Global Reproductive Health Residency Training in Costa Rica: An International Experience for ObGyn residents

C. Patricia Obando, Elizabeth Bogdan-Lovis, Michigan State University

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Abstract: To incorporate a global health perspective to the ObGyn residents training at Michigan State University and at the University of Costa Rica through a 4-week exchange rotation in local hospitals and clinics. The experience provides our residents the opportunity to personally understand the practice challenges of global reproductive health and promotes a reciprocal contribution to improve women’s health worldwide. The US residents are exposed to a country with a “universal health system,” where the trend of health indicators has shown commendable standards despite the lack of advanced technological support.   ObGyn residents from Costa Rica have the opportunity to observe different surgical techniques by using advanced robotics, the use of simulation and the overall health system’s economic impact.  The 4 week rotation provides an appreciation of core competency skills as they relate to women’s health, cultural sensitivity, health disparities and medical ethics.  The program includes six specific learning objectives: 1) Medical knowledge and patient care; 2) Epidemiology and public health; 3) Specific populations (immigrant population); 4) To promote international collaborations; 5) Professionalism and cultural competency and 6) Interpersonal skills and communication.  Residents are matched with a faculty mentor who organizes the rotation for the foreign resident according to the local scheduling system and hospital priorities. In-country supervisors ensure that the resident experience meets the exchange program objectives and the ACGME educational objectives. Selection criteria: the resident must meet the following criteria: 1) must be in his/her third or fourth year of ObGyn residency; 2) must have a proficiency level of Spanish or English; 3) a valid passport; and 4) a recommendation from the Program Director.   The resident applying to the program must provide 2 letters of recommendation from faculty members or mentors, curriculum vitae, and a brief personal statement describing previous similar experiences, personal qualities and how the program will contribute to his/her practice.  A standardized evaluation of the participating resident is conducted by the assigned mentor in each country.  The evaluation includes a mid-term and a final evaluation based on the following criteria: 1) Clinical knowledge,  2) Professionalism, and 3) Global competency.   Once the rotation is completed, the resident must write a five page paper on all experiences related to his/her clinical and research experience and discuss future applications in her home country.  Experiences have been significantly rewarding for residents from each country. The first cycle of the program has provided new insights on innovative surgical techniques to be applied in Costa Rica and new perspectives on health care delivery systems on their impact on the overall quality of maternal and child health. Research collaborations have also developed between residents and faculty from both countries thanks to this initial exchange experience.

About the Presenter: 

Elizabeth Bogdan-Lovis is co-director for MSU’s Center for Ethics and Humanities in the Life Sciences. Her research focuses on the political economy of U.S. medicalized childbirth and the integration of evidence-based medicine both in clinical practice and medical education. E-mail: 

Patricia Obando is assistant professor and Director of Medical Education in the Department of Obstetrics, Gynecology and Reproductive Biology in the College of Human Medicine, Michigan State University. She is actively engaged in health care education and development of electronic, blended resources in medical education. She has been an active researcher on issues related to substance abuse in minorities and women of reproductive age. She is currently working to establish academic collaborations between MSU and the University of Costa Rica to promote global health training for residents and faculty in Obstetrics and Gynecology. E-mail:         

Presented on: 
April 21, 2011
Symposium 2011
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