Steps in Getting Approval For

Steps in getting approval for Global health experiences for undergraduate medical students

TO: UMass Medical School (UMMS) students, UMMS faculty, Learning Community Advisors FROM: The Office of Undergraduate Medical Education (OUME)

Background: This document details the steps that medical students at UMMS must follow in order to have a global health experience approved for credit or recognized by UMMS. A global health experience includes all types of 4th and 5th year electives, including clinical, research, public health, community service, cultural, and language training electives. A global health experience also include experiences such as Flexible Clinical Electives (FCEs) and global health experiences for students in the summer between the 1st and 2nd year of medical school.

UMMS recognizes and supports the value of students completing global health experiences to aid in professional development, career planning and service to communities. In order to ensure that global health experiences provide quality training while also meeting university requirements, students must follow the steps outlined below in order to receive approval, any applicable financial support, and/or academic credit. Step #1. Student identifies a global health experience & reviews the UMMS Office of Global Health (OGH) policies regarding international travel

a) Student identifies a global health experience that matches their interests by investigating and communicating with different resources, which may include: i. Other UMMS students and faculty ii. Learning Community (LC) global health specialty advisors iii. Sources at the Host Institution that is interested in hosting a UMMS student iv. Independent search done by the student

b) Student must review the OGH Policy for International Travel.

c) As per the OGH policy, students involved in international travel are required to attend the UMMS Travel Preparation Workshop.

d) As per the OGH policy, students involved in international travel should visit Student Health (508- 334-2818), Employee Health Services, their Primary Care Provider or the Travel Clinic (508-334-5481) at least 5 to 6 weeks before departure for immunizations, post-exposure prophylaxis, and other travel medications.

e) Student should visit the U.S. State Department website to see what countries currently have travel warnings.

f) Students must read the OGH Policy for Special International Travel regarding travel to countries with U.S. State Department travel warnings. Note that in general, travel to countries with travel warnings is not allowed for students, unless the student, the UMMS Elective Advisor or other UMMS faculty member can provide reasonable rationale to OGH for traveling to that country, and the region where the student would doing the global health experience is not affected by the travel warning. OGH will take this information into consideration when deciding whether or not to approve the global health experience.

0452e21babf912c875f9b1bdbd710a6a.docx 1 Step #2. Student completes a Global Health Experience Request (GHER) Form

a. The GHER Form is available on the OUME website.

b. Students must submit a completed GHER Form with the necessary signatures to OUME for approval. The form should be submitted by email to Colleen Burnham ([email protected]) in OUME at least three months prior to the experience start date (or as soon as possible for experiences in Academic Year 2013-2014).

c. Student must identify a UMMS Elective Advisor: Students must identify a UMMS faculty member to serve as their UMMS Elective Advisor. Any UMMS faculty member is eligible to be a UMMS Elective Advisor. The responsibilities of the UMMS Elective Advisor are listed below, and are not expected to involve a major time commitment:

c.i. Review and sign the Global Health Experience Request (GHER) Form. This form asks the UMMS Elective Advisor to review the description of the student's global health experience and learning objectives, and deem that they are appropriate for the student's level of training.

c.ii. Act as student’s UMMS contact for questions or concerns that cannot be addressed by the Supervisor at the Host Institution while participating in the global health experience. c.iii. Review the International and Intercultural Education Opportunities Form, which the student completes at the end of the global health experience, and provides to the UMMS Elective Advisor. This form provides basic information about the global health experience, which can help UMMS and future students. c.iv. Review the Global Health Reflection which is written by the student towards the end of the global health elective or experience, and provides the student the opportunity to reflect on what they have learned from the experience.

d. Student must identify a Supervisor at the Host Institution: Student must identify a Supervisor at the Host Institution who will supervise the student at the Host Institution where the global health experience will be done. The Host Institution is the organization, agency, school or entity where the student will be doing the global health experience. (Examples of a Host Institution include: The University in Nicaragua, The World Health Organization, The León Spanish Language School.) The Supervisor at the Host Institution typically is the individual who is aware of the student's learning objectives, is responsible supervising the student during the global health experience, and is a contact person at the Host Institution for any questions. The Supervisor at the Host Institution also is likely to be the person to complete the Elective Evaluation Form that will assess the student's performance during the experience.

e. Students should be aware that the GHER Form requires a brief description of the global health experience and several signatures. Therefore, it is recommended that students start planning at least four to six months in advance.

