Designing infectious disease curricula with relevance to local demographics and epidemiology is important and beneficial for trainees, faculty, and the community. In Miami, tropical diseases are frequently included in the infectious diseases differential diagnosis given a large immigrant population as well as returning travelers and tourists from endemic areas.
We present our experience at a large academic center in Miami constructing international rotations (IR) designed to improve understanding of global health issues and increase cultural competency relevant to local immigrant communities. First, we conducted physician surveys in our academic center to determine gaps in knowledge, attitudes and practice pertaining to tropical medicine (TM). Next, we identified countries with large immigrant populations in Miami and endemic diseases that may be seen in Miami patients. We chose to develop three IR sites (in Colombia, Brazil, and Guatemala) that could each provide experience managing relevant diseases, cultural context for frequently encountered Miami immigrant groups, and were safe and feasible in terms of the allotted time and funds available. Each site offers a different focus for training opportunities (clinical care, research, and/or epidemiology). We followed the ACGME implementation policy to comply with RRC program requirements. We partially funded rotations for participating trainees and assured that their salary and benefits continued during their rotation
Residents and fellows from Internal Medicine, Medicine-Pediatrics, and Infectious Disease Divisions have traveled to the three approved IRs. Trainees managed a variety of TM diseases at these sites. All reported that IR enhanced their practice in Miami with immigrant patients as well as improved language skills and cultural competency. They also reported increased awareness of TM as part of the differential diagnosis in patients with epidemiological risk factors.
Understanding local gaps in immigrant health and TM knowledge in our area allowed construction of IRs that improve knowledge and awareness of TM at our institution. IRs can be designed to enhance care for locally important immigrant subpopulations in the US.
P. Lichtenberger, None