"We learn from them, they learn from us": global health experiences and host perceptions of visiting health care professionals.

PURPOSE: It is increasingly common for health care professionals from developed countries to travel to developing regions of the world to learn or teach. This project aimed to describe the perceptions held by health care professionals in a developing region toward those who visit their communities to learn or teach. METHOD: Semistructured interviews were conducted in July, 2011, with nine health care professionals from the University of Namibia School of Medicine. Questions revolved around participants' perceptions of benefits, harms, and ethical impressions of a health care professional visiting from a developed country. Interviews were tape-recorded, transcribed, and analyzed qualitatively using an inductive, iterative approach. RESULTS: The interview analysis identified three main narratives that shaped participant perceptions of visits: (1) culture, context, and concern, (2) expectations, intentions, and miscommunications, and (3) partnership and the desire to share and gain knowledge. CONCLUSIONS: Participants' comments supported actively seeking out information regarding cultural and environmental context before visiting, completing a needs assessment to ensure that activities are needed and relevant, attempting to formulate long-term sustainable relationships, and traveling with the appropriate attitude. These themes provide valuable insight into how international educational collaborations can be created in order to be mutually beneficial

Influence of diet, vitamins and chemotherapeutic agents on gastrointestinal cancer

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106678/1/j.1440-1746.1998.tb01872.x.pd

The promise of competency-based education in the health professions for improving global health

Abstract Competency-based education (CBE) provides a useful alternative to time-based models for preparing health professionals and constructing educational programs. We describe the concept of ‘competence’ and ‘competencies’ as well as the critical curricular implications that derive from a focus on ‘competence’ rather than ‘time’. These implications include: defining educational outcomes, developing individualized learning pathways, setting standards, and the centrality of valid assessment so as to reflect stakeholder priorities. We also highlight four challenges to implementing CBE: identifying the health needs of the community, defining competencies, developing self-regulated and flexible learning options, and assessing learners for competence. While CBE has been a prominent focus of educational reform in resource-rich countries, we believe it has even more potential to align educational programs with health system priorities in more resource-limited settings. Because CBE begins with a careful consideration of the competencies desired in the health professional workforce to address health care priorities, it provides a vehicle for integrating the health needs of the country with the values of the profession.http://deepblue.lib.umich.edu/bitstream/2027.42/112402/1/12960_2012_Article_314.pd

Gender and Future Salary: Disparate Trends in Internal Medicine Residents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/85364/1/Genderandfuturesalary.pd

Pharmaceutical Industry Support and Residency Education: A Survey of Internal Medicine Program Directors

http://deepblue.lib.umich.edu/bitstream/2027.42/85365/1/Industrysupport.pd

Three years of data on the impact of obstetrician/gynecologist coverage in rural Uganda

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135481/1/ijgo284.pd

Taking down ‘the Ivory Tower’: leveraging academia for better health outcomes in Uganda

http://deepblue.lib.umich.edu/bitstream/2027.42/112732/1/12914_2011_Article_147.pd

Career preferences of graduating medical students in China: a nationwide cross-sectional study

Background: China faces major challenges in the distribution of health professionals with serious shortages in rural areas and in the development of Primary Care Providers (PCPs). This study investigates the career preferences of medical students in China and the impact of rural backgrounds on these preferences. Methods: Medical students in the final year of their program in 16 medical schools across China completed a 58-item survey that included questions regarding their demographic characteristics, attitudes toward practice in low resource areas, postgraduate planning, self-assessed competency, university facilities assessment, and financial situation. Descriptive calculation and Logit model were used for the analysis. Results: Completed surveys from 3020 students were included in the analysis. Upon graduation, 48.5 % of the medical students preferred to work in urban public hospitals and this percentage rose to 73.6 % when students were asked to state their anticipated preference five years after graduation. Students' top three ranked reasons for preferred careers were "good career prospects", "living close to parents/families", and "remuneration". Those who preferred to work in rural areas upon graduation were more likely to be those who lived in rural areas when 1-15 years old (beta = 2.05, p < 0.001), had high school in rural areas (beta = 1.73, p < 0.001), or had parents' place of current residence in rural areas (beta = 2.12, p < 0.001). Similar results were found for those students who preferred to work in PCPs. Conclusions: To address the serious shortages of health professionals in rural areas and PCPs, medical schools should consider strategies to recruit more medical applicants with rural backgrounds and to orient students to rural and primary care interests.SCI(E)[email protected]

Variability in student perceptions of mistreatment

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148349/1/tct12790_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148349/2/tct12790.pd

Cultured adult rat jejunal explants as a model for studying regulation of CYP3A

Enzymes within the CYP3A subfamily are major Phase I drug-metabolizing enzymes present in hepatocytes and small bowel enterocytes. These enzymes are highly inducible in the liver by many structurally diverse compounds, including a number of commonly used medications. Studies indicate that CYP3A enzymes present in small bowel enterocytes are also inducible. However, the regulation of CYP3A enzymes in this tissue has not been well characterized, in part because in vivo studies are difficult, especially in humans. Our goal was to develop an in vitro model to study the regulation of CYP3A in enterocytes. To this end, we defined culture conditions under which adult rat jejunal explants maintained viable appearing villi for 21 hr. When dexamethasone, the prototypical inducer of CYP3A1 in rat hepatocytes, was added to the culture medium, there was a time-dependent induction of CYP3A1 mRNA and CYP3A protein in explant enterocytes which was essentially indistinguishable from the time course of induction of CYP3A1 mRNA and protein in enterocytes in vivo. This effect of dexamethasone appeared to be specific since dexamethasone had no consistent effect on the explant concentration of another enterocyte specific mRNA, intestinal fatty acid binding protein. Using this explant culture model, we found that CYP3A1 mRNA was also inducible by clotrimazole but we were unable to detect induction by rifampicin or troleandomycin. Our observations suggest that jejunal explants may provide an appropriate model for the study of the regulation of CYP3A and other drug-metabolizing enzymes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30618/1/0000258.pd