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January 14, 2014; 82 (2) Article

International electives in neurology training

A survey of US and Canadian program directors

Jennifer L. Lyons, Mary E. Coleman, John W. Engstrom, Farrah J. Mateen
First published December 6, 2013, DOI: https://doi.org/10.1212/WNL.0000000000000019
Jennifer L. Lyons
From the Department of Neurology (J.L.L.), Brigham and Women's Hospital, Boston, MA; the American Academy of Neurology (M.E.C.), Minneapolis, MN; the Department of Neurology (J.W.E.), University of California at San Francisco; the Department of Neurology (F.J.M.), Massachusetts General Hospital, Boston; and the Department of International Health (F.J.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Mary E. Coleman
From the Department of Neurology (J.L.L.), Brigham and Women's Hospital, Boston, MA; the American Academy of Neurology (M.E.C.), Minneapolis, MN; the Department of Neurology (J.W.E.), University of California at San Francisco; the Department of Neurology (F.J.M.), Massachusetts General Hospital, Boston; and the Department of International Health (F.J.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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John W. Engstrom
From the Department of Neurology (J.L.L.), Brigham and Women's Hospital, Boston, MA; the American Academy of Neurology (M.E.C.), Minneapolis, MN; the Department of Neurology (J.W.E.), University of California at San Francisco; the Department of Neurology (F.J.M.), Massachusetts General Hospital, Boston; and the Department of International Health (F.J.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Farrah J. Mateen
From the Department of Neurology (J.L.L.), Brigham and Women's Hospital, Boston, MA; the American Academy of Neurology (M.E.C.), Minneapolis, MN; the Department of Neurology (J.W.E.), University of California at San Francisco; the Department of Neurology (F.J.M.), Massachusetts General Hospital, Boston; and the Department of International Health (F.J.M.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Citation
International electives in neurology training
A survey of US and Canadian program directors
Jennifer L. Lyons, Mary E. Coleman, John W. Engstrom, Farrah J. Mateen
Neurology Jan 2014, 82 (2) 119-125; DOI: 10.1212/WNL.0000000000000019

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Abstract

Objective: To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs.

Background: There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown.

Methods: A survey was distributed to all program directors in the United States and Canada (December 2012–February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives.

Results: Approximately half of responding programs (53%) allow residents to pursue global health–related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%–9% of residents (55% of programs) and 10%–19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives.

Conclusions: In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority of Canadian programs that responded allow international electives, likely due to clearer guidelines from the Royal College of Physicians and Surgeons of Canada compared to the Accreditation Council of Graduate Medical Education. However, the number of both Canadian and US neurology trainees venturing abroad remains a minority. Most program directors are interested in learning more information related to global health electives for neurology residents.

GLOSSARY

AAN=
American Academy of Neurology;
ACGME=
Accreditation Council for Graduate Medical Education;
GME=
graduate medical education;
LMIC=
low- and middle-income countries;
RCPSC=
Royal College of Physicians and Surgeons of Canada

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 100

  • Supplemental data at www.neurology.org

  • Received May 17, 2013.
  • Accepted in final form August 23, 2013.
  • © 2014 American Academy of Neurology
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Letters: Rapid online correspondence

  • Reply to Dr. Sethi
    • Farrah Mateen, Department of Neurology, Massachusetts General Hospital, Boston, xFMATEEN@PARTNERS.ORG
    • Lyons JL, Coleman ME, Engstrom ME
    Submitted February 04, 2014
  • International electives in neurology training-it is money well spent
    • Nitin K. Sethi, Assistant Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center 525 East 68th Street, New York, NY 1006sethinitinmd@hotmail.com
    • Nitin K Sethi, New York, NY
    Submitted January 28, 2014
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