Global health-related training opportunities a national survey of pulmonary and critical care medicine fellowship programs

Rationale: Clinical and research training opportunities in global health are of increasing interest to medical trainees, but little is known about such opportunities in U.S.-based pulmonary and pulmonary/critical care medicine (PCCM) fellowship programs. Objectives: Summarize currently available global health-related training opportunities and identify potential barriers to implementing global health curricula among U.S.-based PCCM fellowship programs. Methods: We sent a confidential, online, targeted needs assessment to PCCM fellowship program directors and associate program directors. Data collected included program demographics, currently available global health-related clinical and research training opportunities, potential barriers to the implementation of global health-related programmatic content, and perceived interest in global health-related training opportunities by current and/or prospective trainees. To evaluate for nonresponse bias, we performed an online search to identify global health-related training opportunities offered by nonresponding programs. Results: Out of 171 surveyed programs, 63 PCCM fellowship programs (37%) provided survey responses. Most responses (n=56, 89%) were from combined PCCM training programs; 66% (n=40) of programs offered at least one component of global health-related clinical or research training. Overall, 27% (n =17) had a Ruth L. Kirschstein National Research Service Award Institutional Research Training Grant (National Institutes of Health T32), 73% (n=46) had fewer than 35 faculty members, and 51% (n =32) had at least one faculty member conducting global health-focused research. Most responding programs (66%, n= 40) offered at least one global health-related educational component. Among programs that would like to offer global health- related training components, the most common barriers included competing priorities for lecture content and a lack of in-divisionmentors with global health experience, a champion for global health-related activities, and established partnerships outside the United States. Conclusions: PCCM program leaders are interested in offering global health-related training opportunities, but important barriers include lack of mentorship, dedicated fellowship time, and established global partnerships. Future research is needed to better understand global health-related interests and training needs of incoming fellows and to design creative solutions for providing global health-related training across academic institutions with variable global health-related training capacities.