Global Health and Medicine

©Laura Takahashi. GHEI session presented by Dr. Barry Pakes
By Raissa Chua, University of Toronto

A Closer Look at PGME’s Global Health Education Initiative

©Laura Takahashi. GHEI session presented by Dr. Barry Pakes
©Laura Takahashi. GHEI session presented by Dr. Barry Pakes

As the field of global health is rapidly evolving, more students and professionals are looking for ways to incorporate global health into their respective disciplines. The Global Health Education Initiative (GHEI) is a new program led by the Global Health Division at the Dala Lana School of Public Health and the office of Post-Graduate Medical Education. Specifically, the GHEI provides health professionals with relevant skills they can utilize within the global health realm. 

The GHEI is a 2-year program medical residents can enrol in during training, and is taught by leading UofT global health faculty and practitioners. The program is delivered in a series of modules: a set of core modules and a choice of various elective modules which include Innovation and Technology in Global Health, Global Mental Health, Women and Child Health, and Infectious Diseases in Developing countries. Each module is 2-4 sessions long, with each session being 2-3 hours in length. In order to learn more about the GHEI, I spoke briefly with Natalie Chan, a 2nd year paediatrics resident who is also currently a student in the GHEI program. 

What is your background? What first sparked your interest in global health? Tell us more about your involvement. 

I completed my medical studies at McMaster University in 2011. I first explored the field of global health while at UofT as an undergrad, where I majored in Human Biology/Health and Disease. At the time there were limited choices in the global health courses available, but I took electives in various social science disciplines including sociology. 

One of the courses that greatly inspired me to further explore global health was HMB303: Global Health and Human Rights, taught by Professor Paul Hamel. After taking this course, I began to critically evaluate about many global health issues, which eventually led me to undertake further studies and involvement while in medical school. I became involved with the Canadian Federation of Medical Students (CFMS) as a school representative where I participated as a global health advocate on various committees. I was also able to get involved in national-level work concerning aboriginal health. 

How has your experience been so far in the GHEI curriculum and what do you think sets it apart from other programs? 

I have had an overall good experience with GHEI. It is a great way to stay involved in global health dialogue after medical school. 

I find the program very interactive. One of the modules I took was Surgical Skills and Anesthesia for Global Health, where orthopaedic surgeons and anesthesiologists came and provided us with hands-on tutorials about working in a resource-limited country. I also took a module on capacity building and program planning during my second year.  Many of our lecturers had extensive fieldwork experience and worked with organizations such as Dignitas International. Part of the course had us submit things we had done in the past, where these experts would help us further develop it. 

I think the one of the goals of GHEI is not to build expert knowledge, but to expose us to different ideas in global health and make connections. We often have people come in to speak with us about how they built their career. It is a great aspect of the program because it provides us with many different options on how to integrate our medical expertise into several disciplines within the field. 

How are your colleagues? Were most from the same background as you? 

I met a range of people in the program – almost all have a level of curiosity about global health. It is challenging to cater to all the levels and expertise and interest but it is also a great way to share experiences. I think the program continues to address this challenge – finding the balance of delivering material while keeping everyone interested. 

What do you think is the greatest challenge in the field of global health, particularly regarding working abroad? What do you think about the ethical implications of doing service abroad? 

During my first year of medical school, McMaster had a training program that was part of our clinical electives which allowed me to travel to Uganda twice – once for two months after my first year of medical school and again for five weeks as a third year student. During my second year, I also went to Guyana for 2 weeks where I co-founded a medical equipment donation program. Medical tourism has become a popular choice for many young adults, and it was initially a tough decision for me whether or not to go. I thought of myself as a low-level junior trainee and often wondered about the ethical implications of whether or not it was right to go or if I was “doing more harm than good?” I believe it’s not a bad idea to go, but that we should put more thought into which organizations we choose to volunteer with, outweigh the pros and cons, and ensure sustainable projects are being carried out within these communities. We often forget the resilience and capability these communities abroad have to help themselves. They often just need funding or specialized skills which many volunteers lack. What many students don’t realize is that it is possible to make a larger impact for global health in our home countries than going abroad.  

Because this was a university level clerkship, I felt comfortable, given that it was a structured program. Abroad, there were times when I felt expectations were different and I was asked to do things I did not normally do in Canada. However, I looked at this experience as an opportunity to make a difference. During my time away, I noticed patients arriving with little money who could not afford supplies such as an IV for 10 cents. I helped to establish an organization to aid in the provision of medical equipment to these rural areas with an emphasis on communication with local physicians; it was an attempt to make the most of my experience abroad and to hopefully leave a lasting impact.

I look forward to going back one day and continuing my work in Uganda and Guyana. I think it’s important to plan to go back or leave some sort of sustainable difference within the community. Many people return to their home country and never visit again. However, I think we should all consider ethical implications of doing service abroad and if people choose not to go back, we should strive to leave as few “bad footprints” as possible. 

The majority of our readers are undergraduates. Do you have any advice for students thinking about including global health in their future career plans? 

First, I would make use of different opportunities around campus, such as Juxtaposition. It’s not just about “duffle backpack medicine” – just taking off, building a school, and putting the experience down on your resume. If you think that going away for a week to work at a foreign medical clinic is the best you can do for global health, then I think you are not thinking deeply enough and are being slightly naive. You must constantly consider longitudinal sustainability.

Global health is more than short-term interventions – it is a partnership between groups of people from the north and south. Courses, such as HMB303, can help increase background knowledge and critical thinking about global health. It’s a good idea to initially get some background information about the field through courses, extracurriculars, research, and local involvement before considering a trip abroad.  

Lastly, global health has so many key players, not just the doctors. We often underestimate the other fields: planning, logistics, engineering, etc. Everyone has a role to play in global health – for example, businessmen can become involved in microeconomics initiatives in developing countries. Expertise from a variety of disciplines is needed in the broad field of global health. 

If you were uninhibited by rules or finances, what is the dream global health project that you would set up? 

I have two different ideas for projects that I would like to one day pursue.

The first involves the arts and music. My background before medicine was music, and I believe in the power of arts to bring about positivity and good health. I would like to increase access to the arts – both visual and musical – to all children. I often find that the arts are mainly restricted to the privileged. However, I believe that they have huge potential to do good for all peoples. There is also evidence that there is a connection between neural development and health outcomes when exposed to music and arts. 

My second idea involves early development and the ability to bring about simple resuscitation techniques. This is somewhat similar to the Saving Lives at Birth initiative. With advancement in technology and communication tools there is great promise in this field and an opportunity to better in an area which we are still very much behind on. 

To learn more about the GHEI program, you can visit