Students holding up globe

Worldly-wise – preparing our medical students as global practitioners

  • Education
  • International

RCSI is ranked in the Top 50 for 'International Outlook' in the Times Higher World University Rankings 2022 and our network of 28,000 alumni across 98 countries is a testament to our global reach. Here, Dr Mary Clarke, outgoing Vice-Dean for International Citizenship at RCSI, shares her perspectives on the value of developing students to become world citizens.

COVID-19 has underscored the global nature of health. Responding to a pandemic which affects populations, irrespective of geography, requires healthcare professionals to be equally adept at crossing international boundaries and cultures.

Medical education must prepare our doctors to thrive and meet the challenges of the future. In a world where connections and consequences reach beyond borders and oceans, medical training must prepare our doctors for participation in global cultures. And in a society with an increasingly diverse population, and with strong evidence of racial and ethnic disparities in healthcare, it is essential that our doctors are able to address issues of culture and diversity effectively.

In a globalised world, doctors need to know how best to communicate with patients from cultural and social backgrounds that differ from their own. The International Citizenship Award programme that we have developed in RCSI provides a model that can be used to support the development of cultural and social awareness in our future doctors. The two-year programme aims to develop the specific skills associated with cultural competence and healthcare leadership through a process of civic engagement, mentorship and critical reflection.

Medical students are exposed to a variety of cross-cultural situations and experiences including: an overseas challenge, fundraising leadership both at a local and international level, community engagement at home and abroad and involvement in student societies and committees. Supplementary to their clinical training, the programme is designed to improve the students’ knowledge, skills and attitudes to equip them in caring for diverse groups of patients.

Patients consistently report that the process of delivering their care is very important to them – not just outcomes. This process must include effective communication, provision of adequate information and involvement in decision-making – all of which are impossible without successful cross-cultural communication between doctor and patient. A number of medical schools worldwide have gone to great lengths to integrate the concept of cultural competence into their curricula. However, the evidence suggests that simply teaching students about different cultures does not lead to increased cultural competence.

The International Citizenship programme provides a vehicle for supporting medical and healthcare students to develop the specific skills associated with being culturally competent. It assesses such things as a student’s personal attributes including their global consciousness and contribution to the community on all levels from local to international.

RCSI’s singular focus on global medicine and health sciences extends to medical campuses and collaborations in the Middle East, the Far East and Africa. In our Dublin campus, we have over 3,000 students studying undergraduate medical, pharmacy and physiotherapy with students coming from 69 different countries. Our International Citizenship programme uses this multicultural learning environment to help students to reflect on and learn from the challenges and benefits of multiculturalism and allows them to appreciate how it can enhance their personal and professional lives.

The International Citizenship programme leads to an award for students who become culturally competent and who develop an ‘international outlook’ by demonstrating their personal development and from their interactions with others from diverse backgrounds during extracurricular activities. Students participating in the programme complete an online portfolio of extracurricular activities over a two-year period and submit written reflections on the skills, values and attitudes that they have demonstrated through an on-line diary.

The culmination of the programme requires students to complete a reflective essay: 'What makes me an International Citizen' which is reviewed by the International Citizenship Programme Board.

Volunteer academic, technical and professional staff mentor the students over the two years, with mentors specifically trained in reflective practice, writing and giving feedback.

To date, 255 students have completed the programme and a further 70 students are currently enrolled, with students reporting that they have increased their reflective, intercultural and interpersonal skills as a result.

We believe that graduates who are also International Citizens will be more prepared for the increasingly complex and globalised nature of medicine. By making sure that our future healthcare leaders are culturally competent, socially conscious and have a sense of civic responsibility, we hope to contribute to a more inclusive and tolerant society.

Dr Mary Clarke is Associate Professor in the Departments of Psychology and Psychiatry at RCSI and outgoing Vice-Dean for International Citizenship.

RCSI is committed to achieving a better and more sustainable future through the UN Sustainable Development Goals.