IFMSA MANUAL
Building Holistic Action towards a Socially Accountable Medical Education
IFMSA Imprint SCOME Director 19-20 Marouane AMZIL SCOPE Director 19-20 Gabriela Macedo SCORE Director 19-20 Mathieu Pierre SCORP Director 19-20 Mahmood Al Hamody SCOPH Director 19-20 Sarah Maitho SCORA Director 19-20 Laura Lalucat Garcia-Valdes Sajib Zaman (SCOPH IT) Elena Scholmann (SCORP IT) Batara Bisuk (SCORP IT) Klaudia Szymus (SCORA IT) Chaitra Dinesh (SCOPE IT)
Layout Design
The International Federation of Medical Students’ Associations (IFMSA) is a non-profit, non-governmental organization representing associations of medical students worldwide. IFMSA was founded in 1951 and currently maintains more than 140 National Member Organizations from more than 129 countries across six continents, representing a network of 1.3 million medical students. IFMSA envisions a world in which medical students unite for global health and are equipped with the knowledge, skills and values to take on health leadership roles locally and globally, so to shape a sustainable and healthy future. IFMSA is recognized as a nongovernmental organization within the United Nations’ system and the World Health Organization; and works in collaboration with the World Medical Association.
Miguel Ferreira (PRC IT)
Publisher IFMSA Norre Allé 14, 2200 Kobenhavn N., Denmark
Email: gs@ifmsa.org Homepage: www.ifmsa.org
Contact Us
vpprc@ifmsa.org
This is an IFMSA Publication
Notice
© 2020 - Only portions of this publication may be reproduced for non political and non profit purposes, provided mentioning the source.
All reasonable precautions have been taken by the IFMSA to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material herein lies with the reader.
Disclaimer This publication contains the collective views of different contributors, the opinions expressed in this publication are those of the authors and do not necessarily reflect the position of IFMSA. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the IFMSA in preference to others of a similar nature that are not mentioned.
Some of the photos and graphics used in this publication are the property of their respective authors. We have taken every consideration not to violate their rights.
Click to access the page
Contents
Introduction
What does a holistic action look like?
www.ifmsa.org
What approaches can Standing Committees have in addressing the Social Acountability of Medical Schools? SCOPH Approach
SCORA Approach
SCORP Approach
Exchanges Approach
INTRODUCTION Social Accountability of medical schools an IFMSA Global Priority The commitment of IFMSA to educate, advocate and participate in global actions related to implementing Social Accountability of medical schools is not a fruit of coincidence, but is the result of a cascade of initiatives that transformed students to advocates for Social Accountability of medical schools at all levels. One of the landmark moments in the IFMSA history was the Federation’s participation in the World Summit for Social Accountability (2017), where IFMSA not only was awarded the Charles Boelen Prize for The Students’ Toolkit on Social Accountability of medical schools, but most importantly joined forces with other healthcare students organizations to raise our voice through the Students’ Declaration on Social Accountability in Healthcare Professions Education. It has led to many actions IFMSA has taken to engage members worldwide in being ambassadors for Social Accountability of medical schools on the local level, namely the different capacity building initiatives held on many occasions. Throughout the past years, the Standing Committee on Medical Education (SCOME) has taken the lead in all IFMSA actions related to Social Accountability of medical schools. While SCOME’s main goal related to Social Accountability is to achieve the vision of meaningful students’ engagement towards a socially accountable Medical Education, some pieces of the puzzle are still missing for a perfect image; building comprehensive action plans towards achieving the aforementioned goal requires the collaboration of all Standing Committees to engage students in addressing the priority health needs of the populations and communities. Thus, the purpose of the following manual is to outline the different approaches members worldwide can take so as to implement actions related to Social Accountability of medical schools.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
4
WHAT DOES A HOLISTIC ACTION LOOK LIKE? For IFMSA National Member Organizations (NMOs), or any local medical students organizations, calling for Social Accountability of medical schools can be the fruit of various actions aiming to not only empower medical students as advocates, but also to engage in creating an impact as medical students, medical schools and communities:
1. CAPACITY BUILDING The first step of students’ engagement in any field is capacity building. Developing engagement-related competency requires knowledge about Social Accountability of medical schools and its implication on the health of the population. Thus, IFMSA recommends numerous resources to empower medical students as advocates on this matter: •
The Students’ Toolkit on Social Accountability of medical schools: a toolkit combining a manual, a summary video, an assessment tool, a training handout, a workshop proposal, and a quartet game to build knowledge of medical students on the concept of Social Accountability, and lead their reflection on their context within their own medical schools to raise relevant problematics and brainstorm potential solutions. Access the Students’ Toolkit here.
