Medicine, mobility and global health: Capacity building for qualified and committed medical doctors in health care

Problem statement
Global Health (GH) is not yet included in medical curricula in Germany. Knowledge of GH amongst German medical students, their international health elective (IHE) patterns or commitment to social determinants of health (SDH) have not been analysed.
Understanding education needs in GH and addressing these in their curricula is essential for medical schools in order to strengthen human resources for health services in a global context.
Method
The authors developed a web-based, structured questionnaire to gather information about students’ mobility, knowledge of selected GH topics and commitment to SDH. Students from 36 German medical schools were informed about the survey using mailing-lists of students’ unions. All registered medical students were eligible to participate in the study during the second half of the year 2007.
Results
Out of all medical students in Germany (N=78.000), 1126 online-replies were received and analysed. 
363/1126 (32%) respondents declared at least one IHE, 133/363 (37%) to developing and 230/363 (63%) to developed countries. 9/363 (2%) respondents declared a participation in specific preparation programs provided by medical schools. 751/1126 (67%) could imagine working on international levels. IHE correlated with an increased knowledge of GH issues (p<0.032); a higher commitment to SDH correlated with completed IHE in developing countries (p<0.05), courses in GH (p<0.002) or tropical medicine (p<0.03). 437/1126 (39%) declared their dissatisfaction about the inexistence of GH courses at their faculty.
Conclusion
German medical students are immensely mobile and IHE in developing countries are very common. Preparation for IHE is virtually inexistent and German medical students have insufficient knowledge of GH issues. GH education and IHE are an opportunity to cultivate a commitment to SDH. Structured education in GH should be part of regular curricula in medical education to contribute to capacity building for qualified and committed future doctors in a globalized health care context.