0452e21babf912c875f9b1bdbd710a6a.docx 2 f. Students should identify what type of agreement between UMMS and the Host Institution is appropriate. The three types of agreements are:

f.i. Memorandum of Understanding (MOU): An MOU typically is valid for 3 years.

f.ii. Letter of Agreement (LOA): An LOA typically is valid for 1 year. If a student is doing a global health experience at a new site that recently has not hosted UMMS students, then typically a 1-year LOA is completed prior to considering if the two institutions would like to agree upon an MOU. Both an LOA and an MOU provide evidence that UMMS and the Host Institution are aware of the responsibilities associated with hosting a UMMS student

f.iii. Global Health Experience Notice (GHEN): If the proposed global health experience does not have any clinical activities, and there is not a Memorandum of Understanding (MOU) or Letter of Agreement (LOA) between UMMS and the Host Institution, then the student can complete a Global Health Experience Notice (GHEN) for the proposed global health experience, instead of requesting that UMMS and the Host Institution approve an LOA or MOU. Before a global health experience can be approved, there must either be:

a. An MOU or an LOA between UMMS and the Host Institution, or

b. A GHEN if the proposed global health experience does not have any clinical activities.

g. If the proposed global health experience will use a GHEN instead of an LOA or MOU, then the student should help to complete a GHEN. (The GHEN is described in more detail in step #3).

h. If a student has been approved to receive UMMS reimbursement for part(s) of a global health experience, then the student must purchase their transportation ticket after approval of the GHER Form. Per UMMS policy, expenditures (e.g., transportation tickets) that are made prior to approval of the GHER Form cannot be reimbursed.

i. After completing the GHER Form, the student must submit the completed GHER Form (and the GHEN, if applicable) to Colleen Burnham ([email protected]) to obtain OUME approval.

j. OUME reviews the completed GHER Form by checking that all the required sections of the form have been completed by the student. If OUME approves the GHER Form, then OUME will email notice of OUME's approval of the GHER Form, and a PDF version of the GHER Form (and the GHEN, if applicable) to both:

j.i. The student

j.ii. The Office of Global Health (OGH) in order to obtain OGH approval of the global health experience

0452e21babf912c875f9b1bdbd710a6a.docx 3 k. OGH reviews the GHER Form and the proposed global health experience: If necessary, OGH verifies an existing MOU or LOA, or helps UMMS and the Host Institution to complete a new MOU or LOA. If OGH approves the global health experience, then OGH will email notice of OGH's approval of the global health experience, and a PDF version of the GHER Form (and the GHEN, if applicable) to the following:

k.i. The student, and

k.ii. OUME (to Colleen Burnham at [email protected]), k.iii. The Global Health Pathway Co-Directors (only if the student is in the Global Health Pathway), and k.iv. The Office of Student Affairs (OSA) at [email protected] only if the global health experience is one that will appear on the student's transcript. . Global health electives and Flexible Clinical Electives (FCEs) will appear on the student's transcript. Travel between 1st and 2nd year of medical school typically does not appear on the student's transcript. . After OSA receives notification of OGH's approval of the global health elective or FCE, the OSA will add the elective to the student's schedule in Peoplesoft.

Step #3. Student completes a Global Health Experience Notice (GHEN), if applicable a. If the proposed global health experience does not have any clinical activities (i.e., the student will not be involved in any direct medical patient care), and there is not a Memorandum of Understanding (MOU) or Letter of Agreement (LOA) between UMMS and the Host Institution, then the student should complete a Global Health Experience Notice (GHEN). The GHEN can be used for to global health experiences whose primary purpose is: o Research pilot projects (e.g., needs assessments, preliminary data collection). . Note that research which has been approved by the UMMS Institutional Review Board (IRB) should have either an MOU or an LOA between UMMS and the Host Institution, and therefore it is not sufficient to have a GHEN. o Cultural (e.g., studying how cultural beliefs among refugees impact their use of medical care) o Language (e.g., studying medical Spanish) o Public Health or Community Service (e.g. teaching Basic Life Saving to nurses in Uganda)

b. After completing the GHEN, the student should skip to Step #5, since a Letter of Agreement is not needed if a GHEN is completed.

