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15 Apr 2014

When Lloyd Nash, fresh from medical school, went looking for opportunities to pursue a career in global health, he was given the brush off.

“Wherever I turned, I felt that people were sending me away rather than welcoming me with open arms,” the general physician said. “They were saying, ‘Go away, and come back when you have done some volunteer work and some additional training’.”

So that’s what he did, gaining a Masters in Public Health and becoming a director at the Royal Australasian College of Physicians.

But while Dr Nash’s experience of being forced to make his own way is typical for those who have sought, up to now, to establish a career in global health, he believes it is time to take a more systematic and structured approach.

With several like-minded colleagues, including former Chair of the AMA Council of Doctors in Training Dr Rob Mitchell and emergency registrar Dr Jenny Jamieson, Dr Nash founded the Global Ideas Forum ( as a way to help medical graduates and other young people to tackle health inequity.

Firmly of the view that there is great interest in global health among medical students and those just embarking on their medical careers, Dr Nash is also working with the RACP on the development of global health training opportunities.

“I really believe there is a genuine demand for this kind of training and work, particularly among young doctors,” he said.

Dr Nash said it was “not so long ago” that the International Medicine elective became almost ubiquitous in medical school courses and this, combined with increased first-hand experience of yawning health inequities through travel and the greater flow of information, has fuelled a hunger for global health training and work.

He said Colleges such as the RACP were interested in catering for this demand, but typically had three main concerns about how to organise and oversee global health education for trainees working in resource poor countries, which could be categorised broadly as educational support, professional support and personal support.

In Dr Nash’s view, each of these concerns could be relatively easily addressed and overcome.

He said the internet made the task of supplying educational materials and supervision to trainees in remote locations practicable.

Regarding professional support, Dr Nash said global health training placements typically required a qualified local supervisor and “someone at home that you can turn to professionally”.

In the region, this was not as unlikely or difficult as some might think, because most senior medical staff in countries like PNG, Fiji or Vanuatu would have trained overseas, such as in Australia or New Zealand, and were well qualified to provide the necessary supervision, supplemented by support from a supervisor in the home country.

One of the biggest concerns for Colleges is that they lack the systems and expertise to provide the necessary personal support for trainees going to remote or resource-poor countries, including basic measures such as arranging for health insurance and appropriate vaccinations through to on-the-ground expertise in securing safe accommodation and transport.

Dr Nash said that, rather than try to develop their own expertise or capacity in this area, the Colleges could look at partnerships with organisations like Australian Volunteers International and Medicins Sans Frontieres which have extensive experience in arranging for the safe and effective placement of staff in countries with limited resources and challenging political and physical environments.

He urged Colleges to embrace the opportunity to tap into the interest and enthusiasm of young doctors for global health training, saying the experiences gained would enhance the skills and professional competence of trainees while also providing a benefit for the health and well-being of those living in the region.

Adrian Rollins

Published: 15 Apr 2014