Fit for the future? The place of global health in the UK's postgraduate medical training: a review

Hall, JA; Brown, CS; Pettigrew, L; Malik, ANJ; Watson, J; Topiwala, A; McGregor, L; Ramsay, R

Undergraduate training is adapting, with special study modules and intercalated Bachelor of Science degrees in international or global health having been available for more than a decade. 5 The updated General Medical Council guidelines for undergraduate medical training 'Tomorrow's Doctors' include the learning outcome: 'Discuss from a global perspective the determinants of health and disease and variations in health-care delivery and medical practice' 6 and global health learning outcomes for all UK medical students have recently been developed. 7, 8 This is welcome progress but, without a similar shift in postgraduate training, is not sufficient. Indeed Martineau et al.'s analysis of the career paths of early graduates of intercalated international health BScs concludes that 'the successful establishment of global health education at an undergraduate level must now be replicated in postgraduate training to follow this generation as they progress'. 9 There is high-level recognition of the need for and benefits of the NHS adopting a global health approach, 10,13 including a House of Lords debate led by Lord Crisp. 14 Several Royal Colleges have responded with conferences, 15 -17 position statements 18 or strategies. 19, 20 Despite this, the coverage of global health within UK postgraduate medical curricula has not been systematically assessed. This article presents a review of the current global health content of a cross-section of postgraduate medical curricula in the UK. The global health content of the curricula described in Table 1 was established by examining the competencies within them. For several curricula this was done by more than one person and discussed to achieve consensus. The competencies were coded as 'UK' (statement only relevant to UK work, often referring to UK institutions or structures), 'global' (statement with an explicit reference to aspects of health outside the UK such as the global burden of disease or organizations involved in international health-care issues) or generic (relevant both to the UK and international settings). This built on work previously conducted and published on the Faculty of Public Health's (FPH) curriculum; the results presented here for the FPH curriculum are from this previous work. 22