0452e21babf912c875f9b1bdbd710a6a.docx 4 Step #4. Student assists UMMS and the Host Institution in completing a Letter of Agreement (LOA), if applicable

a. What experiences need an LOA to be completed: If the proposed experience has a clinical component (i.e., it involves direct medical patient care) and the site does not have an active MOU with UMMS, then there must be a LOA completed between UMMS and the Host Institution before the experience can be approved. If an LOA between UMMS and the Host Institution is not able to be completed and signed, then students are encouraged to consider a global health experience at a site which already has an existing MOU between the UMMS and the Host Institution.

b. For experiences that require an LOA, the following steps should be followed for completing the LOA:

1. Students can obtain a template LOA from OGH (by contacting Jessica Chang at [email protected]).

2. Students complete the sections in the LOA that are highlighted in yellow.

3. Students obtain the following information about the proposed experience:

a.i. The proposed start date and end date of the experience

a.ii. A brief description of the experience (e.g., "clinical internal medicine rotation at the University of León Hospital" or "intensive Spanish language training at the León Language School.")

a.iii. Contact information (i.e., name, title, mailing address, email address, phone number) for the person who will be the Coordinating Liaison. As described in the LOA, the Coordinating Liaison is the person who the Host Institution identifies as the representative to: (a) serve as a liaison with the responsibility of advancing the activities in the LOA, and (b) resolve any issues between the Host Institution and UMMS concerning participating students.

a.iv. Contact information (i.e., name, title, mailing address, email address, phone number) for the person at the Host Institution who will be signing the LOA and who is considered to be the Counterpart to the UMMS Dean. If the Host Institution does not have a Dean, then this person should be in a position of authority at the Host Institution.

c. At least two months before the start of the experience (or one month before the start of the experience in Academic Year 2013-2014), students should email the following two things to Jessica Chang ([email protected]) in the Office of Global Health (OGH):

1. the template LOA with the yellow sections completed (and without signatures)

2. confirmation of the experience (i.e., confirmation of the experience can be provided by emailing the information mentioned above in Step #4(b)(3)).

d. OGH will then complete the LOA signature process by doing the following:

i. OGH obtains the signature of the UMMS Dean on two copies of the LOA.

ii. OGH then sends two copies to the Host Institution for signature.

iii. The Host Institution then keeps one copy, and sends a signed copy back to OGH.

0452e21babf912c875f9b1bdbd710a6a.docx 5 e. Once OGH completes this LOA signature process, approves the GHER Form, and approves the experience, then OGH will email the completed GHER Form and notice of OGH's approval of the experience to each of the following:

i. The student

ii. OUME (i.e., Colleen Burnham at [email protected])

iii. The Global Health Co-Directors (if the student is in the Global Health Pathway)

iv. The Office of Student Affairs at [email protected]

Step #5. Student completes the following steps required by the Office of Student Affairs (OSA)

a) For global health experiences that will take place in the Advance Studies years, the student and their Learning Community (LC) Mentor should meet to discuss their upcoming Advance Studies year. The proposed global health experience should be included in the student's Proposed Education Plan (PEP), which the student and LC Mentor should sign and submit to the OSA via the [email protected] email address.

b) As mentioned in Step #2(k), once the global health experience has been approved by OUME and OGH, then OGH will notify OSA at [email protected] that the experience has been approved. The OSA will then ensure that the experience is on the student's approved PEP form on file. If so, the global health experience will be added to the student's official Peoplesoft Schedule.

c) Before leaving for the experience, the student should ensure that they have received via email an Elective Evaluation Form from the UMMS Registrar's Office. The Registrar's Office will email the Elective Evaluation Form to the student before or near the start of the elective. Students should give the Evaluation Form to the appropriate person at the Host Institution in order to evaluate the student's performance.

d) At the end of the global health experience, the student will ensure that they or the Supervisor at the Host Institution submits the Elective Evaluation Form to Colleen Burnham in OUME, who will then submit the Elective Evaluation Form to the UMMS Registrar office.

Step #6. Student completes a Pre-Travel Authorization form

a) As per UMMS policy, the student must complete the Pre-Travel Authorization form, following the UMMS Pre-Travel Authorization Process.

b) This form must be completed and submitted via email [email protected] or via interoffice mail (to the Account Payable office, attn.: Travel Compliance Administrator). The form must be submitted prior to booking airfare and/or making reservations for overnight travel.

The form should be completed prior to booking the travel, and therefore the form should be completed using the estimated date of travel and the estimated travel costs.

When completing the form, all students can list OUME as the Home Department, Funding Department and Funder's name. Students can list Dr. Melissa Fischer as the Department Head.