•
IFMSA Workshops: peer education is one powerful aspect of capacity building that aims to strengthen the competence of medical students, not only in relation to developing deeper knowledge about multiple topics related to Social Accountability of medical schools, but also to gain the necessary skills to implement actions, whether education, advocacy or community engagement related activities. We can cite and recommend the following workshops, yet the list is not exhaustive: •
Implementing Social Accountability in medical schools workshop
•
Advocacy in Medical Education Training (AMET)
•
Public Health Leadership Training (PHLT)
•
Advocacy to Policy-Making Workshop (AtoP)
•
HIV and AIDS Education and Advocacy Training (HEAT)
•
International Peer Education Training (IPET)
•
Human Rights for Medical Practitioners (HRMP)
All these capacity building initiatives are aimed to develop competencies among medical students that are necessary to outline action as this document describes. The choice of the capacity building tool should resonate with both the target population and the expected outcome.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
5
2. ACTIVITY DESIGN AND IMPLEMENTATION Widening the impact medical students can create on the health of communities requires a variety of actions implemented from different perspectives. The following document outlines the different types of activities members can lead on local, national or international levels in multiple focus areas related to each Standing Committee. The main types of activities we recommend are: •
Educational activities: non-formal education has a major role to play not only in building medical competency among students, but most importantly in setting a basis for the curricular changes that are needed to implement a socially accountable Medical Education. As medical students, you are able to take the lead in organizing educational activities for your peers in medical schools, in accordance with the identified needs and the available faculty resources.
•
Advocacy and campaigning: medical students are able to influence the decision-makers so as to implement the required curricular changes in medical schools, through voicing the opinion of the represented medical students in relevant forums and meetings where multiple stakeholders are present and meaningfully engaging in building a socially accountable Medical Education. Such actions could either be a result of involving medical students after the invitation from relevant stakeholders, or an initiative taken from medical students to ensure their participation in the decision-making processes.
•
Community-based action: medical students can not only partake in community services as a learning opportunity, but also lead and organize community-based actions where they can engage their peers and relevant stakeholders in direct exposure to community health and its multiple determinants.
3. ENGAGING WITH STAKEHOLDERS As partnership represents one of the core values of Social Accountability of medical schools, medical students can be the web network connecting all the relevant stakeholders, through meaningfully engaging them in the different activities, whether as educators, co-organizers, or partners in decision-making. The main stakeholders we can cite are: •
Medical schools: As the end goal is to ensure the Social Accountability of the institution, a medical school plays a major role in any relevant action and at all levels, whether through committing to Social Accountability through a formal declaration in the vision and mission of the institution, or its auto-evaluation for accreditation purposes. On the other hand, a medical school can also empower other stakeholders into putting the available resources at the service of community health priorities, whether through logistically and/or financially supporting any educational related activity, or actively involving community partners in all the relevant activities.
•
Health professionals: Community health is not only the concern of medical professionals, but also all the other health professionals, ranging from nurses, midwives, dentists to phar-
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
6
macists and others. An interprofessional approach to addressing Social Accountability of medical schools aims to implement an integrated people-centered care, and thus put the community health as a priority in the working environment in healthcare settings. •
Communities: As the main beneficiaries of the implementation of Social Accountability of medical schools, they can also take an active role to meaningfully shape the delivery of healthcare services, whether in terms of their availability, accessibility, acceptability or quality. For example, if engaged as a community partner of the medical schools, they can actively participate in shaping the medical curriculum, or in curriculum delivery and take part in teaching through sharing patients experiences and perspectives of healthcare delivery, and offer feedback to the quality of services provided by medical professionals and students.
•
Senior health leadership and global health governance: Leaders in global health play a key role in ensuring the integration of Social Accountability as a value and as a concept into health governance. Nowadays, health is a political choice, which is why stakeholders at senior health positions of power need to proactively strive towards greater Social Accountability through community actions, increased transparency and evolving decision-making processes.
To summarize, collaboration is the essence of implementing actions related to Social Accountability of medical schools, and it takes a village to echo and strengthen the voice of medical students as advocates for their implementation. Thus, we highly recommend developing activities from multiple Standing Committees perspectives so as to maximize the impact of your NMO or Local Committee.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
7
WHAT APPROACHES CAN STANDING COMMITTEES HAVE IN ADDRESSING THE SOCIAL ACCOUNTABILITY OF MEDICAL SCHOOLS?
