Training Canada's next generation of global health leaders

In January 2010, a massive earthquake killed or injured hundreds of thousands of Haitians. Health professionals from around the world rushed to Haiti to help save lives and treat the injured and suffering.

Sadly, many of the medical staff couldn’t give Haitians the care they needed. Some watched helplessly as patients died — all because they didn’t have the knowledge or skills to treat conditions that are common in developing countries but rare in wealthier ones.

Some of the volunteers went home feeling they may have done more harm than good, by arriving without global health training and taking up valuable resources. It was a painful lesson for those eager to help.

It was also a valuable lesson for the young doctors enrolled in the University of Toronto’s Global Health Education Initiative (GHEI). The residents and fellows in the program learned about what didn’t work well in Haiti from experts who were there or who have studied the world’s response to the crisis.

These trainees will become Canada’s next generation of global health leaders, equipped to work in low-resource contexts and meet the needs of vulnerable patients at home and around the world.

“The curriculum challenges your conceptions of global health,” says Alexander Caudarella, a second-year family medicine resident who entered the GHEI program two years ago. “You come in wanting to change the world, but then you see the struggles of the people trying to do it. It’s complicated, and you need a well-prepared team.”

Caudarella was one of 175 postgraduate trainees, many of them GHEI students, who took part in a graduation ceremony May 27 at the first annual Postgraduate Medical Education Global Health Day. The event featured talks from experts — many of whom teach in the GHEI program — and offered residents and fellows a chance to think about how they might apply their medical specialties in the broad field of global health.

“For GHEI graduates, Global Health Day is the culmination of years of interest, practice and education in global health. For many others it’s a beginning — introducing new concepts, problems and perspectives,” says Professor Barry Pakes, the program’s director and global health lead for Postgraduate Medical Education.

The GHEI program brings together trainees in over two dozen specialties to explore the ethical, social and medical challenges of global health. More than 60 instructors from faculties including Medicine, Law and the Dalla Lana School of Public Health deliver the curriculum, which is about 100 hours. The classes are small and run in the evening, so students can pursue their core medical training through the day.

Pakes and program administrators consulted more than 70 experts and got input from 500 residents and fellows when designing the program, and they survey students before and after each class in ongoing program evaluations. The program, now in its fifth year, has almost 100 graduates.

Sarah Khan is a GHEI graduate, and she helped coordinate the Global Health Day. While at McMaster University for her paediatric residency, she commuted from Hamilton for the first part of the GHEI program, and finished the curriculum as a fellow in paediatric infectious disease at U of T.

She says the GHEI’s breadth and flexible format are unique in Canada, and that the program changed her path in global health.

“When I came to U of T, I was focused on becoming a global health clinician-educator. But in learning from many GHEI experts, I’ve realized that to roll out an evidence-based, innovative, global health intervention, you need the research to back it up,” says Khan.

This fall, Khan will start a master’s degree in health research methodology and a research fellowship at U of T. She’ll investigate evidence-based infant feeding strategies to prevent mother-to-child transmission of HIV in Canada and other developed countries, and in lower-resource settings. 

Jim Oldfield is a writer with the Faculty of Medicine at the University of Toronto.