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Integrating a Novel Global Surgery and Health Inequity Course to the Surgical Clerkship

Abstract:

Objective: Medical students report growing interest in health inequity and global surgery, subjects not currently integrated to their core curriculum. Currently, fundamental tenets of global surgical inequity are only available to students on an elective basis or in special interest groups. Therefore, an hour-long course with emphasis on global surgery was developed for third-year medical students. The aim of this study was to examine student response to this pilot course and to establish whether course content was applicable to clinical rotations. Design: A 1-hour structured curriculum was delivered to third-year medical students (MS3s) during the 2-day orientation phase of each rotation of an 8-week surgery clerkship from August 2018 to May 2019. The course targeted approximately 30 students per session in the preclinical orientation at Rutgers—New Jersey Medical School. Upon completion of the 8-week clerkship rotation, a paper survey was administered to evaluate student's exposure to previous content, attitudes toward global health, interest and engagement in course materials, and applicability of learned course content to local environments. Setting: Rutgers—New Jersey Medical School, an urban medical school located in Newark, New Jersey. Participants: A total of 191 students attended the global surgery and health equity course; 146 participants participated in the postcourse survey. Results: When asked about baseline interest in global or public health, the majority (51%) were extremely interested or very interested. Nearly all participants found the course to be valuable (94%). When asked which educational modality was preferred, 23% of participants favored the traditional lecture component and 29% favored case-based discussions. Nearly half (48%) the respondents found both modalities to be valuable. Fifty students (34% of respondents) reported encounters with patients affected by barriers in access to surgical care during their clerkships. Conclusions: Medical students responded favorably to this health inequity and global surgery pilot course and requested supplemental lectures. Additionally, course content was applicable to local clinical experiences. Therefore, 1 modality of integrating global surgery to the established curriculum is under the framework of health inequity and social determinants of health during surgical clerkships. This study demonstrates that meaningful inclusion of global surgery and health inequity can be implemented within the existing curricular structure.