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
8
SCOPH APPROACH
INTRODUCTORY NOTE WHAT IS THE PUBLIC HEALTH TAKE ON SOCIAL ACCOUNTABILITY OF MEDICAL SCHOOLS? Public deals with with the the health health of of the populaPublic health health essentially essentially deals tions. tions. Therefore, Therefore, it goes without saying that the public health curriculum inevery everymedical medical school should purposefully curriculum in school should purposefully cater cater to the health concerns of its population. Public health to the health concerns of its population. Public health focuses focuses on p disease prevention andphealth promotion. For a on d isease revention and health romotion. F or a public public curriculum to be socially accountable, it must health health curriculum to be socially accountable, it must identify identify the prevalent in the community and equip the prevalent diseasesdiseases in the community and equip medical medical prevent Thus, medical schools studentsstudents to preventtothem. Thus,them. medical schools should work should work alongside their communities and key stakeholalongside their communities and key stakeholders to anticipaders to anticipate their population’s health-related needst heir and te t heir population’ s health-related needs and adapt adaptcurriculum their publictohealth public health them. curriculum to them. For public health curricula to b e socially accountable, t hey should include public health r esearch skills, and employ community-based learning.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
9
FOCUS AREAS WHAT ARE THE PUBLIC HEALTH AREAS THAT RELATE TO SOCIAL ACCOUNTABILITY OF MEDICAL SCHOOLS?
1
2
3
4
Preventive Health
Health Literacy
5
6
7
8
Mental Health
Rural health
Social determinants of health
Climate change and environmental health
Integrated people- Primary Health Care centered care and and Universal Health patient safety Coverage
TYPES OF ACTION
1. EDUCATION
1. Preventive medicine: the educational experience should not only comprise theoretical knowledge about preventive measures related to either communicable or non-communicable diseases, but also case-based learning and fieldwork to enable medical students to appropriately communicate them to the general population. 2. Health Literacy: empower medical students with communication skills that will enable them to identify the groups at risk, and conduct effective patient education accordingly. 3. Primary Healthcare and Universal Health Coverage: enable medical students to describe their national health system and how it affects the health of the population. This should include education about health systems strengthening, importance of primary health care, universal health coverage and its building blocks. 4. Rural Health: Medical students should not only be taught about the particular health priorities in the rural areas but most importantly should have the opportunity to parti-
cipate in rural health practice, as it allows the exposure of medical students to the rural population, their healthcare needs and the sociocultural context surrounding them. 5. Social determinants of health: medical students should be able to take on a biopsychosocial approach to patient care, acknowledging the social and economic conditions that influence individual and group health status, and empowered enough to make clinical decisions accordingly. 6. Climate change and environmental health: Climate change manifests differently depending on the geographical area. Students should be taught about this topic in their respective locations and its direct and indirect impacts on population health. Other aspects of environmental health that should be explored cover water and sanitation including waste management, air pollution, and sustainable food production and consumption amongst others. These should address the national situation and the relation between environmental health and different diseases onset.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
10
2. ADVOCACY AND CAMPAIGNING 1. Interprofessional Education: call for involving medical students alongside with other students from other healthcare professions in public health related learning opportunities is key to achieving integrated people-centered care and strengthening patients’ safety through a strong collaborative practice in healthcare settings.
3. Climate change and environmental health: advocate for medical schools to adopt a framework for climate change and environmental health in Medical Education, in a way it addresses all the relevant competencies in their curricula, and adopts an internal policy reinforcing its commitment towards planetary health.
2. Rural placement for medical students: advocate for medical students’ rural exposure to opportunities within their medical curriculum and decent conditions for learning in rural healthcare settings..
4. Residential Field Site Training: call for an early immersion of medical students in primary healthcare centers will raise medical students awareness of the key roles a physician plays on a community level, and thus increase their interest in choosing a career related to community health
3. COMMUNITY-BASED ACTIONS 1. Health Literacy: allow medical students to promote a healthy lifestyle and the measures related to diseases’ prevention within the general population, whether through faculty-led or student-led community-related activities.
