Table 1
Demographics of focus group participants (n = 26), September–November 2023, Miami, Florida.
| n = 26 (%)a | |
|---|---|
| Trainee status | |
| Resident | 21 (81) |
| Fellow | 5 (19) |
| Subspecialties: Child and adolescent medicine, emergency medicine, gastroenterology, hospital medicine | |
| Year in training | |
| PGY1 | 9 (35) |
| PGY2 | 10 (39) |
| PGY3 | 2 (8) |
| PGY4 | 2 (8) |
| PGY5+ | 3 (12) |
| Gender | |
| Female | 23 (89) |
| Male | 3 (12) |
| Race/ethnicityb | |
| Hispanic/Latino | 17 (65) |
| White (non‑Hispanic) | 6 (23) |
| Other: Black/African American, Asian/Pacific Islander, Middle Eastern | 6 (23) |
| Completed any part of formal medical training outside the United States (IMG) | |
| Yes | 17 (65) |
| No | 9 (35) |
[i] aPercentages may not add to 100 due to rounding; bRespondents were able to select more than one option.
[ii] Abbreviations: PGY, postgraduate year; IMG, international medical graduate.
Table 2
Drivers of engagement themes, with descriptions and quotes.
| THEME | THEME DESCRIPTION | QUOTES |
|---|---|---|
| Finding meaning | Trainees seek to engage in GH experiences as a way of finding meaning and purpose in medicine. | “When you are in those rural areas, they really value your opinion, what you’re saying. For me it kind of almost grounds me and it’s just like, OK, this is why I exist … I am doing something in this world.” (FGD 4, P7) “I think the one thing that is constant, and will always be constant, [is] we’re all human beings and health care is, you know, medicine is the same everywhere in terms of, like, what do you need to do to save a patient.” (FGD 3, P4) |
| Previous exposure | Subtheme 1: US/American medical graduates (AMGs) described early exposure to underserved populations as shaping their interest in GH. Subtheme 2: International medical graduates (IMGs) felt a sense of duty to give back to their home communities. | “Seeing all the needs and how privileged I am […] I never had to deal with not having anything to eat or not being able to have specific medical care or being far away from the doctors, like it’s definitely something that motivated me.” (FGD 1, P5) “I feel like I’ve been really lucky to be able to have all these opportunities, and I want to do GH to help my country, I feel like I have a responsibility to go back and teach or […] improve whatever I can.” (FGD 4, P6) |
| Professional development | Trainees look to GH as an opportunity to fill perceived gaps in their US medical education, including better clinical and procedural skills. | “We have one CT machine; we have one MRI on the whole island. So, the doctors sometimes would be like, OK, you don’t have imaging, how are you gonna differentiate what stroke this patient had?” (FGD 4, P5) “Learning the basics like I’ve drawn blood once, you know, things like, [..] administering vaccines like I’ve done it like three times, like putting a PPD [..] little things like this that as physicians here we don’t get that much exposure [to]” (FGD 1, P2) |
[i] Abbreviations: FGD, focus group discussion; P, participant.
Figure 1
Conceptual model of trainee‑perceived needs in global health training: these five themes illustrate the interconnected and dynamic curricular components of a meaningful global health program as described by pediatric trainees.
Table 3
Barriers and solutions to global health engagement with quotes.
| Barriers | Quotes |
| Institutional/Administrative hurdles | “I could see maybe institutions being hesitant to send people to places where they open themselves up to some liability as well as trainee not having credentials.” (FGD 2, P4) |
| Limited time | “Being a trainee doesn’t particularly leave you with much time.” (FGD 2, P1) |
| Financial burden | “Financial… it’s the biggest one [barrier]” (FGD 1, P3) |
| Family responsibilities | “I used to love traveling and doing global health. Now that I have a kid, it’s like a lot harder logistically to plan for us.” (FGD 3, P3) |
| Host‑site access | “My school had an established partnership with a place in Nicaragua, but since it was very unsafe to go there when I was in Med school, they decided to not do that trip.” (FGD 1, P3) |
| Solutions | Quotes |
| Leverage trainee skills and connections | “I think we have to take advantage that we have a lot of IMGs because like, of course, we know about the culture… so [we] can be a good team.” (FGD 5, P2) |
| Invest in mentors | “An important piece of successful tracks is mentorship and to have mentorship we have to have people with protected time.” (FGD 3, P3) |
| Build trainee research teams | “Doing research in global health could also be part of the project. If people don’t wanna go or travel because maybe they have family or they have things they cannot do, they can be involved in research.” (FGD 1, P5) |
| Restructure schedules | “Building it into the curriculum or at least for trainees having an elective that dedicates a set of time.” (FGD 2, P1) |
| Start local | “I think we could be more involved with those [immigrant health] clinics here to start, because I know that we will all want to fly somewhere, [but] that’s more difficult because of course you need more time, you need to organize a bit more money and it you need to make sure it’s safe, but we are here in [city name] and there’s need here.” (FGD 1, P5) |
[i] Abbreviations: FGD, focus group discussion; P, participant.