Exclusionary practice: medical schools and global health clinical electives
Clinical reciprocity between teaching hospitals in high and low income countries is imperative.
Global health clinical electives have become popular components of academic medical education.1 Approximately 40% of UK medical students2 and 30% of US and Canadian medical students3 take clinical electives in resource challenged settings. Rhetoric about globalization and our newly “flat” world might lead one to assume that electives are a bidirectional exchange between teaching hospitals—send one, get one—and that medical students from poor countries could readily pursue electives in high income countries. Yet teaching hospitals in wealthy countries rarely provide true reciprocity. For most students from poor countries placement options are few and elusive. In the United States, for instance, while nearly all medical schools provide international opportunities for their own students, almost half deny clinical opportunities to international students.4 This exclusion may seem subtle to students and teachers in wealthy nations; it is obvious to medical school faculties and medical students in low income nations. Africa experiences the least