2. Community-based research: involve medical students in all the relevant research projects, from designing the research protocol to data collection from communities and results analysis, as it will allow a broader understanding of the communities health, the social determinants of health and how they can influence medical practice.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
11
EXAMPLES AND GOOD PRACTICES FROM NMOS
AMRphobia
FINGER
IFMSA-Morocco
(Fighting Dengue Forever) CIMSA Indonesia
STOPPING THE CLOCK
Wissenshunger Brainfood
Climate Chande and Tropical DIseases AEMPPI Ecuador
Health and Environmental Asaptive Response Rask Force (HEART) CFMS CANADA
Healthsphare SaMSIC
bvmd Germany
Click here to find more details about these activities
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
12
SCORA APPROACH INTRODUCTORY NOTE WHAT IS THE SRHR TAKE ON SOCIAL ACCOUNTABILITY OF MEDICAL SCHOOLS? The connection between Social Accountability of Medical Schools and Sexual and Reproductive Health and Rights (SRHR) happens to be extremely relevant, as under the SRHR umbrella there are several areas in which for multiple reasons, the needs of the communities we serve are far from being met. As a few examples, fear from being stigmatised by healthPublic health essentially deals with the health of the populacare providers is found to be the main barrier for people living with HIV tions. Therefore, it goes without saying that the public health to access healthcare services, LGBTIQA+ specific health needs are unacurriculum in every medical school should purposefully cater dressed in medical curricula worldwide - or often addressed with plenty of to the health concerns of its population. Public health focuses bias and discriminatory approaches - and access to contraception or safe on d isease p revention and health p romotion. F or a public abortion services are far from being a reality across the globe. health curriculum to be socially accountable, it must identify prevalent diseases the community medical engaSociallythe accountable medicalin schools together and withequip meaningfully students to lead prevent them. Thus, medical schools shouldthat worktake us ged students can to SRHR ground breaking initiatives alongside their communities stakeholders to anticipacloser to achieving SCORA vision inand thekey foreseeable future. Ensuring that te t heir population’ s health-related needs and adapt t heir communities’ SRHR diverse needs are covered in the curricula and that public health curriculum to them. students are competent enough to address any SRHR topic, are crucial to achieve health health for all curricula and it is to deemed necessary that SRHR For public b e socially accountable, t hey topics are understood from a public sex-positivity capacitating students to should include health rapproach, esearch skills, and employ promote healthy lifestyles. community-based learning.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
13
FOCUS AREAS WHAT ARE THE SRHR AREAS THAT RELATE TO SOCIAL ACCOUNTABILITY OF MEDICAL SCHOOLS?
1
2
3
Access to Legal and Safe Abortion
Family Planning and access to contraception services
Addressing Gender-based Violence and support to survivors
4
5
Comprehensive gynecological care
LGBTQIA+ health and rights
TYPES OF ACTION
1. EDUCATION
1. People Living with HIV or AIDS (PLWHA): medical students are taught about the up-to-date HIV or AIDS diagnosis and treatment protocols. Additionally, medical students are equipped with appropriate and stigma-free communication skills, taking into consideration the socio-cultural context and mental health implications for PLWHA. 2. LGBTQIA+ Health: Students are taught a non-discriminatory approach to patients through establishing an appropriate doctor-patient relationship, based on good communication skills that require learning: a. The LGBTQIA+ related terminology and its appropriate usage in a healthcare related dialogue b. The appropriate usage of pronouns while taking patient history c. The special healthcare needs related to each sexual orientation and/or gender identity, especially those caused by minority stress. Students learn how to address health issues effectively (e.g. testicular cancer prevention: focusing on the cancer reducing fertility will not
have the same effect on homosexual men as fertility is mostly not their first concern, so the narrative should be changed). Further readings: i. Building an LGBTQ+ Health Curriculum Manual - here ii. IDAHOT ABC: an LGBTIQA+ acronym short dictionary - here iii. Pride Fridays - Policy implementation brief - here 3. Family planning: medical students learn a person-centered and evidence-based approach to prescribing contraceptive methods, while taking into account the available contraceptive methods, as well as the social and moral aspects in question. Additionally, students are knowledgeable about abortion methods and their evidence-based indications, while taking into consideration the country’s related legislation and the cultural and social acceptance of each abortion method. 4. Gender-based Violence (GBV) survivors: Students are taught about physical, psycho-
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
14
logical and behavioural symptoms of victims of violence. Most importantly, students train their communication skills to build a rapport and atmosphere of trust with the victim, support and empower them to make an informed decision regarding their situation.
Note that many GBV survivors were never asked by their healthcare provider about experiencing violence (even though the majority would like to be asked), medical schools should aid students with establishing a personalized approach to every patient.
