Abstract:

Objective: There is a growing need to incorporate a global health perspective into the formation of gynecologists and obstetricians in aim to reduce global health disparities in women’s reproductive health. Such partnerships promote the development of professional relationships and team work by creating an environment of mutual learning based on mutual needs with a reciprocal contribution. Michigan State University in collaboration with the University of Costa Rica have partnered through a formal agreement to develop and implement a residency exchange program for Obstetrics and Gynecology (ObGyn) residents training at both countries through a 4-week exchange rotation in local hospitals and clinics. The US residents are exposed to a country with a “universal health system” where the trend of health indicators has shown commendable standards despite the lack of advance technological support. ObGyn residents from Costa Rica have the opportunity to observe different surgical techniques by using advanced robotics, the use of simulation and the overall health system’s economic impact. The 4 week rotation provides an appreciation of core competency skills as they relate to women’s health, cultural sensitivity, health disparities and medical ethics. The program includes six specific learning objectives: 1) Medical knowledge and patient care; 2) Epidemiology and public health; 3) Specific populations (immigrant population); 4) To promote international collaborations; 5) Professionalism and cultural competency and 6)Interpersonal skills and communication.
Methods: Residents are matched with a faculty mentor who organizes the rotation for the foreign resident according to the local scheduling system and hospital priorities. In country supervisors ensure that the resident’s experience meets the exchange program objectives and the ACGME educational objectives. There are specific criteria to be met in order to qualify and participate in the program. A standardized evaluation of the participating resident is conducted by the assigned mentor in each country. The evaluation includes a mid-term and a final evaluation based on the following criteria: 1) Clinical knowledge, 2) Professionalism, and 3) Global competency. Once the rotation is completed, the resident must provide a presentation at his/her home country regarding his/her clinical and research experience and discuss future applications in the practice.
Results and conclusions: Experiences have been significantly rewarding for residents from each country. Two residents have already completed their program, one from each country. There is now a higher demand to increase the number of residents per country per year based on the increase number of applications. The first cycle of the program has provided new insights on innovative surgical techniques to be applied in Costa Rica and new perspectives on health care delivery systems on their impact on the overall quality of maternal and child health. Research collaborations have also developed between residents and faculty from both countries thanks to this initial exchange experience. As a result of the first year’s experience, the first Latin American symposium on Women’s Reproductive Health was also held back in June 2011 in San José, Costa Rica, allowing researchers, educators and clinicians in Obgyn to present topics of interest for and from both countries opening the window to new collaborations.

Keywords:

Reproductive health, obstetrics, gynecology, Costa Rica, Michigan, exchange program, international.