The ACGME and Global Health: International PGME Partnerships to Support Training Physicians into the Future
The drive to create and expand international partnerships has accelerated in recent years as efforts to enhance the quality of post-graduate medical education (PGME) have come into greater focus. With this in mind, ACGME Global Services and ACGME International (ACGME-I) curated the educational session “International PGME Partnerships to Support Training Physicians into the Future” at the 2024 ACGME Annual Educational Conference, held March 7-10, 2024, in Orlando, Florida.
The session was designed to present examples from three global institutions, and to allow the audience to take some of the ideas and build on them in global collaborations. “Not one size fits all,” noted ACGME Chief Financial and Administrative Officer and ACGME Global Services Executive Vice President John Ogunkeye, MS.
Contextualizing the session, speakers introduced the results of a survey of thought leaders conducted by ACGME Global Services in late 2022 on emerging issues in PGME, indicating that globalization was one of the major trends. “In this globalized world, we cannot exist in isolation,” said Mr. Ogunkeye, adding that components of health care must “work in unison,” yet maintain cultural sensitivity.
ACGME-I President and Chief Executive Officer James A. Arrighi, MD stated that as the global PGME space is getting smaller, it is currently optimal for building relationships, collaborations, and partnerships to foster a truly global PGME community. Of the three institutions discussed in the session, two are currently accredited by ACGME-I and the third is pursuing accreditation.
A Partnership to Create: VinUniversity College of Medical Sciences
Lisa Bellini, MD, the senior vice dean for Academic Affairs at Penn’s Pearlman School of Medicine, described the partnership fostered by Penn Global to collaborate with Vingroup, a private entity in Vietnam, to create an institution of higher learning in Hanoi, Vietnam, that would be globally competitive in just a few years. She prefaced the challenge by stressing the need to fully appreciate the local context. “There was a lot of listening,” she said, adding, “you need to understand the culture before you build.”
Dr. Bellini noted that although the project was well resourced financially, human capital was a larger challenge. Concepts like work hours and mental health needed to be introduced, while local partnerships need to grow to enable sufficient caseload for learners. Even a “boot camp” was established to get incoming residents ready.
The goal of the partnership is to facilitate development of independent operations for the Vietnamese organization, and for the team from Penn to gradually step back, explained Dr. Bellini, noting that the ACGME-I-accredited internal medicine program is now fully locally led, while Penn is still assisting with and co-leading the pediatrics and surgery programs with local counterparts. “Our goal was never to be there in perpetuity,” she added.
A Partnership to Heal: Unidad Nacional de Oncología Pediátrica
Care for children with cancer in Guatemala and its wider region was dire, with only about half of patients being effectively diagnosed. The establishment of Unidad Nacional de Oncología Pediátrica (UNOP), in partnership with St. Jude Childrens’ Research Hospital in Memphis, Tennessee, enabled achieving a goal of raising survival rates for childhood cancers to 40-60 percent in the region.
Daniel Moreira, MD, MEd, the director of Global Professional Education at St. Jude, discussed the importance of partnership as a model for a modern solution. Rather than exchanges or simply sending physicians from well- to less-resourced countries, a key component of his institution’s partnership in Guatemala involved optimizing the workforce by stressing the need for localized and regionalized PGME to produce more pediatric oncologists for the country and region.
This strategy enabled UNOP’s pediatric oncology residency program, which achieved ACGME-I accreditation in 2021, to become a regional center of educational excellence. He noted the successful retention of talent, sharing that of the 44 graduates of UNOP’s pediatric oncology residency, 43 are currently practicing in 10 countries in the region.
Dr. Moreira said they started with clear goals but remained adaptable to building local expertise. “Think globally and regionally, but act at the local level,” he advised.
A Partnership to Grow: King Faisal Specialist Hospital and Research Center
King Faisal Specialist Hospital and Research Center (KFSH&RC) in Saudi Arabia is a leading regional center for medical treatment, research, and teaching in the Kingdom. They are currently pursuing ACGME-I accreditation to further engage with global PGME by strengthening existing and fostering new partnerships.
Ali Alshehri, MBBS, KFSH&RC’s deputy executive director of Academic and Training Affairs, stated that a key PGME priority for his institution is to educate and train physicians of high quality and retain talent, by also creating and strengthening unique fellowship programs to further specialize the physician workforce. Strong focus is placed on the wellness of learners, noting the correlation of physician well-being with patient satisfaction, and on promoting research opportunities as a path to upskilling.
KFSH&RC currently has 80 international residents and fellows and is seeking partnerships to expand international education and training opportunities for both local and international learners. Dr. Alshehri said the benefits of pursuing such partnerships include the opportunity to work together and to share ideas and experiences to mutual benefit.
An Accelerating Trend
Global health demands advancements in cross-border approaches to educating and training the next generation of health care professionals. Collaboration in advancing PGME has become essential in preparing future workforces to address evolving health needs worldwide. These collaborations are transforming international medical education by fostering knowledge transfer between institutions and learners while promoting cultural understanding and awareness
Through this series, The ACGME and Global Health, ACGME Global Services seeks to engage the global medical and health care communities in conversations on challenges facing global health that transcends borders. The goal of this content series is to provoke discussion about issues that concern the global PGME community, enabling critical conversation that engages with stakeholders across borders, disciplines, and perspectives. This post includes input from ACGME and public health leaders from recent interviews and presentations.
ACGME Global Services, a department of the ACGME, was created to advance the ACGME Mission by working with global entities to enhance the quality of resident and fellow physicians' education. We invite comments by email (global@acgme.org) and through X and LinkedIn (with the hashtag #ACGMEGlobalServices). We also seek external voices in future posts in the ACGME and Global Health Blog series; email us if you would like to participate.