National and international studies point to the need for more trained personnel to work on global health problems. Two examples will suffice. (1) Since 2000 the Institute of Medicine has published more than 20 reports on global health issues, of which seven were in substantial part concerned with personnel needs. (2) In 2002 a multistakeholder learning process was created to study human resource needs for the health sector. The final report The Joint Learning Initiative’s final report, ‘Human Resources for Health: Overcoming the Challenge', outlines a global strategy for addressing the problems ahead. To increase visibility and priority for its recommendations the report suggests that the decade 2006-2015 be designated ‘The Decade of Human Resources for Health,' since it will take at least a decade of investment for targets to be met.

A recent American Association of Medical Colleges survey documents the rapid rise in student interest in overseas experiences, rising from only 6% of graduating US seniors in 1986 to over 21% in 2001. On average about 20% of North American medical school students go overseas during their studies and in some schools this number exceeds 30%, with large class enrollments in introductory global health courses. Many public health schools now offer courses in global health topics, some have departments or programs devoted to global health themes, and a few nursing, physician assistant and other health programs also offer courses. Besides courses and overseas travel, intra-school student interest groups and student-run associations have organized listserves, grand rounds, lecture series, conferences and partnership relationships with institutions abroad.

Global health offerings in most health professions schools have been labors of love for a few dedicated instructors. For the most part they have added global health teaching activities on top of other, unrelated teaching and service responsibilities, and they receive no special recognition for their endeavors. Faculty entry into the field has usually been via some prior overseas experience but with little or no formal training in global health topics. Most schools have insufficient faculty to meet student demands for courses and mentors and those that are available may be limited in their range of expertise.

Courses in global health are almost invariably elective except in schools of public health offering a concentration in this field. As a result courses have tended to lack academic rigor and instructors cannot rely on student compliance with reading assignments. With limited contact hours available, instructors tend to rely predominantly on lectures to transmit information, leaving little time for more effective teaching methods such as class discussion, case studies and problem-based learning.

Student exposure to global health problems, programs and policies can enhance their ability to provide culturally appropriate health care in both international and domestic practice settings.  For domestic practice with immigrant and minority populations three skills will be especially important, viz: knowledge of a foreign language, especially Spanish; an awareness of how different populations perceive health and disease; and the ability to communicate appropriately with patients and families.

Students go overseas to further their own education and experiences, often with little thought about what they might contribute to their host institution and community. The expectation is, however, that they will provide some service (clinical, data collection, volunteering, etc.) to their hosts in return. Students will not be in a position to provide useful services unless their education has prepared them to do so. Good pre-departure global health education can help reduce the risk of ‘inflicting the unprepared on the unaware.’