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Melissa Melby is a medical anthropologist and the lead author of a paper that recommends ways to evaluate and improve short-term international experiences for medical students.
As American medical students increasingly
want and expect to have international work experience, more and more
short-term programs are being offered to give them that opportunity,
according to Melissa Melby, assistant professor of anthropology at the University of Delaware.
The trouble is, she writes in a new article in Academic Medicine,
that too many of these programs — called STEGH, or short-term
experiences in global health — focus on the needs of the student
trainees and not on what’s best for their patients or for overall health
care in the countries they visit.
“Most students who participate in these programs genuinely want to
help people,” Melby said. “But many of them may not be aware of the
unintended consequences that can occur. In this article, we propose four
core principles that we hope will help guide both the developers and
the participants in STEGH programs.”
Melby, who specializes in the biological and medical aspects of
anthropology, is the lead author of the article, written with colleagues
who are medical doctors involved with global health care issues. She
said her co-authors, who connected with her through the Delaware Health Sciences Alliance,
of which UD is a founding partner, saw problems with many STEGH
programs and sought her out for an anthropological perspective.
“STEGHs are often very short term, perhaps about three weeks or even
less, and many times the participants are dropped into an area with very
little preparation,” Melby said. “They don’t know the language, they
don’t know the culture, and they’re jet-lagged. They’re
well-intentioned, but this is often not the best way to help people.”
The authors of the paper list four principles that they say can be
used to create better STEGH programs and to help students evaluate
existing programs and make good choices about which to join. The
While STEGHs can provide students with important global and
cross-cultural education, the authors say they believe a paradigm shift
is needed to ensure that the programs benefit both the trainees and the
communities they visit. And, Melby said, the proposed guidelines can
apply beyond medical or pre-med students to include other study-abroad
and global service-learning programs.
“We think these principles are relevant to a lot of student groups
that do global work,” she said. “Most people’s hearts are in the right
place, but there are often aspects to what they’re doing that they just
don’t think about.”
The article, “Beyond Medical ‘Missions’ to Impact-Driven STEGHs:
Ethical Principles to Optimize Community Benefit and Learner
Experience,” is available online. It will be published in an upcoming print edition of Academic Medicine, the journal of the Association of American Medical Colleges.
The co-authors are Drs. Lawrence C. Loh, Jessica Evert, Christopher
Prater, Henry Lin and Omar Khan, who also is an affiliated faculty
member in UD’s College of Health Sciences.
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