF supported the participants by conducting pre-travel orientations, arranging for arrival and transition to Kenya, and holding feedback meetings upon return. As of June 2014, there is now a Research and Training Coordinator in Kenya assigned to coordinate STEP. The creation of this position has improved the program by providing full-time support to participants and address any issues more comprehensively.
Thanks for the description - very impressive multi-level and and multi-disciplinary capacity.
I am aware that the FACES program addresses HIV, maternal health, and the efficiencies around integrated family care. It seems that most of your trainees work semi- independently when they are on site? This would make sense, as I believe the FACES program has 300+ clinical sites. And that makes the presence of a FACES trainee-coordinator very important. With 10 learners per year, are they typically working in parallel projects? How long are their placements? Do other UCSF trainees based in Kenya and Uganda have access to the Research and Training Coordinator in Kenya?
Trainees conducting clinical electives work under supervision (although the amount of supervision depends on their level of training), and those doing research electives have a U.S. and/or Kenyan mentor they are working with. We actually have averaged about 25 learners per year, but many are from outside UCSF. Placements range from a minimum of 4 weeks (resident clinical electives) to several months, depending on the trainee's program/availability/interest. The Research and Training Coordinator position is specific to Kenya, and supports trainees that are in some way affiliated with FACES.
GPAS – Global Partners in Anesthesia & Surgery (www.globalsurgery.org)
The GPAS collaboration in Uganda has facilitated educational experiences for residents and medical students from a variety of disciplines including general surgery, anesthesia and obstetrics & gynecology. This initaitive has primarily focused on srengthening the learning capacity for our Ugandan trainees, though we have also found numerous opportunities for synergistic learning with non-Ugandan trainees. Most trainees who have participated with our program are from UCSF, though trainees from Stanford, University of British Columbia, and the University of Washington have also participated.
UCSF current collaboration with Makerere University (MU) in Uganda started studying malaria in 1998 and today, also includes research in the areas of TB, HIV, pulmonary disease, non-communicable diseases, immunology, parasite and drug resistance with over 20 collaborating principal investigators (www.muucsf.org). The goals of this collaboration are: 1) conduct high-quality research in infectious diseases; 2) build capacity through training; and 3) strengthen infrastructure to help integrate research into policy by linking researchers and policy makers. Infectious Diseases Research Collaboration (IDRC), an NGO, formed in May 2008 with the support of MU-UCSF collaborating investigators and founder members of Ugandan health scientists from MU and Ministry of Health (www.idrc-uganda.org). A Collaboration Executive Committee was formed in 2008 with members from MU, UCSF, IDRC, and LSHTM to direct and monitor goals for the scientific direction of the research collaboration. To date the collaboration accomplishments include: malaria and TB surveillance of over 750,000 patients throughout Uganda; enrolling ~230,000 persons in research studies; contribution of 250-300 publications; carrying out annual MOH dissemination meetings on malaria and HIV findings to policy makers; maintaining 2 high functioning research laboratories in Kampala and Tororo; and support for internal and external training programs and research symposiums for U.S. and Uganda students. Trainees apply through collaboration investigator mentors and receive support for orientation in person and 20-page visitors manual, in-country logistics, and medical/emergency assistance protocols.
Center for Global Surgical Studies (CGSS)
UCSF learners have the opportunity to play a role in any of our ongoing research projects at any given time. Because of our strong collaboration and relationships with in-country partners, we are able to accommodate the interests, needs, and schedules of learners at various levels of training, including first- to fourth-year medical students, residents, fellows, master’s candidates, and doctorate-level candidates.
For each project, our research team provides guidance and research support to our learners across the continuum of the research process, supporting proposal development, study design, data analyses, conference preparation, and manuscript preparation. In the event of travel to new sites, we provide orientation materials based on information from past experience at these locations and from local partners, concluding with a debriefing upon return.
CGSS also logistically and administratively supports transportation and accommodation arrangements according to past experience at study sites and with the support of in-country partners. In this way, CGSS has the capacity to support a wide range of levels of training for international public health research focused on issues related to global surgery.
GAIA, discussed in greater detail under the topic of Strength of Infrastructure has multi-learner capacity that supports all types of graduate and professional degree students. For example, a pharmacy faculty member conducted a NIH-funded project on traditional healers in Malawi,masters level nursing students have completed Clinical Scholars projects, and doctoral students in nursing have gathered data for dissertations. Some of GHS students have been health care professionals and others have been representative of other disciplines.
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IGOT's Global Knowledge
IGOT's Global Knowledge Exchange Program has historically been focused on the Reisdent Global Elective but has expanded to include bilateral exchange, research fellowship & observerships.
The logistics & organizational infrastructure needed to manage these programs are significant & limitations in funding, housing & administrative support limit growth. The University requirments for clinical observership are significant & prevent offering more robust clinical experience for our partners.
IGOT has been successful in focusing on research capacity building in-country along with GPAS/U-STOP to support research fundamentals to help our partners answer their own questions & encourage academic collaboration. This is a strength of UCSF & an area where as a collective we can build upon. This expertise combined with on open-source portal for communication (posting of clinical case consultation, review of documents, registry/data share & education/lectures/videos) is a low risk meaningful tool that would greatly enhance our efforts.
