The Ethical Conundrum of International Health Electives in Medical Education

This paper discusses the ethical challenges of global health education programs and, specifically, International Health Electives (IHEs). The growing popularity of IHEs in medical school has ballooned in recent years largely from students who genuinely want to serve in resource-poor areas of the global South, and also from those students who wish to use the field experience to build a superior CV. Medical schools have responded to the demand, but ethical considerations have not kept pace.  In fact, the practice of many of these programs has brought about complex ethical concerns of individual hubris of Northern medical students, and of structural dependency from resource-poor to resource-flush settings. In light of these two concerns, IHEs largely require restructuring.  This paper proposes that program changes need to focus on the very ethical issues that the current programs perpetuate.  While many IHEs do offer some pre-departure training on ethics, pre-departure training can be trivial if it focuses largely on the behaviour of individuals working in resource poor settings.  I propose that a complete reorientation of moral ethics pedagogy and a fresh introduction of social theory training are needed so that the IHE experience is aimed at overcoming current global health inequities at the structural level