Global health education is becoming increasingly visible and the proliferation of new programs in the region shows that interest and participation in global health education specifically has accelerated in recent years. Merson and Chapman Page attribute this growth in the United States to three factors, including greater emphasis on internationalization in higher education, heightened public visibility of the global health agenda, and the expansion of new resources and opportunities for universities and students . This trend has also been emphasized in the literature by Merson , Drain et al.  and Crump and Sugarman .
Our findings suggest that the growing demand for global health education and training programs is likely to continue. A preference for practice-based degrees, such as the MPH, over the traditional research PhD degree was evident in our study. However, very few schools had established dedicated departments, or centers, of global health and very few offered undergraduate courses in global health. However, our results show that global health programs can be included in a wide variety of disciplines and housed in many different types of schools (e.g., medical, public health, nursing), which reflects the trend towards a more multidisciplinary global health field .
Here, we offer four major recommendations on providing global health education and training based on our collective experiences in training and educating students in this field, considering the special challenges that universities without schools of public health may face. First, the proliferation and the diversity of global health education programs in the Pacific Rim suggest that universities should meet the growing demand for global health education by offering more programs and degrees focused specifically on global health. Increasing the number of dedicated global health research institutions in the Pacific Rim could contribute to building capacity in the region. We found that very few schools in our study had established dedicated departments, or centers of global health. Many public health-related degrees were offered in schools of medicine, which may not be equipped to teach global health-related courses. One important challenge is the lack of teaching capacity in public health in general and global health in particular, especially in the smaller programs. Faculty may not be prepared to teach the diversity of topics required in global health education. Furthermore, schools of medicine may not have enough faculty members equipped to mentor students who are interested in global health.
Combined degree programs with a global health track, concentration or specialization, such as MD/PhD and MD/MPH programs, could help meet the demand for global health training in multidisciplinary programs. Institutions that do not have schools of public health should consider incorporating global health courses into already existing degree programs, such as medical degrees. In addition, by offering certificate programs in global health, students could pursue training in global health without participating in a full public health degree program. Universities that already offer general public health degrees should add core courses in global health to afford the opportunity for their students to broaden their training into global health.
Second, we also found that very few programs in our study offered undergraduate courses in global health. We encourage universities to offer more global health courses that undergraduate students can join. Exposing undergraduates to global health courses may help spark students’ interest in global health early in their academic careers and encourage them to pursue graduate training in this field. At the University of Southern California, there has been substantial demand from undergraduates for global health courses and opportunities over the last five years. Similarly, in other institutions, the introduction of global health as part of the undergraduate medical training is beginning to emerge, although it is likely to face challenges in terms of perceived relevance by pre-clinical and clinical students and program overload. We suggest that global health problems represent a superb platform for teaching interdisciplinarity.
While globalization has brought challenges for health, it has also brought new ways to collaborate in education. New, more flexible models of learning should be embraced, such as distance learning and experiential learning opportunities . These can provide another way that universities can offer a wider range of global health courses without additional expenses. Curricular materials can be shared; lectures can be webcast globally; and multi-institutional research is increasingly feasible. Universities can take advantage of online courses offered for free, such as those offered by The Johns Hopkins Bloomberg School of Public Health or the Consortium of Universities for Global Health (CUGH). Faculty from two APRU member universities in the United States (the University of California at Irvine and the University of Southern California) developed an online course in global health leadership in which five universities from around the Pacific Rim participated. Students can also be encouraged to enroll in massive open online courses (MOOC). However, careful attention must be paid to ensure that contact hours within these courses remain as high as in traditional full-time programs and that quality instruction is maintained [6, 24, 28–31].
Third, there is a growing recognition that improving the health of populations across the globe will require a multi-faceted, multi-disciplinary approach, as highlighted in the literature [1, 4, 5, 21, 22, 24]. The factors which determine health status are complex and global health training requires an understanding of the multitude of determinants of health, such as social, economic, political and demographic factors. Preparing a global health workforce with expertise in an array of disciplines and contexts can help address global health challenges. Training of more than just medical doctors or epidemiologists will be required to meet these challenges. As the world becomes increasingly globalized through international travel and commerce, it is necessary to think about health in a global context. Improving global health can support national, regional and global security interests by fostering political stability, diplomacy, and economic growth worldwide. Experts in trade, migration, security and governance can help promote health globally. Solutions to combat the rise in non-communicable diseases and the influence of the environment in health status require the application of theories and knowledge from multiple fields. The research capabilities and surveillance required to combat pressing global health problems require significant capacity at many levels, including governmental, research and clinical. In addition, the ability of universities to conduct research requires the existence of capable Institutional Review Boards (also called Research Ethics Committees) that possess an advanced level of public health ethics, research methods, as well as knowledge from many other disciplines, in order to protect human subjects involved in research within the country, as well as outside. Diversity within schools in terms of programs and disciplines can promote training at many levels.
Universities are encouraged to involve faculty from different departments and disciplines in providing global health education. Courses from a variety of disciplines should be offered, such as courses in medical anthropology, health economics, environmental health, psychology, demography, big data and health informatics, business and leadership, and global health diplomacy. In addition, the role of cultural beliefs and practices in health outcomes is well-acknowledged and calls for training in qualitative methods. A major gap in many students’ training is the absence of qualitative research methods courses, especially among medical students.
Fourth, our results corroborate those of Frenk et al. and others’ in showing that the current financial investment in professional education is insufficient to meet the growing demand in global health [7, 24]. Engaging all stakeholders in global health education and training is needed in order to adequately fund professional education in the field and train the multi-disciplinary workforce required to address current global health priorities and to help foster health equity around the globe.
Increased global health training opportunities for students and faculty should be considered a priority. Short-term fellowship and training programs are available for faculty in developing economies to spend time in a developed country, such as the Fulbright Training Program, U.S. National Institutes of Health or programs funded by governments, such as Japan, These programs can provide training opportunities that do not require local university support. Such programs contribute to sharing of unique experiences and expertise from both developing and developed nations, benefitting both parties and can often lead to additional research collaborations.
Increased funding of international field placement opportunities will allow more students to gain valuable global health experience first-hand. Universities should provide competitive scholarships and placement assistance for students who want to do well-planned fieldwork abroad. While universities struggle with budget constraints that often make these programs cost-prohibitive, we feel global health practicums are a vital part of global health education and training. The value of international global health practicum opportunities as been well-documented in the literature; through such experiences students can gain crucial exposure, empathy and witness first-hand how public health works in the real world including cultural competency and language skills, increased awareness regarding health challenges in resource-constrained health systems and greater self-confidence [28, 32, 33].
In addition, financial support to cover travel costs to global health conferences may also be an important way to expose students and faculty to global health research being conducted around the globe and to meet others doing similar work. Extramural conference funding opportunities, such as conference travel grants, are also often available. Offering free global health symposiums and conferences at universities for local students and faculty might also facilitate increased interest and exposure to global health research, as well as promote networking opportunities.