As the health crises of the developing world continue to attract concern, master of public health (MPH) students studying in the U.S. are becoming increasingly aware of and interested in international health studies.1 The University of Washington School of Public Health (UW SPH) in Seattle, Washington, has met this challenge by expanding and reorganizing its international public health teaching. We have established competencies for our global health MPH scholars, with a focus on addressing large public health problems with a social justice perspective.
The emergence of the global health concept over the last decade reflects heightened awareness of accelerating globalization processes that challenge the traditionally drawn boundaries between the international and domestic health professional worlds. While the precise definition of global health continues to be contested, it is widely agreed that increased global flows of resources, information, people, and infectious diseases, together with growing global inequality, have created new public health problems that require fresh and innovative approaches. With this recognition has come a spate of new global health centers, departments, institutes, and programs in American and European universities that seek to redefine approaches to public health and recalibrate training to new global health realities for the next generation of health researchers and practitioners. While the urgency for such redefined training is apparent, there is little in the current public health literature that attempts to identify just what this training should include.
In spite of new global health program proliferation, core professional global health competencies have yet to be defined, and no consensus for development of appropriate curricula has emerged in the public health field. The recent creation of a new Department of Global Health (DGH) at UW has presented curriculum planners, charged with developing new MPH, doctor of philosophy (PhD), and doctor of medicine programs, with these immediate challenges. This article describes the consensus-building process conducted by the DGH curriculum committee over a one-year period in which global health competencies were identified and curriculum needs redefined. While debates about the meaning and scope of global health will continue, basic guidelines for new kinds of training are urgently needed to prepare health workers for the rapidly changing environment they will soon confront.
Through this recently established DGH (which has received much of its new funding through an endowed grant from the Bill and Melinda Gates Foundation), UW is poised to rapidly expand its international health student enrollment, course offerings, and degree programs. Other prominent universities have launched similar efforts in just the last two years. In 2006, Duke University in Durham, North Carolina, which does not have a school of public health (SPH) to date, launched a new Global Health Institute, which started its education program with an undergraduate certificate. The Johns Hopkins University in Baltimore, Maryland, launched a Center for Global Health, bringing together its SPHs, medicine, and nursing schools in a collaborative effort. In addition, other schools such as The George Washington University in Washington, DC, have recently started offering MPH degrees in global health.
As UW prepared to launch its DGH—a collaboration between the SPH and the school of medicine—the curriculum committee of the existing international health program embarked on a complete review of UW's current course offerings in anticipation of growth and expansion. We found very little guidance for this effort in the public health literature. Patrick reported major gaps in public health training, along with the implication of inadequate coursework in SPHs and in medical schools.2 In a commentary on an international traineeship, Edwards and colleagues said medical students were generally being provided inadequate course electives to be competent enough in international settings.3 Hotez provided a thorough lament of the lack of global health content in U.S. and Canadian academic health centers compared with those in Europe, particularly in Britain.4 Dato and colleagues did provide a concept for helping discern our own capacity in course offerings to meet the challenge of global health training.5 And Drain and colleagues have published a call for more training and opportunities in global health, especially for medical students.6
The purpose of this article is to report on how we developed international health competencies to guide our curriculum development.