Global health training and education at universities in the Netherlands

Over the last decades, Global Health training and education programmes have been developed at all eight University Medical Centres (UMCs) in the Netherlands. While initially meant for medical students, these programmes have become very popular with biomedical and health/life science students. They help them to acquire a good understanding of the global burden of disease, its distribution and contributing factors. Students familiarize themselves with some of the successes, failures and ongoing efforts to alleviate the global burden of disease. They further develop critical views on the challenges that global health threats pose to local health systems and society in general, in low and middle income countries but also in Europe.

In this brief overview, we reflect on the different Global Health training and education programmes from which students can choose in the Netherlands.

All universities and all (bio) medical curricula follow the internationally accepted Bachelor – Master model. All eight University Medical Centres have incorporated global health aspects in their core BSc and MSc programmes and also offer specific global health courses (see Table 1). These courses attract Dutch and foreign students from the biomedical and health & life sciences as well as social sciences.

Medical curricula in the Netherlands are based on a nationally agreed framework that sets the targets to be achieved for all relevant topics. Although the content and the quality (indicators) of programmes are set, the way the various medical curricula are implemented differs. This has led to different priorities and emphases between the UMCs in their Global Health medical curricula. The biomedical and health & life sciences curricula have no national framework, allowing for differentiation of the training programmes at various UMCs in line with their respective expertise and specific fields of global health research.

Several faculties have recently revised their training curricula quite radically. Radboud UMC, for example, emphasizes self-directed learning and has adopted a personalized healthcare approach based on the molecule-man-population continuum. UMC Groningen dedicates 40% of its Bachelor curriculum to competency development via learning communities (of which Global Health is one), with 60% of the curriculum focused on typical medical content through problem-based learning. The CanMEDS competencies of medical expertise, communication, collaboration, health advocacy, academic development, professionalism and leadership are at the heart of the curriculum.

Laying a good basis in the bachelor phase

The various curricula typically offer three types of Global Health training and education programmes:

• a loose set of elective or compulsory courses around Global Health themes throughout the bachelor phase. This used to be the set-up, but at most UMCs it has been replaced by:
• a minor in Global Health: over a period of 10 to 20 weeks, students follow a programme organised around a certain theme or a mix of themes (e.g. sexual & reproductive health rights, child health, infectious disease control, non-communicable diseases, health systems development), sometimes followed by participation in or evaluation of a project in a low or middle income country. In other cases, it includes a visit to one or more multilateral health agencies (WHO, UNAIDS, the International Red Cross).
• a profile in Global Health: at Groningen University Medical Centre, first-year medical students may choose Global Health as one of four bachelor profiles.

The value of internships in the master phase

Medical students have the option of a doing a clinical Tropical Medicine/Global Health internship for three months in a hospital in a low or middle income country or a research internship. Several faculties have a long tradition of providing clinical internships, sometimes in partnership with universities in Africa, Asia or Latin America. Some offer preparatory courses that include specific skills training and social-cultural aspects of working in a foreign setting. UMC Utrecht offers an on-line pre-departure course. Biomedical and health/life science students may do a research internship abroad as part of their master training.

Students who completed an internship in a low or middle income country have pointed out that it is an invaluable experience to get exposed to a foreign setting and situations of serious resource constraints. It broadens their horizon and helps them to expand their personal networks. It also helps them in making a choice whether to specialize as a doctor global health & tropical medicine – or as a global health researcher – and pursue an international career.

Our modern society requires global health professionals who have not only (bio) medical and public health skills and expertise, but who are also able to work in multidisciplinary teams and appreciate different socio-cultural environments. Today’s students are the professionals of tomorrow. They are expected to actively contribute to appropriate forms of healthcare and health systems that incorporate appropriate and sustainable innovations that societies value and can afford.