Over the past 12 years, the
Over the past 12 years, the Roatan Program has developed great trust with the island population in general, as well as local medical and political leadership, and has developed a growing relationship with national governmental leadership. Beginning in 2005, the Program has sponsored a local Pediatric “Fellowship” to train Honduran general practitioners in Pediatrics (1-3 years/fellow; 5 fellows to date); graduates include the current Medical Director of the Public Hospital Roatan Raymond Cherington; Medical Director of the Flowers Bay public health clinic Charles Welcome; and current clinic physician and Program Site Director Karla Cerritos. Together with Dr. Omar Brito (MoH Bay Islands Director), they all continue to advocate for growth in the UCSF partnership, including expansion of training and research. Drs. Cherington and Fermin Lopez (MoH representative from Roatan) attended our first UCSF Roatan Symposium, at Mission Bay in November 2014. They were joined by the Universidad Tecnologica de Honduras’ (UTH) Academic Chancellor Javier Mejia; UTH has recently opened a campus in Roatan and is eager to collaborate with UCSF on research and education, with a goal of improving technological support of local medical care. The Program has additional relationships with the Honduran Red Cross and the National Autonomous University.
Very nice video about the
Very nice video about the Roatan collaboration here.
IGOT and the Roatan
IGOT and the Roatan collaboration have done an excellent job with this. I think GPAS has also made strong efforst in this direction. I look forward to hearing about more programs that have been successful at this as it remains a weakness in general here at UCSF.
As the Student Training
As the Student Training Education Program has grown in size and gained in reputation in western Kenya, the question of whether there is an ability for Kenyan learners to visit UCSF for work has continually been raised. Kenyans currently involved in the program are able to work in the clinical sites in the same manner as UCSF participants; however, the loss of subsidized housing for the duration of the elective (1-3 months) has made it difficult for Kenyans to participate in the program in similar numbers. Thus, although the program was founded as a partnership with University of Nairobi, UCSF, and University of British Columbia, the equity of ability to participate could be improved – especially since UCSF offers its medical students research grants.
Do you mean that the loss of
Do you mean that the loss of housing in Kenya has impacted the ability of Kenyans to participate in clinical sites in Kenya? or the loss of housing in US has impacted Kenyans access in the US? Housing costs are one of the main barriers here and abroad! Has having an in-country co-ordinator in Kenya helped generate efficiencies on that front?
We were referring to the loss
We were referring to the loss of housing in Kenya impacting the ability of Kenyans to participate in clinical sites in Kenya. We used to have subsidized flats in every district, and Kenyan participants were usually allowed to stay in these free-of-charge. However, since the flats were often empty and our program was losing significant money on them, we did not continue to lease flats in some of the districts. There are still a lot of other housing options at a very economical cost for U.S. trainees, but a prohibitive cost for Kenyan students. The in-country coordinator has helped as far as researching and updating housing options, communicating with trainees about them, and coordinating reservations.
Given that the lack of
Given that the lack of housing for visitors and the general cost of living in the Bay Area are such significant barriers, at an entirely practical level, to hosting visitors from our partner sites, what do you think about trying to set up a limited 'home stay' program whereby faculty members who live in San Francisco or close enough to have a reasonable commute by public transportation would host a visitor for a month or two? Crazy?
That sounds like a nice idea!
That sounds like a nice idea! Although we do occasionally have a Kenyan colleague spend some time at UCSF meeting with people, working on papers, giving presentations, etc. (i.e. in particular those who receive CFAR RAP grants), it has been several years since we have had anyone come to participate in clinical training of any sort. There is apparently a desire by Kenyan learners to do this, but to date we have not had much discussion on the feasibility of this.
The SON Global Health Nursing
The SON Global Health Nursing Fellowship was designed and launched in 2014 in partnership with the international non-profit Partners In Health (PIH), at one rural hospital in Haiti. The program's dual aims are to provide experience in global health competencies for UCSF-graduate Nursing Fellows, and to establish new professional development opportunities for Haitian nurse colleagues. The UCSF-PIH partnership aligns with the PIH model to emphasize local staff capacity building. Through the Fellowship, UCSF SON provides academic support in the development of the newly established PIH Center for Nursing Excellence, which empowers nurse leaders and builds on their role as advocate, both on the levels of the patient and the Haitian health system.
In its pilot year (2014-2015), both partners have learned:
1. UCSF Fellows can provide a new, unique influence at the hospital in Hinche, Haiti, by maintaining focused, continuous attention on professional development in nursing:
2. The importance of encouraging flexible expectations for and by the Nursing Fellows:
Evaluation results and deliverables will serve to enhance both future global health education programs at the SON, as well as provide PIH Haiti with data and information to inform their ongoing nurse education initiatives.
