This document discusses developing a global health curriculum at the Northern Ontario School of Medicine (NOSM). It outlines why global health is an important part of medical education given global influences on health and NOSM's mandate to serve local populations. A working group will iteratively develop curricular areas focusing on key global health competencies like burden of disease, health impacts of travel, and social determinants of health. Potential curriculum components include epidemiology, travel medicine, ethics, and international clinical electives. The process aims to reflect on social accountability and work with communities to lay the groundwork for a long-term global health curriculum.

1. Global health and health equity:
developing a global medical
curriculum
Dr. Basia Siedlecki MD PhD
Assistant Professor, Global Health
Coordinator, NOSM
Hospitalist/ ER Physician,
Georgian Bay General Hospital

2. Faculty/Presenter Disclosure
Slide 1
• Faculty:
• Dr. J Basia Siedlecki
• Relationships with commercial
interests:
• Faculty of NOSM
• Staff Physician at Georgian Bay
General Hospital

3. Outline
• Why a Global Health curricular
enhancement in a school that has a
local social mandate?
• What process can foster the goals
of promoting awareness and
altruism, social accountability?
• What curricular components inform
a competency in Global Health?
• How does this fit into the existing
curriculum?
• The long road ahead…

4. Why?
• Purpose of global health curricular
enhancement:
– Global health as part of modern medical
practice
– Global influences and health foster an
awareness of the social context of practicing
medicine
– Global nature of Aboriginal populations
(circupolar, etc)
– Determinants of health: poverty, environment
– Social accountability: local and global
– Global citizenship: fostering altruism and
activism
• vs/+ local social mandate

5. Process
• Working Group – including faculty,
staff, curriculum designers and
students – consultative/consensus
group – discussing/developing
curricular areas of focus
• Process is iterative, creative,
serendipitous
• Many guidelines for global health
competencies (institutional, governing
bodies, student groups)
• Champions and individuals
• Research promotion/partnerships

6. Quick overview of NOSM
curriculum
Surgery, Internal Medicine, Children’s
Health, Women’s Health, Mental Health,
phase 1
(years 1 and 2)
community-based
specialist clerkship rotations:
Emergency Medicine, and Family Medicine
comprehensive community clerkship (CCC)
The four-year MD curriculum is split into
three phases: Phase 1 covers years 1
and 2 and involves a sequence of 11
modules with ongoing community
integrated learning
Phase 2 consists of a 8.5 month long
community clerkship
Phase 3 consists of seven specialist
clerkship rotrations
Five themes link teaching, learning and
assessment into a single integrated
curriculum
module 111
module 110
module 109
module 108
module 107
module 106
module 105
module 104
module 103
module 102
module 101
themes:
Northern and Rural Health
Personal and Professional
Aspects of Medical Practice
Social and Population Health
Foundations of Medicine
Clinical Skills in Health Care
phase 2
(year 3)
phase 3
(year 4)
1 2
3
Northern Ontario School of Medicine MD Program Curriculum Structure
community integrated
learning (CIL)
4 5

7. Process
• Current Global health consists of a
single case in a case based
curriculum in Phase 1
• Theme chairs invited to participate
• Both undergrads and grads have
specifically asked for sessions on
travel medicine/global health
clinical/epidemiological issues
• Recognition and development of
current international elective
activities (Pre-departure workshop)

8. Competencies
1 Global burden of disease
2 Health implication of travel, migration and
displacement
3a Social and economic determinants of health
3b Population resources and the environment
4 Globalization of health and healthcare
5 Healthcare in low resource settings
6 Human rights in global health
• Canadian Federation of Medical Students has
mapped these to the CanMEDS roles
• Joint Association of Faculties of Medicine of Canada
Resource Group on Global Health and Global Health
Education Consortium 2008

9. GH Curricular Areas of Interest
• Epidemiology/Biostatistics
• Travel Medicine
• Mental Health
• Cultural Safety
• Ethics and bioethics
• History of medicine
• Environmental health
• Research and Service Learning
• Clinical International electives
• Clinical work with global populations in
Canada
• Global Aboriginal Health

10. Purpose/reflection
• Core of the experience – to reflect
on the purpose
• Service Learning sets up a
paradigm of transaction – social,
financial, ethical, cultural
• Work on facilitating institutional and
faculty modeling of social
accountability
• Work with Aboriginal communities
sets the groundwork

11. Long Road Ahead
• My personal view:
1. Safety
2. Ethics
3. Cultural knowledge
4. Clinical components
Next steps:
1. Theme committee suggestions
2. Curriculum designers

12. Reading list
• Evert J., Drain P., Hall T. (Eds). Developing Global Health
Programming: A Guidebook for Medical and Professional Schools, 2nd
Ed. San Francisco: Global Health Education Collaborations Press,
2014.
• Global Health Resource Group of the Association of Faculties of
Medicine of Canada. “Towards a medical education relevant to all: the
case for global health in medical education.” 2006
• Arthur M., Battat R., Brewer T., “Teaching the basics: core
competencies in global health.” Global Health, Global health Education
and Infections Disease: The New Millennium, Part 1. Ed. Anvar Velji.
Infect Dis Clin N Am (2011) 347-358
• Houpt E., Pearson R., Hall T. “Three Domains of Competency in Global
Health Education for all Medical Students.” Academic Medicine 82:3
(2007): 222-25.
• Redwood-Campbell L., Pakes B., Rouleau K., et al. “Developing a
Curriculum Framework for Global Health in Family Medicine: Emerging
Principles, Competencies and Educational Approaches.” BMC Medical
Education, 11:46 (2011)

13. Questions?