International Health Education

Despite the technological advances in health and medicine in this century, more than half of the world's people remain medically underserved as they cope with severe economic, population and environmental pressures. The international health education program at the University of Connecticut Health Center seeks to respond to these needs with an education program that has the following objectives:

• Understand and respond to the problems and needs of underserved communities, both in this country and in the developing world
• Learn and to implement, through cross-cultural and cross-national interaction with health professionals and community leaders, the principles and approaches of primary health care
• Encourage medical, dental, master in public health (MPH) and health social science Ph.D. students to enter fields of primary care and community health and to use their international experience to improve their communication, clinical and research skills to develop the University of Connecticut Health Center as a nationally and internationally recognized academic resource, conducting research, training and education related to global health needs.

The first year medical elective seminar, "Community Health Research Methods" which prepares students for the development of international health research proposals draws 15-20 students. Students conduct research for two months during the summer and then are guided in their analysis of the data by faculty advisors. At least half of the oral and poster presentations at recent Medical/Dental Student Research Day were based on international research.

Historical Development

In 1984, two fourth-year medical students accompanied Dr. Schensul to Lima, Peru where they worked in the Canto Grande clinic serving shantytown communities in the northwestern portion of the city. These international opportunities have attracted many students to the University of Connecticut School of Medicine. International health has become an increasingly important component of the University of Connecticut School of Medicine curriculum. These experiences provide skills that are valuable to contemporary practice in the United States including how to work with diverse populations and cultures.

The program has grown dramatically from its inception in the mid-1980s. Of the 190 students who have participated, 165 have been trained since 1992. These students have gone to 66 countries and Puerto Rico. The program has established several long-term collaborations with institutions in other countries to support these activities and improve health in local communities. These include the Haitian Health Foundation in Jeremie, Haiti, the International Health Central American Institute in San Jose, Costa Rica, the University of Peradenyia in Sri Lanka, the University of Puerto Rico, Buguruka Orphan and Community Economic Development Program in Buguruka, Tanzania, the Deepak Charitable Trust in Baroda, Gujarat, India, the Mauritius Family Planning Program, Cayetano Heredia School of Medicine in Lima, Peru, and the International Institute for population Sciences in Mumbai, India. Students also work with individual programs in many other countries.

Faculty and staff support for these programs is provided through the Department of Community Medicine and the Academic Dean's Office. The International Health Program is co-directed by Professors Judy Lewis and Stephen L. Schensul, and the Center for International Community Health Studies as well as the Community Based Education program. Student stipends have been provided through the Health Center Research Advisory Committee (HCRAC) of the University of Connecticut Health Center and private donors. Partial travel funding has been provided by the Executive Dean's Office, and some scholarships from programs they attend. Students receive academic credit for work that is not funded by a stipend.

The International Health Program sponsors two electives in community health research methods, one to develop a proposal and data collection instruments and the other for data analysis and report preparation. The University of Connecticut is one of the few U.S. medical schools providing this level of instruction to prepare students for international health work. The projects that result from these electives take place in the 2 months of the summer between the first and second years of medical school. The program also provides mentoring and individual consultation related to student projects and career planning. Other sponsored international health activities include language immersion programs and fourth year electives and projects (called "selectives") that are 2 month research or intervention activities in the fourth year of medical school.

Seventeen students have presented their work at the International Health Medical Education Consortium (IHMEC) annual meetings, and 5 others have presented at regional IHMEC meetings. Two students, Jennifer Kirkland and Ritu Pati won the IHCAI (International Health Central American Institute, Costa Rica) Best Student Project Award for 2001. In addition, many students have won awards at the annual University of Connecticut Medical/Dental Student Research Day.

Indicators of the Quality of Student Research

Preparation: All students seeking to conduct international research receive extensive consultation from faculty in terms of site, topic, design and methodology. In addition to individual consultation, Professors Schensul and Lewis conduct an elective in "Community Research Methods" to provide students the skills to conduct community health research abroad.

Proposal Quality: All students submitting international health research proposals to the HCRAC program since 1990 have been funded. Since a system of grading of the quality of proposals has been instituted, most of the internationally focused research projects have received high ratings. HCRAC members have commented to faculty preceptors about the high quality of international research proposals.

Overseas Preceptorship: With faculty consultation, all students establish an in-country preceptor who is familiar with the topic, the population, and research methods.

International Community Research Contract: All students sign a binding contract agreeing to stipulations requiring the effective planning, implementation, analysis, writing-up and dissemination of research results.

Post-Field Supervision: All students receive extensive faculty consultation on their return from the field for methods of data entry, data analysis, and presentation of results.

National Competitions: University of Connecticut medical students have received highly competitive SmithKline Beckman Medical Perspectives Awards (no longer given) in 1984, 1986, and 1987 for international health research.

Presentations at Medical/Dental Student Research Day: In 1990, two students who had conducted international research were selected to do an oral presentation at Student Research Day. Since that time students who have conducted international research have been well represented among those selected for oral presentations at Student Research Day.

William M. Wadleigh Award in International and Cross-National Health

William M. Wadleigh, MA (Anthropology) was assistant director of the CICHS program from its inception to his passing away in 1991 from complications due to HIV/AIDS. He made a vital contribution to the CICHS program and was especially committed to the CICHS role in student education. As a result, the William M. Wadleigh Award in International and Cross-National Health has been given since 1992 to the student whose research project best exemplifies the highest standards of research and cultural understanding.

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