How Do We Decolonize Global Health in Medical Education?

Abstract

Medical schools are increasing global health training opportunities, but these have been marketed to medical students as an exotic vocation. The challenges of global health education in high income country (HIC) medical schools are rooted within broader inequities in global health partnerships. More meaningful engagement during medical training is hindered by students’ inability to take extended absences, difficulty securing funding, a paucity of mentors with demonstrated commitment to equitable global health practice, and inadequate preparation. Calls for decolonizing global health have recently amplified, and medical schools must seize the opportunity to train decolonizers. We outline steps medical schools can adopt to shift their global health education approach to develop practitioners better prepared to contribute equitably. First, students should be exposed to more global health courses, including the history of colonial medicine and its effects on specific local contexts. Medical schools should deemphasize short-term unidirectional engagement, and encourage extended experiences. International experiences must have clearly defined roles, clarified with pre-visit contracts and supervision of the experience to ensure students do not engage in medicine above their level of training. For any exchange, medical schools must provide pre-visit training that includes site-specific orientation and strategies for effective collaboration. Finally, medical schools must recruit faculty committed to developing equitable, long-term collaborations, and institutional promotion criteria must be aligned to encourage this work. An understanding and commitment to this lifelong practice can be fostered through medical school curricula that expose students to global health work that prioritizes equity in clinical work and research.