Physician perspectives on benefits in patient care from UNC-Project Malawi

Background: The growth of academic medical centres associated with international programmes has raised questions about the benefits and harms of medical experiences abroad for medical trainees and patients. Few studies explore the potential benefits to the institution or country that send these individuals. Objective: This pilot qualitative study explores the benefits medical professionals perceive they bring back to the USA from their global health experiences abroad. Methods: Medical staff who participated in University of North Carolina (UNC)-Project Malawi and who could meet for an in-person interview from October 2016 - March 2017 were recruited. Interviews were guided by an a priori semi-structured questionnaire. Each interview was transcribed and analysed by three reviewers. Results: A total of 8 out of 13 (62%) eligible potential respondents were interviewed. Participants perceived UNC-Project Malawi to benefit themselves, partnership institutions, and patients in Malawi, North Carolina, and throughout the world. After returning to UNC, participants recalled specific instances of increased diagnostic confidence (2/8) influenced by their experiences abroad. In addition, by partnering in research, participants felt that certain concepts were advanced including the syndromic management of symptomatic patients with sexually transmitted infections (1/8), the use of antiretroviral therapy to treat and prevent HIV transmission (2/8), and malaria vaccine development (1/8). Conclusion: Participants perceived that their global health experience either influenced their thought processes concerning the medical management of patients in the USA or resulted in a better understanding of research relevant to the global standard of care for specific diseases. International academic medical centre partnerships can offer rich settings for career skills development and a unique platform for collaborating on the management of clinical diseases that affect patients globally. These benefits can be maximised by establishing bi-directional curriculum goals and defining shared research agendas.