Abstract
Medical schools and colleges of medicine are increasingly highlighting the role of short-term outward mobility programs in the form of International Medical Experiences (IMEs). In this way, doctors acquire skills as they study or work outside their countries of training. Although many benefits have been reported about the role of these IMEs in staff development, few studies have linked these with national workforce strategies, national economic and diplomatic strategies. This chapter fills that gap by arguing how these IMEs can be used to meet New Zealand workforce challenges such as the emigration of this country's doctors, as well as national economic and diplomatic agendas of increasing trade with Asian countries. This chapter concludes by challenging key stakeholders of these experiences to increase support through a range of strategies: IME recognition in accreditation programs; policy action; student resourcefulness; and multi-stakeholder involvement in funding and promotion of IMEs.
TopIntroduction
Medical schools and colleges of medicine are increasingly highlighting the role of short-term outward mobility for study and work placements in the development and acquisition of skills for life and work (Drain, Holmes, Skeff, Hall, & Gardner, 2009; Godkin & Savageau, 2003). Globalisation of diseases such as the 2014 Ebola outbreak in West Africa and international emergencies such as earthquakes and tsunamis are some of the factors that are currently contributing to the importance of IMEs (Kerridge & Gilbert, 2014; Wilson, Baker, Crampton, & Mansoor, 2005). Both undergraduate medical students and trained medical professionals yearn for these international medical experiences (IMEs) as they prepare them for diverse work settings and improve their clinical skills (Macfarlane, Jacobs, & Kaaya, 2008).
Further, global skills are becoming important in New Zealand where diversity is brought about by the presence of immigrants from other HICs as well as low- and middle-income countries (LICs)/(MICs) (Cha, McCool, & Bagg, 2013). This chapter proposes short-term mobility programs in the form of IMEs for both undergraduates and practicing doctors as a training and retention strategy and as a means of responding to career aspirations and lifestyle travel opportunities of doctors. This chapter also considers IMEs as strategies for linking medical training with government economic and political agendas.
IMEs discussed in this work relate to both student exchange programs and work placements for doctors who are doing in-service training such as residencies or other continued professional development activities (Russell, 2013). For university students these programs include short-term student exchange or study abroad programs and are generally defined as programs that allow enrolled students in a source country to undertake study in a foreign (destination) country for a relatively short period, and cross-credit the content studied (Doyle et al., 2010; Llewellyn‐Smith & McCabe, 2008). Such programs are usually for a semester or a year but in other programs such as in the medicine curriculum (medical electives) they tend to be 2-8 weeks (Law, 2013). Moreover, in terms of duration studies have recommended that IMEs should be at least six weeks for preclinical students. For clinical students, 4-8 weeks has been recommended (Godkin & Savageau, 2003) while others have recommended 6+ weeks for postgraduate residents (Drain et al., 2009). In New Zealand, medical electives are usually undertaken during senior clinical years over 2-8 weeks, either locally or overseas, in both high- and low-income settings (Law, 2013).
Key Terms in this Chapter
Low-Income Countries (LIC): Those with a GNI per capita of USD $1,045 or less in 2013.
Resident: A medical graduate engaged in specialised practice under supervision in a hospital.
Trans-Tasman: An adjective taken from the sea that lies between Australia and New Zealand and used to refer to the interrelationship between these two countries.
Trainee Intern: Refers to 6 th Year medical students in New Zealand who participate in medical teams in a junior capacity whilst maintaining their student learning.
Health Workforce New Zealand: An agency that is tasked with developing strategies, implementing programs and driving initiatives to create a more flexible and dynamic health workforce that will enable the country to cope with increasing demand of health services in the future.
Clinical Rotation: A period in which a medical student in the clinical part of his/her education is required to rotate through different specialties or hospital settings to gain knowledge and experience in 1-4 month blocks.
High-Income Countries (HIC): Those with a Gross National Income (GNI) per capita of USD $12,746 or more in 2013
Middle Income Countries (MIC): Those with a GNI per capita of more than USD $1,045 but less than USD $12,746 in 2013.
Medical Elective: An optional course or hospital placement undertaken by a medical student.
Continued Professional Development: Involvement in audit of medical practice, peer review and continuing medical education, aimed at ensuring that a doctor is competent to practice medicine.