Wilderness medicine within global health: a strategy for less risk and more reward.

s h p M p w c s a s p In the last several years, healthcare workers and trainees have demonstrated an unprecedented interest in global health and the medical challenges facing developing countries and regions in crisis. Perhaps nowhere is this interest so apparent than in our medical schools and universities, where educators have moved quickly to create programs that meet this enthusiasm. It is now common for medical schools to build relationships with partners overseas and to create formal programs in global health education. The Association of American Medical Colleges (AAMC) documented that 45 US medical schools have some sort of global health component in their curricula, with 29.9% of graduating US medical students stating they have had a “global health experience.” However, these programs vary widely, making it unclear whether schools are meeting a baseline standard of global health knowledge in the types of academic and hands-on opportunities offered to students. Collaborative groups such as the Global Health Education Consortium (GHEC) and the Consortium of Universities for Global Health (CUGH) have made preliminary attempts to standardize global health curricula by identifying core competencies for medical school global health programs. However, few efforts have been made to assess the risks of institutions sending students abroad, or to decide what skill sets are needed as preconditions to go overseas in a medical capacity. Although there is ample literature on the benefits of short-term international medical training experiences, the dangers associated with sending ill-equipped students to train in resource-poor regions are more difficult to quantify. Little data exist describing accidents occurring among students and trainees working abroad. The US State Department incident database is the most widely cited for injuries