International health training in family practice residency programs

This survey determined the extent of involvement in and support of international health training by family practice residency programs. We mailed a 17-item survey about four areas of international health training (curriculum, faculty, financial support, and international health sites) to the 192 family practice residency programs that answered affirmatively to the American Academy of Family Physicians (AAFP) 1996 survey question, "Does your program offer or encourage an elective in an international setting?" Of the surveyed programs, 75% (144/192) responded. Fifty-four percent of programs offered some form of international health curriculum, and 15.3% (22/144) provided significant support for resident involvement in international health, defined as having 1) an international health curriculum, 2) funding support (other than paid salary while away), and 3) at least one faculty member who had done health care work in a developing country in the past 2 years. Of the responding programs, 24.3% (35/144) had none of the three criteria. The number of residents who worked in developing countries most strongly correlated with the number of faculty who have done such work in the past 2 years. Logistic regression suggested that the factors associated with a program having residents who have worked in developing countries in the past 2 years included the number of faculty who worked in developing countries in the past 2 years, the number of months of salary paid while on an international health elective, the length of time a program had offered an international health experience, and paid living expenses while at the international site. A wide range of support is offered for international health education by programs that are self-identified as offering or encouraging international health rotations. This survey begins to clarify the specific factors associated with placing residents in international training opportunities.