Has the Time Come to Envision a Global SGIM?

Nearly two decades ago, SGIM’s annual meeting theme featured the role of generalists in global health. The planning committee reached out to the Society of Teachers of Family Medicine and co-hosted a joint session with Dr. Jack Geiger, a colleague of mine, as keynote speaker. We both served for many years on the founding board of directors of Physicians for Human Rights. In preparation, I placed a copy of the Universal Declaration of Human Rights on every seat. At the close of his talk, those in attendance gave Jack a standing ovation. And with that enthusiasm, the SGIM Global Health and Human Rights Interest Group (GHHR IG) was established. We have met annually since 2006 with 20 to 50 participants in attendance—ranging from students to senior experts in the fields of global health and in human rights, including long-standing members of the Society.

Our meetings have consistently focused on cultivating expertise of SGIM members in global health and human rights. We discuss strategies for building careers in these fields and networking with colleagues who lead clinics for refugees, asylum seekers, or torture survivors; direct educational tracks for students, residents, or fellows; and successfully secure funding for work, including research, abroad and in the US. Over the years, GHHR IG annual meeting contributions have included pre-courses, workshops, plenary panels, oral presentations, and research posters. We have authored SGIM position papers, books, articles, and on-line training programs; and members have received local, regional, national, and international awards.

At our last meeting in 2023, I asked people attending the GHHR IG their ideas about the future. They shared openly; our discussion pushed all of us to envision new ways to think about what we as GHHR IG members could do to grow and strengthen our beloved Society.

Many of us in the fields of global health and human rights work at our local institutions on programs such as inclusion excellence, social justice, and health equity, and as such, we welcome efforts to honor the land on which our institutions reside. Could SGIM’s opening sessions mirror what has become commonplace and a way of practicing local global health—honoring the contributions of Indigenous American by acknowledging the area’s indigenous history?

As concepts such as colonialism and structural racism become part of our conversations about health equity, can GHHR IG members offer our expertise to other groups in SGIM by advocating for incorporation of global human rights into curricula as a strategy to address worldwide and local inequities?¹ Similarly, those who do medical asylum evaluations and work in inner-city clinics know all too well the need for skills training in trauma-informed care to ensure safe care—emotional, psychological, and physical—to undocumented immigrants, refugees, and others who come from homes they have been forced to flee. Their life experiences often remain hidden because we lack the knowledge and skills to seek deeper conversations and facilitate more complex healing interventions than just management of hypertension or joint pain.² How can we equip all generalists with these competencies?

GHHR IG participants envisioned within SGIM broader conversations on indigenous approaches to health and wellness that embrace communal and ecocentric framing of life, together with the biologic world around us.³ These alternative health narratives offer a way to bring others into our society. Similarly, those GHHR IG members working closely with lay practitioners abroad could share their insights about models of healthcare delivery that include a focus on social justice, public health, equity, and access to health care for all.

As the perspective piece authored by David Heller, James Hudspeth, Sandeep Kishore, Tim Mercer, Jeremy Schwartz, and Tracy Rabin argues, a broader focus within SGIM that embraces global health offers us new ways to think about what we research; what we publish in JGIM; what we teach students, residents, and our colleagues; and how we deliver care.⁴ As these authors emphasize, with the growing epidemic of chronic illnesses both here and around the world, and with the foundation laid by SGIM members active in these areas, the Society is poised to move in new directions. Becoming a global society of generalists asks that we deepen our understanding of the human right to health, expand our vision of partners—scholars and practitioners—and invite them into our dialogues, classrooms, and organization.^5,6

The question remains, “How can we can enable SGIM members to best serve patients, learners, colleagues, and our world in the decades ahead with a much more complex framework of global health and human rights?”.

Declarations

Conflict of Interest

The author has no conflict of interest.