Table 2.

Proposed core competency areas for global health education in pulmonary and critical care medicine fellowship training programs

Core Competency Areas	Objectives
Clinical knowledge	Develop a comprehensive understanding of the global burden of respiratory and critical illness,  including:
	Knowledge of the global epidemiologic distribution of major infectious and noncommunicable diseases imparting morbidity and mortality.
	Social, environmental, and economic determinants of health, including how host-, environmental-, and health systems–based factors govern health worldwide.
	Identification of the clinical presentation and management of complex diseases in resource-limited settings through completing didactic coursework concerning major pathological processes (e.g., malaria, tuberculosis, viral hemorrhagic syndromes, human immunodeficiency virus), their biological alterations, and how they affect specific organ systems.
International research training	Complete didactic coursework and receive mentorship from domestic and international  investigators, focused on developing an understanding of the unique cultural, legal, and  societal considerations required of research conducted in low- and middle-income countries,  including:
	International research ethics and human subject protection.
	Needs assessment, including community-based involvement, to generate locally relevant research.
	Study design and implementation.
Cultural competency	Cultivate and develop awareness of the attitudes, beliefs, and processes that facilitate the  doctor–patient relationship and allow effective partnership across international clinical  and research collaborations by:
	Actively participating in seminars regarding cultural beliefs and practices of international training sites.
	Establishing mechanisms to address conflict resolution in international clinical and research settings.
Clinical and research capacity building	Actively participate in clinical and/or research capacity building with a focus on sustainable,  longitudinal partnerships by developing:
	“Train the trainer” educational models to develop local subspecialty expertise, ultimately aimed at local clinical and research independence.
	Multilevel participatory needs assessments with international stakeholders.

Reprinted by permission from Reference 1.