The pursuit of global health during residency: Essential lessons in scholarly inquiry, quality improvement, and health equity

Global health is in the zeitgeist of undergraduate and postgraduate medical education. Medical students and residents from high-income countries (HICs) are more likely to have global health experience and be interested in integrating global health into their current training and future careers.^1,2 Although trainees’ motivations to pursue global health differ, they commonly include some combination of an interest in health equity, service, or novel research and clinical experiences.

However, there is seemingly a gap between trainee enthusiasm and training program offerings, particularly in radiation and medical oncology. Program directors, department chairs, and other key leadership in HICs are rightly grappling with how to rigorously and sustainably integrate global health education and research efforts into residency education across specialties.³ Several challenges exist, including arranging time away from education and service requirements in the primary program, assuring necessary mentorship and supervision, and adequate funding.

The Association of Residents in Radiation Oncology’s Global Health Subcommittee (ARRO GHSC) has provided a supportive platform to enhance the pursuit of global health research and clinical innovation during residency for many residents, myself included. ARRO GHSC has monthly calls with committee members to discuss individual and joint projects. Efforts have included global health surveys of residents and program directors, scholarship funding for resident rotations, and a mutual mentorship program that pairs ARRO residents with peer residents abroad to discuss clinical cases and residency experiences.⁴

I am fortunate to be the first resident pursing global health research in the American Board of Radiology’s (ABR) B. Leonard Holman Research Pathway. The Holman Pathway is a national track for United States radiology and radiation oncology residents that allows additional research time during training for those with a demonstrated interest in and aptitude for a primarily research-focused career.⁵ My work has focused on building a breast cancer research collaboration with the University of Zimbabwe, the Parirenyatwa Hospital, and the Harare Central Hospital to study women with breast cancer and their clinical and quality of life outcomes after mastectomy, with a focus on the role of radiation in this setting. Without the support of my residency program, the ABR, and ARRO GHSC, this would not have been possible.

While my experience has been unique, the lessons I have learned may be instructive to other residents who hope to pursue global health and to programs hoping to foster an environment that recognizes the potential benefits of global health experiences for their trainees, namely:

There is a great need to expand radiation oncology capacity in LLMICs.⁶ As ARRO GHSC has shown, residents are poised to lead our field in global health scholarship, systems strengthening, and equity. I am hopeful that more medical students and residents in the years to come will find that the field of radiation oncology will support their global aspirations, as it has wholeheartedly supported mine.