title: Comparative analysis: potential barriers to career participation by north american physicians in global health.
abstract: Physician interest in global health, particularly among family physicians, is reflected by an increasing proliferation of field training and service experiences. However, translating initial training involvement into a defined and sustainable global health career remains difficult and beset by numerous barriers. Existing global health literature has largely examined training experiences and related ethical considerations while neglecting the role of career development in global health. To explore this, this paper extrapolates potential barriers to global health career involvement from existing literature and compares these to salary and skills requirements for archetypal physician positions in global health, presenting a framework of possible barriers to sustained physician participation in global health work. Notable barriers identified include financial limitations, scheduling conflicts, security/family concerns, skills limitations, limited awareness of opportunities, and specialty choice, with family practice often closely aligned with global health experience. Proposed solutions include financial support, protected time, family relocation support, and additional training. This framework delineates barriers to career involvement in global health by physicians. Further research regarding these barriers as well as potential solutions may help direct policy and initiatives to better utilize physicians, particularly family physicians, as a valuable global health human resource.
authors.affiliation: Department of Pediatric Surgery, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Rhee
authors.affiliation: Department of Urology, University of Wisconsin Hospital and Clinics, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Heckman
authors.affiliation: Department of Internal Medicine and Pediatrics, University of Illinois at Chicago, Room 1405, 840 S. Wood Street, Chicago, IL 60612, USA.
authors.forename: Sae-Rom
authors.identifier: 0000-0001-5404-7558
authors.initials: SR
authors.lastname: Chae
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, 155 College Street West, 6th Floor, Toronto, ON, Canada M5T 3M7 ; Department of Family Medicine, University of British Columbia, 3rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, BC, Canada V6T 1Z3.
authors.forename: Lawrence C
authors.identifier: 0000-0001-9210-3290
authors.initials: LC
authors.lastname: Loh