Global Health Fellowship Programme

A letter from Dr Robin While (Head Global Health Fellowship Programme) 12th November 2020

 

'Dear Peninsula and Severn GP ST1s and ST2s 

As you may be aware, the Global Health Fellowship Programme was temporarily suspended as a result of the COVID-19 pandemic. Health Education England (HEE) is keen for the GH Programme to continue because of opportunities for the personal and professional development of individual GHFs, benefits to the NHS and the opportunity to improve health outcomes in resource poor rural communities.

HEE are planning to recruit a small number of Global Health Fellows from English Deaneries to work in low resource communities in sub Saharan Africa for 4 - 6 months as a GHF volunteer, or possibly as a 12 month paid full time Medical Officer in a rural, level 1 South African hospital.

The hybrid programme will be a mix of 4 - 6 months full time GHF volunteer posts, which are guaranteed, as well as an unknown number of 12 month full time (F/T) Medical Officer (MO) posts in SA. Deployments will depend on duration, a satisfactory ARCP outcome and completion of ST2.

You are now eligible and encouraged to apply.

Opportunities are also available for ACCS and Paediatric Trainees on completion of CT2

We have already secured circa fifty 4- 6 month volunteering opportunities in SA, Namibia, Uganda, Malawi, and Kenya. We can arrange medical registration in all countries. GHF Volunteers will be responsible for their own Medical Indemnity and Health Insurance. Health Education England will pay a small stipend to Global Health Fellow Volunteers deployed overseas to cover travel, professional and living expenses. A small additional stipend and use of a car may be available with some deployments.

The availability of a 12 month full time paid Medical Officer post in the Eastern Cape, KwaZulu-Natal and Mpumalanga may not become apparent until the spring of 2021 and 2022; this will depend on the Provincial Government’s decision to allocate available budget and fill rural hospital staff shortages with overseas workforce.

All GHFs planning to work as a volunteer in a SA medical facility need to be registered with the HPCSA (SA GMC) with either 6 months or a full 12 months “extended stay” visa. Occasionally volunteers can enter SA on a 90 day tourist visa but must leave the country for a destination outside the SA economic area at the end of their stay.

The registration process with the HPCSA is easier and less costly for 4-6 month volunteers compared to that of full time 12 month posts. GHF volunteers can opt to pay more for full HPCSA registration (which includes SAQA and ECFMG verification) if their intention is to accept a 12 month MO post at a later date, if the opportunity arises, or they can go down the cheaper HPCSA route for registration as a 4-6 month volunteer. We can arrange Volunteer Registration with a 6 month “extended stay” visa in SA for a fee of circa £1000 excluding visa costs. GHFs who decide to apply for a F/T 12 month MO post are still able to take up a 4 - 6 month GHF Programme volunteer post at a later date should no F/T posts become available. All GHFs will need to pay a small administration fee to our partner agency (Pro Talent) in Africa.

In line with HEE policy, we anticipate that these conditions will all be met prior to the first deployments in August 2021:

1. The UK Foreign and Commonwealth Office (FCO) – will need to lift its current ban on all but essential travel; we expect this will happen when:

a. The overseas country health risks are at pre-COVID-19 levels
b. The overseas country (or region) political or civil unrest risks are stable

2. There are commercial flights and inland travel available to the partnership site at least weekly and at a reasonable price
3. Private health insurance, including repatriation for GHFs is available
4. The capacity of NHS is sufficient to release staff for overseas placements

We envisage that prospective GHF Volunteers will apply for a 12 month OOPE and plan for a 6 month deployment to include working, travel and holiday etc leaving the other six months to do NHS locum work while they build up skills, knowledge and funds for their deployment or perhaps take the opportunity to attend a Dip TM&H course? Alternatively, a shorter OOPE can be applied for to minimise the time out of GP Training.

A short 4 month full time deployment during ST3 is an alternative for GP Trainees. They should discuss plans with their ES and TPD before a formal OOPE application to their Head of School. Successful application is not a “given” and depends on their academic progress and the logistics in their Training Practice.

