University of Washington School of Medicine
Seattle, WA

Program Director: Mark Tonelli, MD
Program Type: Pulmonary and Critical Care Medicine
Abstract Authors: Tyler J. Albert, MD, Engi F. Attia, MD, Mark R. Tonelli, MD, MA, T. Eoin West, MD, MPH

RATIONALE
25 million people die annually of treatable respiratory illnesses, severe illness and serious infections worldwide. The University of Washington (UW) Division of Pulmonary and Critical Care Medicine (PCCM) has instituted a Global Health Pathway (GHP) in the Fellowship training program, leveraging Seattle’s position as a global health leader to train Fellows to tackle the burden of lung disease globally.

EDUCATIONAL STRATEGY
Integrated within the PCCM Fellowship training program, the GHP augments trainees’ clinical and research education. GHP trainees complete the comprehensive clinical pulmonary training curriculum required of all fellows. Subsequently, GHP Fellows select from a Research (Clinical Outcomes, Basic Science, or Translational) or Clinician/Educator Track to provide a focus for GHP activities. They participate in the PCCM core global health lecture series and semi-annual global health journal club. The GHP facilitates trainee participation in the month-long UW Integrated Residency Global Health Leadership Course and numerous multidisciplinary Department of Global Health seminars. GHP trainees in a Research Track are also required to complete the UW courses “Research Methods in Developing Countries” and “Responsible Conduct of International Research.”

EXPERIENCES
During clinical training, GHP Fellows may participate in local internationally-oriented experiences, attending tuberculosis, immigrant, or travel clinics at UW. Two UW centers based in the Division of PCCM – the International Respiratory and Severe Illness Center (INTERSECT) and the Firland Northwest Tuberculosis Center – facilitate networking opportunities for GHP Fellows in the UW Department of Global Health, PATH, the Bill and Melinda Gates Foundation, Health Alliance International, International Training and Education Center for Health, and other Seattle-based international programs. These connections offer a rich selection of skilled mentors across a wide range of disciplines to foster trainees’ academic career development. During their research or clinician-educator training period, GHP trainees undertake a 1-2 month international elective to initiate original projects. Funding is provided by the PCCM division, INTERSECT, and other UW sources. For research trainees, this sets the stage for submission of career development award applications to support continued lung-related global health research. For clinician-educator trainees, this serves as a critical opportunity to establish key relationships and define an educational project that can be built upon in the ensuing years.

EXPECTED IMPACT AND OUTCOMES
The GHP focuses on development of clinical excellence, knowledge of global health systems and research methods, and international scholarly activity that will prepare graduates for academic faculty positions. Although still in its early stages, the GHP has fostered development of Fellow projects with great potential to impact lung health globally, including creation of a mechanical ventilation and respiratory care training program in Cambodia, investigation of the effects of indoor air pollution on influenza in rural Senegal, and determination of the prevalence of and risk factors for chronic lung diseases among HIV-infected adults and adolescents in Kenya. GHP Fellows have already presented their work at multiple international conferences, including the American Thoracic Society International Conference and the International Primary Care Respiratory Group conference. Highlighting their collective productivity, several abstracts have been submitted to 2015 conferences, such as the Conference on Retroviruses and Opportunistic Infections. Original, peer-reviewed manuscripts stemming from these timely and important projects are nearing completion. Additionally, GHP Fellows have been awarded funding from NIH, foundational and institutional sources, preparing them to submit strong applications for mentored K-level Career Development Awards.

INNOVATION
The GHP is among the first PCCM global health training programs in the US. It leverages the highly successful training platform of the UW Division of PCCM and Seattle’s global health infrastructure to nurture the development of a new generation of internationally-focused clinicians, educators, and researchers to tackle the global burden of respiratory disease and critical illness.