0452e21babf912c875f9b1bdbd710a6a.docx 6 c) The student should submit this form even if they are not sure if they will receive funding for travel. In other words, the student should submit this form even if they are planning to pay for travel using their personal finances instead of using a stipend, reimbursement or grant award from UMMS.

0452e21babf912c875f9b1bdbd710a6a.docx 7 Step #7. Student registers their travel with the U.S. State Department

As per OGH policy, the student must register travel through the U.S. State Department's Smart Traveler Enrollment Program (formerly known as “Travel Registration” or “Registration with Embassies”).

Step #8. Student completes an on-line International Travel Registration Form

As per OGH policy, students must complete the on-line International Travel Registration Form on the OGH website: http://www.umassmed.edu/globalhealth/registration/index.aspx

At the end of the on-line form, the student will be asked to confirm that they have registered their travel with the U.S. State Department (as mentioned above in Step #7).

In compliance with the OGH Policy for International Travel, anyone traveling under the UMMS auspices must complete this travel registration form. Once your registration has been approved, you will receive a copy of the AIG travel insurance policy number and brochure from the OGH. (AIG is the insurance company that provides the travel insurance.)

Step #9. Student attends a UMMS Travel Preparation Workshop

a. As per the OGH Policy for International Travel, students must traveling internationally must attend a UMMS Travel Preparation Workshop which are sponsored by OUME, OGH and Student Health Services.

Step #10. After returning from the global health experience, students do the things listed below

a. Complete a Global Health Reflection, which is written by the student towards the end of the global health experience, and provides the opportunity to reflect on what was learned from the experience.

o Students can follow the guidance on the 1-page guideline for this Global Health Reflection.

b. Complete the 3-page International and Intercultural Education Opportunities Form

o If the student is traveling to multiple countries, they should submit separate forms for each country.

c. Email the completed Global Health Reflection and the International and Intercultural Education Opportunities Form to your UMMS Elective Advisor and ask him/her if they recommend any changes before the student submits it on the UMMS Library's eScholarship@UMMS website as a resource for UMMS and other students.

d. Submit the Global Health Reflection and the International and Intercultural Education Opportunities Form electronically to the UMMS Library’s eScholarship@UMMS website (http://escholarship.umassmed.edu.ezproxy.umassmed.edu/intmeded). These two things serve as a resource for UMMS and other students. Students must create an account in order to use the UMMS Library’s eScholarship@UMMS website for the first time.

0452e21babf912c875f9b1bdbd710a6a.docx 8 e. Complete a Site Information Form (SIF):

o If the student did a global health experience that had a clinical, research, public health or community service component, then the student must complete a Clinical and Research Site Information Form (CRSIF).

o If the student did a global health experience that was a language or cultural experience (and did not have a clinical, research, public health or community service component), then the student must complete a Cultural Immersion Site Information Form (CISIF).

f. The student notifies OGH and OUME:

The student notifies OGH and OUME by sending an email to Colleen Burnham in OUME ([email protected]) and to Jessica Chang in OGH ([email protected]) that includes the following: i. the completed CRSIF or CISIF form ii. notification that the student has submitted the Global Health Reflection and the International and Intercultural Education Opportunities Form electronically to the UMMS Library’s eScholarship@UMMS website after the UMMS Elective Advisor has reviewed them.

g. Ensure that the Elective Evaluation Form gets delivered to OUME:

o As mentioned above in Step #5(c) and #5(d), the Elective Evaluation Form must be completed by the Supervisor at the Host Institution, and then should be submitted to Colleen Burnham via mail, e-mail, or hand-delivered.

o Colleen Burnham will forward the completed Elective Evaluation Form to the UMMS Registrar's office once she receives the following:

1. the Elective Evaluation Form, 2. the student's Global Health Reflection, 3. the student's International and Intercultural Education Opportunities Form. 4. the student's CRSIF or CISIF.

o After the UMMS Registrar office receives the Elective Evaluation Form, and Colleen Burnham has received all four documents listed above, then the student can then receive credit (and/or reimbursement, if applicable) for the global health experience.

h. Getting reimbursed for a global health experience (if applicable):

In some cases, before completing a global health experience, a student may receive notification that they are eligible for reimbursement for specific expenses. Only expenses incurred AFTER the full approval of the GHER Form are eligible for reimbursement. UMMS students and faculty cannot purchase their airplane ticket (or their tickets for other forms of transportation) prior to date of approval or it will not be reimbursed.

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