Suggested educational requirements for 4 month GHF volunteer OOPE during ST3 are:

1 Outcome 1 at their last ARCP
2 AKT Pass before starting ST3
3 CSA/RCA Requirement specific to the dates of their overseas rotation

Rotation 1: August - December RCA/CSA not required.
Rotation 2: December -April Trainee must have made at least one attempt to pass in either the October or December exam.
Rotation 3: April - August Mandatory to have passed all RCGP exams

A number of GP Trainees from the SW have accepted this challenge over the last few years and previous SW GH Alumni who have returned from their 12 month deployment in a low resource environment reporting that they have improved their leadership, resilience, decision making and clinical skills as well as knowing that they have made a major contribution to health care in a resource poor African community. They belong to a group of very special doctors. Most GH Alumni describe their experience as the single most formative event in their careers and return to work in the NHS as future leaders of our profession.

Completing the GH Programme is an extremely tough and demanding assignment and in the past, the 12 month placements have been associated with a 50% drop out rate after an expression of interest. We understand that personal circumstances change, but retention of GHFs is important to us and we want to be sure that you have made an informed decision. Resignation from the Programme during ST1 and ST2 before deployment can lead to the following: gaps in the GH programme which may be impossible to fill, gaps in service provision, disappointment for GHF colleagues and the host health institution.

Severn and the SW Peninsula have championed the Global Health Fellowship Programme for a number of years. During ST1 and ST2 GHFs can request a Mentor who will usually be a GH Alumni. GHFs are required to attend GH Study Days. Completion of the 4 years GHF Programme will lead to the award of a Deanery specific Global Health Certificate (GH CCT) and eligibility to join UK Med.

Global Health Fellows are encouraged to apply for the three month Dip in TM&H course at the Liverpool School of Tropical Medicine or one of the alternative courses in Glasgow, Sheffield or London (MSF Course) at their own expense. The time out can be taken as unpaid Study Leave OOPE. Other GH opportunities include Diplomas, Certificates and Masters Programmes available at many Universities including Plymouth and Berlin. There is no requirement for GHFs to participate in any GH academic activities prior to deployment. GHFs are however requested to complete a QIP during their deployment but will not be required to maintain their e-portfolio (other than as a means to record their clinical reflections).

GHFs will not need to complete any assessments or demonstrate competences during deployments.

GHF applicants should be reassured that HEE will try to deploy them in groups of two for mutual support and that they will be clinically supervised during their deployment. Full time MOs deployed to rural SA level 1 hospitals will usually be offered further clinical skills training in a 2-3 week block at their nearest referral hospital.

Further information about the Global Health Placements can be found via the following websites:

HEE advice

RCGP

BMA 

Please note - Global Health Fellowship applicants with primary medical qualifications (PMQs) from countries other than the UK may not be eligible for medical registration with the Health Professional Council of South Africa (HPCSA) (SA GMC) without passing qualifying examinations in South Africa at the expense of the applicant. If in doubt, please check with the HPCSA. Applicants with a tier 2 visa are eligible but should contact the National Recruitment Office gpnro@hee.nhs.uk

Appointment as a GHF is subject to an informal meeting with your Global Health Lead to discuss the GHF Programme along with your motivation, suitability and resilience. There will be an opportunity to ask any questions that you may have. There is no formal competitive interview process.

Expressions of interest are now invited from newly recruited GP ST1 trainees for deployments in 2022/23, and ST2s for deployment in 2021/22. If you think that a Global Health Fellowship is right for you and you would like to strengthen your CV but at the same time give something back to a resource poor African community, apply now.

Please send your completed application to Paula Cain or GP School:
paulacain@nhs.net or SEVGPSchool.SW@hee.nhs.uk

If you have any further questions or if you want to speak to a SW GHF Alumni about their experiences, please contact Paula Cain the SW GH Manager (paulacain@nhs.net) or 01225 824894

A flier with a summary of opportunities in Southern and East Africa is attached.

If this new HEE Global Health Fellowship Programme Pilot is successful, further worldwide opportunities may be available in future years?

Best Wishes

Dr Robin While'