Fantasic overview of the
Fantasic overview of the program in its pilot year. Are there any synergies in place with the UCSF hospitalists and the HEAL initiative? I know they are active in Haiti, and wonder if there are plans to foster team placements? Am particularly impessed that planned evaluations are in place.
In addition to Teresa's
In addition to Teresa's question, I'd be interested in knowing whether you think there is any potential to expand your model to other health professions? I appreciate that your program is built around strengthening nursing skills and, more broadly, contributing to the formation of professional identity in young Haitian nurses but it wold be great to explore the implicatiosn of what you are doing for the other health professions.
Greater Bay Area Family
Greater Bay Area Family Medicine Global Exchange
In 2009, the Aga Khan University (AKU) and UCSF committed to a long-term partnership and in 2012, AKU and UCSF signed an affiliation agreement that defines the special working relationship between the two universities. Twelve UCSF and UCSF-affiliated faculty and learners have visited AKU, and have engaged in primary care research activities, and a wide range of inpatient and outpatient clinical activities.
In the spirit of reciprocity, three AKU third year family medicine residents will visit UCSF, UCSF-affiliated Contra Costa County Hospital and Stanford to learn about primary care delivery models, research in primary care, family medicine procedures such as bedside ultrasounds, and family medicine education and faculty development in June.
AKU residents will have sessions with faculty of the UCSF Center for Excellence in Primary Care and SFGH Family Medicine Residency program. At Contra Costa, they will observe clinical activities in the hospital, enroll in an NALS course, and participate in the bedside ultrasound course. At Stanford they will tour the simulated patient lab, Center for Primary Care Research, the surgery simulation center, and learn about directly observed clinical assessments.
Hi Megan- I was really
Hi Megan- I was really interested to hear an update on the AKU affiliation! I know that the affiliation was with the AKU in Tanzania, are the planned visitors Tanzanians? Or Pakistani? There was some plan to develop a second AKU in northern Tanzania. Is that still happening, and is there a mechanism being put in place for UCSF to be part of that capacity building piece?
Thanks Teresa for your
Thanks Teresa for your comments! UCSF has an affiliation agreement with Aga Khan University East Africa. AKU East Africa family medicine residency program was established in 2012 with strong support from AKU family medicine programs in both Dar Es Salaam and Karachi, and UCSF. The AKU undergraduate joint nursing and medical school will open in 2016 at the Nairobi campus with a possible longterm plan of colocating with the planned liberal arts university in Arusha TZ (northern TZ) in the future. AKU has involvement with UCSF in a stem cell program, development of population health sciences, PTBi, and family medicine global exchange. There are several potential educational and research opportunities for UCSF learners as a result. Elisabeth Wilson and Norm Hearst are the main contact persons at UCSF.
Hi Megan, Thanks for this
Hi Megan,
Thanks for this contribution. How long are the AKU residents in the Bay Area and how have you dealt with housing and cost of living in general?
although this comment is not
although this comment is not specifically about a program, what about a university-owned house in San Francisco to house visiting scholars and global health partners for relatively short-term stints? Often sites have housing for such collaboration/trainings and it would seem a good use of university money plus give our visitors a sense of our committment to them. Am I wildly dreaming here?
It's dream many share, Kim!
It's dream many share, Kim!
Center for Global Surgical
Center for Global Surgical Studies (CGSS)
The Kampala Advanced Trauma Training, co-taught with GPAS and local partners, allows for the exchange of specialty-specific knowledge and context expertise for the appropriate training of medical interns.
The building of surgical and trauma surveillance systems in Soroti, Uganda and nationally across Cameroon provides a tool to use towards increasing surgical care capacity through the generation of evidence for efficient resource allocation as well as providing greater understanding of patterns of injury and surgical disease for effective policy development and prevention efforts. Through these projects, UCSF learners gain valuable, hands-on experience in public health research methods, while local partners have the increased technical capacity to build surveillance systems that are sustainable and context-appropriate.
This concept of reciprocity
This concept of reciprocity is an important one, but one where I don't think we are doing all that well at UCSF. That is, we are sending many of our trainees abroad for international experiences, but I believe we are only seeing only a trickle of international students here at UCSF. In many instances, we may not be able to establish full trust between UCSF and international partners until the international partners see more opportunities for their trainees to get the same world class training that the UCSF scholars get. That we have no formal short-term housing on-campus (or close to on-campus) housing available for visiting international scholars is all one needs to know about how many visiting scholars are coming here.
I agree completely with the
I agree completely with the sentiment that there should be increased effort to build opportunities and infrastructure to host international trainees.
In the shorter term, while the ability to host international learners is so constrained, there might be a greater return from hosting a relatively smaller number of more advanced learners (e.g. junior or midcareer academics), who could benefit from enhancing their skills in grantwriting or program development and who could then use those skills to build capacity at their home institutions.
Another effort that would benefit our colleagues in all parts of the world would be to place more training content online. It's no match for face-to-face, hands-on interaction, but there are many topics that would be amenable to online, self-paced teaching. UCSF could be an online learning hub. I know the SOD Coursera course on caries management from Dean Featherstone attracts enrollees worldwide.
I'm sure there are other good examples.