INTERNATIONAL ACADEMIC PARTNERSHIP IN OBSTETRICS AND GYNECOLOGY TRAINING AND GLOBAL HEALTH EDUCATION: COSTA RICA AND MICHIGAN STATE UNIVERSITY

There is a growing need to incorporate a global health perspective into the formation of gynecologists and obstetricians with the aim of reducing global health disparities in women's reproductive health. Global partnerships promote the development of professional relationships and team work by creating an environment of mutual learning based on mutual needs and with reciprocal contributions. Through a formal agreement, in 2010, Michigan State University (USA) in collaboration with the University of Costa Rica partnered to develop and implement a residency exchange program for Obstetrics and Gynecology (ObGyn) resident training at both countries through a 4-week exchange rotation in local hospitals and clinics. The US residents are exposed to a country with a "universal health system" where the trend of health indicators has shown commendable measures despite the lack of advance technological support. ObGyn residents from Costa Rica have the opportunity to observe different surgical techniques using advanced robotics, simulation and to observe as well the overall health system's economic impact. The 4-week rotation provides an appreciation of core competency skills as they relate to women's health, cultural sensitivity, health disparities and medical ethics. The program includes six specific learning objectives: 1) Medical knowledge and patient care; 2) Epidemiology and public health; 3) Specific populations (immigrant population); 4) To promote international collaborations; 5) Professionalism and cultural competency and 6) Interpersonal skills and communication. Residents are matched with a faculty mentor who then organizes the rotation for the foreign resident according to the respective local scheduling system and hospital priorities. In-country supervisors ensure that the resident's experience meets the exchange program objectives and the American College Graduate Medical Education (ACGME) educational objectives. Specific criteria must be met in order to qualify and participate in the program. A standardized evaluation of the participating resident is conducted by the assigned mentor in each country. That evaluation includes a mid-term and a final evaluation based on the following criteria: 1) Clinical knowledge, 2) Professionalism, and 3) Global competency. When the rotation is completed, the resident must provide a presentation at his/her home country regarding his/her clinical and research experience, and discuss future applications in the practice. Experiences have been significantly rewarding for residents from each country respectively. Two residents have already completed their program, one from each country. There is now a demand to increase the number of residents per country/per year based on the increase number of applications. The first cycle of the program has provided insights on innovative surgical techniques to be applied in Costa Rica and new perspectives on health care delivery systems and on their impact on the overall quality of maternal and child health. Research collaborations have also developed between residents and faculty from both countries thanks to this initial exchange experience. As a result of the first year's experience, the first Latin American symposium on Women's Reproductive Health was also held back in June 2011 in San Jose, Costa Rica, allowing researchers, educators and clinicians in ObGyn to present topics of interest for and from both countries, opening the window to expanded collaborations.