Abstract:

Background:
The University of Florida College of Medicine offers a Global Health Education program for medical students. Medical students who have completed an international clinical rotation often report a greater ability to recognize disease presentations, do more comprehensive physical exam skills with less reliance on expensive imaging, and greater cultural sensitivity. This study aim to determine the effects of global service trips on medical student’s learning and their future career choices.

Methods:
A survey questionnaire was developed in an electronic format and sent to 203 previous global service trip participants. The UF College of Medicine Office of International Education Programs provided email addresses for 203 medical students who participated in global medical service trips from 2012 to 2015. Questionnaires were sent via email using REDcap through UF’s secure server during a 4 month period in 2015. Each participant was assured that results will be strictly confidential and totally voluntary. Surveys are anonymous and completion implied consent to participate in the study. We received 75 completed surveys, 17 email addresses were undeliverable for a total response rate of 37%. A descriptive analysis that include counts and percentages for each of the survey questions was performed including cross tabulations. Chi square analysis was performed to compare two groups, current students versus alumni.

Results:
Of the 75 responses included in the analysis, 80% were medical students and 20% were alumni. Third and fourth year medical students (37% and 56%, respectively) were the majority of students who responded to the survey. With regards to the alumni, 33% are in primary care and 67% are specialists. Out of 75 responses, 31% participated in medical service trips 3 or more times. The majority of those who responded (69%) participated in medical service trips only 1-2 times. Based on our study, global service trips positively impact trip participant’s medical skills. It showed improved history taking, physical examination, diagnostic and procedural skills, and medical decision making ability. It increased their cultural competency and empathy for the poor and underserved. It also reinforced their leadership skills but created stress during the trip. As far as choosing a medical specialty, our study showed mixed results. Only one question had a significant difference in the response between the students and alumni. Only 18% of the students strongly agreed that the trip resulted in improved decision making while the alumni reported 53% (p value = 0.09).

Conclusion:
Our study provides strong evidence that these global health trips improved history taking, physical examination skills, empathy for the poor and underserved, and leadership skills. There were mixed results as to whether these trips had any impact on medical specialty choice, although a certain percentage strongly agreed that it had. Longitudinal studies will be needed to fully describe career trajectories influenced by students’ global health service learning experiences.

Keywords:

Global Mission Trips, Medical Mission, Physician Career, Medical Student Competency.