2. ADVOCACY AND CAMPAIGNING 1. Comprehensive gynecological care: advocacy should aim to empower an interprofessional workforce in numbers, distribution, and competencies so as to provide comprehensive gynecological care and for all people, especially in rural areas (with the emphasis on decreasing the average distance to the closest facilities that offer a minimum service). 2. Contraceptives for all: advocate for strengthening healthcare facilities with sufficient resources and an available workforce to ensure equal access to contraceptives for all groups, especially young people and adolescents, sex workers, people with disabilities, diverse sexual orientations and gender identities.
3. Discrimination against patients identifying as LGBTQIA+: call for inclusive public policies that guarantee their right to access to healthcare and ensures healthcare settings as a safe and non-discriminatory space for all people regardless of their gender identity or sexual orientation. 4. Medical schools as a safe space for all students: Commit to protecting students against discrimination on the basis of sexual orientation and/or gender identity both at university and on clinical placements through creating an anonymous, transparent, and accessible reporting process
3. COMMUNITY-BASED ACTIONS 1. Comprehensive Sexuality Education: encourage medical students’ participation in promoting sexual and reproductive health and rights among youth through peer education initiatives within relevant institutions. 2. Decentralized awareness-spreading: since most student-led activities are held in big
municipalities in which the university is placed and the same regards the majority of local NGOs, rural communities are disadvantaged from awareness campaigns. Student-led activities in rural communities should involve gynaecological screening, GBV-reporting means, family planning methods, among others
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
15
EXAMPLES AND GOOD PRACTICES FROM NMOS
Love shoudn’t hurt LeMSIC Lebanon
Anti Female Genital Mutilation
Inclusive Communication
Rainbow Love
Redefining Realness: Becoming Trans Selves
IFMSA-Egypt
Reproductive Health Services Drive (Pop a pill contraceptive drive)
FEVESOCEM Venezuela
FASMR Romania
BMMS Bangladesh
MSAKE Kenya
Pinkish Blue IMSA-Iran
Click h ere more to find de about tails the activit se ies
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
16
SCORP APPROACH INTRODUCTORY NOTE WHAT IS THE HUMAN RIGHTS-BASED APPROACH TO ADDRESSING SOCIAL ACCOUNTABILITY OF MEDICAL SCHOOLS? The concept of social accountability is at the heart of a human rights-based approach to health, especially being centred around right-holder participation and duty-bearer accountability. It entails identifying and removing obstacles and barriers to health equity to ensure that the interests and Public essentially dealsmarginal with the are health of the populaneeds of the health vulnerable and most adequately addressed. tions. Therefore, it goes without saying that the public health Being socially accountable requires leaving no one behind, and hence is curriculum in every medical and school should purposefully cater fundamental in promoting fulfilling the right to health. to the health concerns of its population. Public health focuses Sociallyonaccountable and rights-based medical education d isease p revention and health p romotion. F or a should public teach students about clinical reasoning and accountable, cognitive biases, educating health curriculum to be socially it must identify them about the of bias andcommunity discrimination healthcare. theconsequences prevalent diseases in the andinequip medicalMoreover, it should alsotoequip students with the knowledge onshould the intersectional students prevent them. Thus, medical schools work nature of health, between health conditions and different socio-economic alongside their communities and key stakeholders to anticipafactors,teaffecting the treatment and health needs outcomes patients. t heir population’ s health-related and of adapt t heir Adopting such an intersectional lensto tothem. healthcare, while also promoting equapublic health curriculum lity and non-discrimination practice, is crucial to ensuring the accessibility, For public health curricula to b e socially accountable, t hey acceptability and quality of healthcare services. should include public health r esearch skills, and employ community-based learning.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
17
FOCUS AREAS WHAT ARE THE HUMAN RIGHTS AREAS THAT RELATE TO THE SOCIAL ACCOUNTABILITY OF MEDICAL SCHOOLS?
