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Global Health Area of Concentration

The Cone Health Family Medicine Area of Concentration (AOC) in Global Health has been developed in recognition of the increasing cultural and linguistic diversity of peoples in the United States, facilitated ease of both persons and transmissible diseases across borders, and the increasing “double burden” of noncommunicable and communicable diseases in both developed and developing nations. 

Family physicians, whether working abroad or in under-served areas of the United States, are often called upon to care for people of vastly different backgrounds.  Furthermore, rising interest in global health among medical students and residents requires family medicine residencies to be cognizant of greater changes in health care across the globe and design curricula to address these changes.  

PhillipinesWith this in mind, the Global Health AOC is a longitudinal track targeted at second and third year family medicine residents. The AOC curriculum is flexible and can be designed to meet the needs and interests of the individual.  Residents participating in this track will develop an understanding of the broader issues within global health, while also having the opportunity to focus on specific areas such as population health, health advocacy, global health policy, developing procedural skills, maternal/child health, infectious disease, travel medicine, global health leadership, and conservation medicine.  Residents will choose from among these diverse disciplines to create a set of goals tailored to their career and personal interests.  Those who complete this course will receive a Certification of Completion in Global Health upon graduation. 

Global Sites

Faculty from Cone Family Medicine have worked closely with the private, non-profit non-governmental organization Shoulder to Shoulder (http://shouldertoshoulder.org/) for the past 15 years.  Year after year, residents and faculty have returned to Intibuca, a remote and rural district located in the mountainous region of southwestern Honduras to care for the residents living there.  Prior elective resident rotations have included Kiwoko Hospital in Uganda, Bwindi Community Hospital in Uganda and rotation sites in Costa Rica. 

 Goals of the AOC

  • To develop the knowledge and skills to provide care to international patients both abroad and in the US
  • Attendance in weekly Refugee and Immigrant Clinic
  • Participation in the quarterly noon conference Global Health Series.  Residents will present at least one of these lectures in their second or third year.
  • Specific learning areas include:
    • Developing a global perspective on diseases and the burden of care needs.
    • Completion of a longitudinal Scholarly Project.  See below for details.
    • Assessing the health care needs of both individual patients as well as the greater population.
    • Appreciating the factors limiting nations' medical care systems.
    • Cultivating an appreciation of the stresses resulting from immigration into the United States.
    • Developing skills for working effectively with interpreters.
    • Demonstrating competence in effective communication with patients, taking into account issues of health literacy and patients' cultural viewpoints.
    • Gaining an appreciation of the social, environmental and political determinants of disease and health equity, and how these factors impact health equity and social justice.
    • Improved foreign language proficiency, if desired. 

Time Commitment

  • Two to four months of elective time, preferably one in the second year with the remainder during the third. At least one month will include time spent in a global health elective rotation. 

Curriculum

Global Area of Concentration(Flexibility exists in structuring activities.) 

Sample Second Year Global Health Elective Month:  Meet with Dr. Walden at the beginning of the Second Year to discuss your longitudinal goals for the Area of Concentration.

  • Attend Immigrant and Refugee Clinic – Monday afternoons.
  • Assist in preparations for Honduras brigade - one day.
  • Participate in Honduras medical brigade - 7 - 14 days.
  • FPC continuity clinic - five half-days per week. 

Sample Third-Year Elective Month

  • Assist in preparations for Honduras brigade - three days.
  • Prepare research study for Honduras trip - three days.
  • Team leader for Honduras medical brigade - 7 - 14 days.
  • Present a noon conference on a topic in Global Health - one day.
  • FPC continuity clinic - five to eight half-days per week. 

Longitudinal Opportunities

  • Provide medical care for families from at least five disparate language and cultural backgrounds.
  • Participate in quarterly Global Health discussion groups
  • Attend and present poster at an international health meeting (e.g. CUGH, AAFP Global Health Workshop).

 

Scholarly Project

An integral component of the Global Health AOC is the development of a longitudinal scholarly project focusing on a relevant area in global health.  This Scholarly Project can be designed to complement the international clinical experience.  Topics can include:

  • Care of refugee and immigrant populations
  • Systematic reviews of current topics in global health
  • Designing a research project to be completed at an international rotation site
  • Quality improvement projects, either at FMC clinic or abroad
  • Health advocacy and policy papers
  • Medical humanism, with emphasis on global health

The scholarly project is not required to be published in a journal or off-site conference, though this is strongly encouraged. 

Refugee and Immigrant Clinic

In an effort to increase access to care among recently arrived residents to Guilford County, Cone Family Medicine started a Refugee and Immigrant Health Clinic in December of 2014.  The goals of the clinic are twofold:  to increase access to care for these underserved patients while also providing education to residents and medical students on the medical, psychological and social needs of refugees and immigrants.  


County Resettlement for Refugees GraphGuilford County resettles approximately 600 – 650 refugees each year, with an increase to 815 refugees in FY2014.  The majority of these refugees are resettled in the greater Greensboro area, and for the past several years have been primarily from Iraq, the Democratic Republic of Congo, Bhutan and Burma.  

Residents are required to rotate through the Refugee and Immigrant Clinic during their Community Medicine month, which is two weeks during the second year and four weeks during their third year.  Residents are also able to spend more time in this clinic during elective time.  

This clinic serves as an educational opportunity, with time set aside to obtain the often complicated histories of these patients.  We also work closely with the local volunteer resettlement agencies as well as the Center for New North Carolinians to provide care for our patients.  We are fortunate to have in-person interpretation for the majority of languages in our clinic.  

The clinic serves as an introduction for residents to the refugee and immigrant process.  Other important goals are learning aspects unique to the medical and psychological care of recently arrived persons while also teaching the fundamentals of cultural competency, cross-cultural medicine and working with interpreters.  

Click here to read more about a Syrian refugee family who relocated to Greensboro. 

For more information about our clinic, please contact Jeff Walden at jeff.walden@conehealth.com  

 

Certificate of Completion

Upon completion of two-year track

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