Impact of Global Health Experiences During Residency on Graduate Practice Location: A Multisite Cohort Study

The impact of global health experiences on practice location is not clear.

We studied whether participants in global health tracks (GHTs) and global health electives (GHEs) were more likely to practice in underserved areas.

Our study used the 2010 American Medical Association Masterfile to evaluate the practice location of 999 graduates (1980-2009) from 5 family medicine programs. The variable of interest was participation in a GHT or GHE. Outcome measures were percentage of graduates practicing in (1) health professional shortage areas, (2) medically underserved areas or populations, (3) rural areas, (4) areas of dense poverty, and (5) any rural or underserved area. We also examined whether availability of a GHT or GHE in the program affected nonparticipants' practice location.

Sixty-four percent (112 of 174) of participants practiced in areas of dense poverty compared with 56% (463 of 825) of nonparticipants (P  =  .04). Those graduating after GHT implementation were more likely to practice in a rural or underserved area compared with those graduating before implementation. After controlling for potential confounders, GHT participants were not more likely to work in an underserved area.

Graduates of programs with global health experiences were more likely to practice in an underserved or rural area. Making these experiences available may affect participants and nonparticipants.