1
2
3
Intersectional and Non-discriminatory healthcare
Migrants’ Health
Refugees’ Health
4
5
Child Abuse
Persons with Disability
TYPES OF ACTION
1. EDUCATION
1. Migrants’ Health: Medical students should be equipped with knowledge on global health, intercultural care, as well as understanding ethnic diversity and health-related needs of migrants as part of the community. Additionally, students need the capacity to avoid medical scapegoating and discrimination (stereotyping of particular immigrant groups as disease carriers), and barriers that they might face in treating migrant patient. 2. Refugees’ Health: Refugees have an added set of vulnerabilities usually due to the settings of camps, resettlement housing or migration routes, resulting in special health needs and concerns. Medical students should be aware of these vulnerabilities through special courses aiming to develop capacities such as: care for a multicultural patient population (including treating diseases seen in new arrivals and long-term foreign-born residents), how to identify barriers and inequities in healthcare services for refugees, health systems interventions designed to reduce disparities in service for refugees, and how to apply patient-centered
communication to advance care planning. 3. Child Abuse: Medical students are taught about the visible symptoms and behavioural patterns of children and young adults that suffer(ed) from abuse, neglect or maltreatment. Students should be informed about their legal responsibility as physicians, and possible courses of action that can take upon suspicion of child abuse. Additionally, it’s important to cover the short- and long-term impacts on the individual, as child abuse might be identified only years to decades later. 4. Persons with Disabilities: As they usually face the vulnerability of superadded health conditions, with healthcare services unresponsive to their needs. Medical students should be equipped with the skills and knowledge about the intersection of disability, socioeconomic factors and the health condition of persons with disability. It is also important to educate students about the basics of habilitation and rehabilitation as part of their practice.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
18
2. ADVOCACY AND CAMPAIGNING 1. Socially accountable and quality education is highly dependent on curricula. However, medical curricula still fail to respect the diversity of the served community, with their deficiency in presenting and tackling the different health needs, and their intersection, of all members of the community. Thus it is important to advocate for inclusiveness in medical curricula through: a. Promoting an intersectional approach to research and to curriculum development, ensuring they address the key health needs of all members of a community, as well as avoiding biases and discrimination of any kind. b. Advocating for curricular frameworks that promote medical students’ exposure to minority and vulnerable groups’ health and cultural safety as key components of medical education; c. Advocating for the integration of migrants’ health into the medical curricula. d. Advocating for the training of medical students on the basics of psycho-
social support as part of their medical education. 2. Inclusive medical education should also be reflected in the learning environment and healthcare settings. This is achieved through promoting a safe and non-discriminatory environment in medical schools for all medical students regardless of their backgrounds, so as to ensure all communities are represented in the health workforce. a. Advocating for anti-racism and anti-discrimination policies with clear ramifications for any student as well as teaching or faculty staff identified as bullying and/or harassing students, based on gender, race, cultural background or sexual orientation. b. Advocating against the racial bias in Medical Education, as curricular resources and content tend to be white male centric. c. Advocating for equal access to quality learning opportunities regardless of medical students social or financial backgrounds.
3. COMMUNITY-BASED ACTIONS 1. Breaking the language barriers: Medical students can help develop multilingual information materials or medical questionnaires to decrease the language barriers. Bi- or multilingual medical students can support service delivery and help with translating for and from patients arriving from overseas to ensure a better patient-doctor communication.
a university program or with relevant NGOs, medical students can support in service delivery to refugee populations in camps and shelters. 3. Awareness raising: medical students can participate in and develop awareness and education campaigns and activities on vulnerable groups related topics, and ways of bridging the gap towards health equity.
2. Volunteering in a refugee camp: as part of
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
19
EXAMPLES AND GOOD PRACTICES FROM NMOS MIGRANTS’ HEALTH
Against The Current:
LIVH: Medical and Health Care
AECS Catalonia
IFMSA Sweden
Migration and Health in the Mediterranean
Students Informs About Health Care and Health
REFUGEES’ HEALTH
Healthcare Delivery Sessions to Refugees and Asylum Seekers SfGH-UK
Click o n th logos f e NMO or mor details e about e a ch activity
Feed and Warm the Refugees IFMSA Kurdistan
CHILD ABUSE
Viola bvmd Germany
Differential Diagnosis: Child Abuse and Neglect TurkMSIC Turkey
PERSONS WITH DISABILITIES
DifferentlyAble Disabilities Awareness Campaign AMSAHK Hong Kong
