Revisiting International Student Outbound Mobility in 2020 – Time for a Change to Internationalization at Home?
References
T. Ostbye, M. White, G. Hoffer, et al. The electronic medical-student exchange: a low-cost alternative to overseas electives. CMAJ 1995;153:1327-1328.
M. Ambrose, L. Murray, N.E. Handoyo, D. Tunggal, N. Cooling. Learning global health: a pilot study of an online collaborative intercultural peer group activity involving medical students in Australia and Indonesia. BMC medical education. 2017;17(1):10.
D. W. McKinley, S. R. Williams, J.J. Norcini, M.B. Anderson. International exchange programs and U.S. medical schools. Acad Med. 2008;83(10 Suppl):S53-7.
A. Wu, B. Leask, E. Choi, L. Unangst, H. De Witt. Internationalization of Medical Education – a scoping review of the current status in the United States. Medical Science Educator 2020:1-13.
A. Custodi, C. Deegan, C. Fimmen, A. Gordon, K. McLaughlin, A. Phylactopoulos, et al. Six pillars for rebuilding international higher education. Univeristy World News. September 12, 2020.
More than two decades ago, Ostbye and colleagues (1995) proposed online exchanges via email as an affordable alternative to overseas electives in medical education (1). Few articles on international learning at home have emerged since then (2), while in parallel internationalization of medical education (IoME) and Global Health programs have exponentially increased (3).
Particularly in the “Global North”, IoME very often involves popular international student outbound mobility to the low and middle-income countries (LMIC) via selected Global Health programs (3, 4).
There is no doubt that student travel for research and/or clinical placement in a foreign country has its place in IoME, and expedites the acquisition of skills that prepare students for cultural competency and international understanding, while simultaneously being of significant value for underserved regions and countries.
However, in 2020, with the COVID-19 pandemic placing many international student travel programs on hold, leaders should regard the pandemic as an opportunity to revisit current practices in IoME, particularly student outbound mobility.
Discussions regarding reforms in internationalization of higher education have arisen because international student exchanges are deemed to be unsafe and unpredictable in times of crisis (5). The authors add to the above, newer concerns regarding social equity and justice, and claim that current IoME programs are not available to all students and institutions - precluding access for individuals from disadvantaged backgrounds or institutions with limited resources. Increasing travel opportunities for more students to achieve equity is not sustainable or desired, particularly with ongoing deliberations about climate change and carbon footprint. Furthermore, ethical concerns pertaining to current practices in medical volunteerism, including attitudes of neo-colonialism in the LMIC, have been raised.
At a time of widely available social media and technology, one must consider alternatives to teaching international competencies without resource draining travel abroad programs.
The purpose of this correspondence is to initiate a discussion about changes to current practices in IoME; away from an emphasis on student outbound mobility to an increased focus on activities at home - accessible to all.
Via interdisciplinary approaches, collaboration, and building on experiences of the social sciences (i.e., the emergent field of international higher education at home), guidelines need to be established in order to ensure the viability of IoME.
In 2020, IoME must be equitable and sensible with respect to the LMIC, and sustainable - while helping students to acquire international competency skills that can be utilized both in local and global practice. Revisiting Ostbye’s idea 25 years later can serve as an inspiration for IoME at home today.