Global health outreach by United States ophthalmology residency programs: Understanding of host country systemsbased practice

Introduction: For medical residents, global health outreach is the first experience of learning how todevelop partnerships with foreign medical systems. The overall objective of this project was to develop an overview ofglobal health programs in U.S. ophthalmology residencies. The investigation focused on characterizing the goals andservices offered, the didactics taught to residents, and the program director's understanding of systems-based practicegained in the host country. Materials and Methods: An online survey was sent to all U.S. ophthalmology residency program directors. The two outcome measures of the study were characterization of global health outreach and didacticscompleted by U.S. ophthalmology residency programs and review of program director understanding of host countrysystems of care. Results: Twelve program directors of 117 (10.26%) answered the survey. 100% of programs from theDepartment of Defense responded. Countries served included Ecuador, Panama, Honduras, Dominican Republic,India, Tanzania, Nepal, Bhutan, Guatemala, Micronesia, Haiti, Mongolia, Bolivia. Sixty five percent worked at a freestanding public hospital. Many programs offered resident participation with only 41.87% giving residents ACGMEcredit. Most programs (91.67%) offered fewer than 5 hours of global health didactics. When program directors wereasked about their knowledge of host country systems of care, most noted understanding of the hospital functions likethe referral system, transitions of care, hospital funding, and medical supply chain, but not of the perception of patientswith chronic or congenital ophthalmic diseases, host country general or ophthalmic medical education, patient researchsafeguards and host country malpractice system. Conclusion: From the small sample of program directors,Ophthalmology residency program global health outreach varies in faculty and resident participation, and in goals andservices offered. In addition, there was a wide variation in ophthalmology program director understanding of hostcountry systems of care.