Empathy and help in disabilities AMMEF Mexico
Together Against Stigma IFMSA Egypt
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
20
EXCHANGES APPROACH INTRODUCTORY NOTE HOW CAN SOCIAL ACCOUNTABILITY OF MEDICAL SCHOOLS BE ADDRESSED THROUGH BOTH THE IFMSA RESPECTIVE PROFESSIONAL AND RESEARCH EXCHANGES? Exchanges are a learning experience, both from a clinical and research perspective. However, IFMSA exchanges can also be viewed as a Global Health educational experience, promoting commitment to social responsibility. By definition, exchange students immerse themselves into a difPublic health withand the education health of the popula-thereby ferent culture, local essentially healthcaredeals setting system, Therefore, it goes without saying thatpatients, the public health proearningtions. a sense of social responsibility towards healthcare curriculum in every medical school purposefully fessionals, their education and peers. Asshould the world is full ofcater inequities, to the health concerns of its population. Public health focuses there are differences in how health care is managed depending on the d isease that p revention and one health p romotion. F orothers. a public unique on conditions distinguish place from all the As a conhealth curriculum to be socially accountable, it must identify sequence of this variety of situations, we also find inequities in Medical the as prevalent diseasesschool in theusually community equip medical Education every medical trainsand its students to face the students to prevent them. Thus, medical schools should work situation they are most likely to find in their close environment or local alongside their communities and key stakeholders hospitals. This results in doctors with poor knowledge,toifanticipanot complete te t heir population’ s health-related needs and adapt t heir unawareness, of topics that in other places mean a capital issue to public public health curriculum to them. health and, consequently, the need of a different way to handle local healthcare. For IFMSA Exchanges, through Professional Research Exchanges, public health curricula to b e sociallyand accountable, t hey aims toshould tackle this issue in order to promote include public health r esearchintercultural skills, and understanding employ and prepare students to be culturally competent healthcare professionals community-based learning. and researchers.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
21
1. EDUCATION 1. Exchange Officers are encouraged to include trainings on Social Accountability and its relevance to Exchanges in their Pre-Departure Trainings and Upon Arrival Trainings. 2. Exchanges are tailored to the (health) needs of the local community, for example through specific skills that are taught and learned. 3. Students are encouraged to tailor their Handbook or Logbook to the needs of the
local healthcare system by including specific learning objectives, and by comparing the differences between the home country and the host country. 4. Through specific training in the host country, also called Upon Arrival Trainings and Educational Activities, incoming exchange students are taught about the healthcare system, medical education system, Social Determinants of Health of the host country.
2. CLINICAL DEPARTMENTS 1. The Standing Committee on Professional Exchanges (SCOPE) encourages Professional Exchange Officers to find departments accountable to the needs of the local or national healthcare system and to promote them throughout the Local Committees Explore Pages and National Member Organizations Explore Pages, promotional materials and booklets. 2. SCOPE works on promoting the importance of Primary Healthcare departments, such as Family Medicine, with trainings and simulations, such as the Universal Health Coverage Simulation (LINK) and Global Health within Exchanges (LINK), in which is descri-
bed the importance of social determinants of health, health systems, global health education and how it can be linked with exchanges. 3. SCOPH in collaboration with SCOPE, conducts Public Health Exchanges which provides students with the opportunity to experience public health work in other countries and gain skills in ways to approach public health projects and activities. These are four-week internships in various public health bodies, thus students provide their skills to directly benefit the local community of the country they do their exchange in.
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
22
3. RESEARCH PROJECTS 1. The Standing Committee on Research Exchange (SCORE) encourages Research Exchange Officers to find research projects accountable to the research needs of the local or national healthcare system. 2. SCORE has a specific type of research projects, called Global Action Projects, which aims to teach future health professionals the necessary skills for the prevention, detection and treatment of endemic diseases worldwide. Through a four-week intervention program, students will reinforce
basic research abilities in special circumstances and experience the way these endemic diseases are handled in their native environment. Students will also be involved in the development of health promotion programs. A Global Action Projects is composed of three parts: theoretical teaching about the disease, community and/or field work (including work at NGOs, primary care centres, local hospitals etc.), as well as research work itself about the endemic disease. As for 2020, SCORE has about 20 Global Action Projects.
RESOURCES AND EXAMPLES FROM NMOs
Pre-departure training endorsed by UNESCO
Webinar: Intercultural learning
Public Health Exchanges regulations
SCOPH Incomings
Educação para todos
he icons t n o k c i Cl etails d e r o m for IFMSA Brazil
ANEM Portugal
IFMSA Manual: Building Holistic Action towards a Socially Accountable Medical Education
23
Afghanistan (RMSA
Dominica)
Kyrgyz Republic (AMSA-KG)
(TaMSA)
Afghanistan)
Dominican Republic (ODEM)
Latvia (LaMSA)
Rwanda (MEDSAR)
Albania (ACMS Albania)
Ecuador (AEMPPI)
Lebanon (LeMSIC)
Senegal (FNESS)
Algerwia (Le Souk)
Egypt (IFMSA-Egypt)
Lithuania (LiMSA)
Serbia (IFMSA-Serbia)
Argentina (IFMSA-Argentina)
El Salvador (IFMSA-El
Luxembourg (ALEM)
Sierra Leone (SLEMSA)
Armenia (AMSP)
Salvador)
Malawi (MSA)
Singapore (SiMSA)
Aruba (IFMSA-Aruba)
Estonia (EstMSA)
Malaysia (SMMAMS)
Slovakia (SloMSA)
Australia (AMSA)
Ethiopia (EMSA)
Mali (APS)
Slovenia (SloMSIC)
Austria (AMSA)
Finland (FiMSIC)
Malta (MMSA)
South Africa (IFMSA-SA)
Azerbaijan (AzerMDS)
France (ANEMF)
Mauritania (AFMM)
Spain (IFMSA-Spain)
Bangladesh (BMSS)
Gambia (GaMSA)
Mexico (AMMEF-Mexico)
Sudan (MedSIN)
Belgium (BeMSA)
Georgia (GMSA)
Montenegro (MoMSIC)
Sweden (IFMSA-Sweden)
Bolivia (IFMSA-Bolivia)
Germany (bvmd)
Morocco (IFMSA-Morocco)
Switzerland (swimsa)
Bosnia & Herzegovina
Ghana (FGMSA)
Namibia (AMSNA)
Syrian Arab Republic (SMSA)
(BoHeMSA)
Greece (HelMSIC)
Nepal (NMSS)
Taiwan - China (FMS)
Bosnia & Herzegovina –
Grenada (IFMSA-Grenada)
The Netherlands
Tajikistan (TJMSA)
Republic of Srpska (SaMSIC)
Guatemala (IFMSA-
(IFMSA NL)
Thailand (IFMSA-Thailand)
Brazil (DENEM)
Guatemala)
Niger (AESS)
Tanzania (TaMSA)
Brazil (IFMSA-Brazil)
Guinea (AEM)
Nigeria (NiMSA)
Togo (AEMP)
Bulgaria (AMSB)
Haiti (AHEM)
Northern Cyprus, Cyprus
Trinidad and Tobago
Burkina Faso (AEM)
Honduras (IFMSA-Honduras)
(MSANC)
(TTMSA)
Burundi (ABEM)
Hungary (HuMSIRC)
Norway (NMSA)
Tunisia (Associa-Med)
Cameroon (CAMSA)
Iceland (IMSA)
Oman (MedSCo)
Turkey (TurkMSIC)
Canada (CFMS)
India (MSAI)
Palestine (PMSA)
Turkey – Northern Cyprus
Canada – Québec (IFMSA-
Indonesia (CIMSA-ISMKI)
Pakistan (IFMSA-Pakistan)
(MSANC)
Québec)
Iran (IMSA)
Panama (IFMSA-Panama)
Uganda (FUMSA)
Catalonia - Spain (AECS)
Iraq (IFMSA-Iraq)
Paraguay (IFMSA-Paraguay)
Ukraine (UMSA)
Chile (IFMSA-Chile)
Iraq – Kurdistan (IFMSA-
Peru (IFMSA-Peru)
United Arab Emirates
China (IFMSA-China)
Kurdistan)
Peru (APEMH)
(EMSS)
China – Hong Kong
Ireland (AMSI)
Philippines (AMSA-
United Kingdom of Great
(AMSAHK)
Israel (FIMS)
Philippines)
Britain and Northern Ireland
Colombia (ASCEMCOL)
Italy (SISM)
Poland (IFMSA-Poland)
(SfGH)
Costa Rica (ACEM)
Ivory Coast (NOHSS)
Portugal (ANEM)
United States of America
Croatia (CroMSIC)
Jamaica (JAMSA)
Qatar (QMSA)
Cyprus (CyMSA)
Japan (IFMSA-Japan)
Republic of Moldova (ASRM)
(AMSA-USA) Uruguay (IFMSA-Uruguay)
Czech Republic
Jordan (IFMSA-Jo)
Republic of North
(IFMSA-CZ)
Kazakhstan (KazMSA)
Macedonia (MMSA)
Uzbekistan (Phenomenon)
Democratic Republic of the
Kenya (MSAKE)
Romania (FASMR)
Venezuela (FEVESOCEM)
Congo (MSA-DRC)
Korea (KMSA)
Russian Federation (HCCM)
Yemen (NAMS)
Denmark (IMCC)
Kosovo - Serbia (KOMS)
Russian Federation –
Zambia (ZaMSA)
Dominica (IFMSA
Kuwait (KuMSA)
Republic of Tatarstan
Zimbabwe (ZIMSA)
Commonwealth of
www.ifmsa.org
medical students worldwide