Abstract
This study aims to describe global health training (GHT) programs through the ethical lens suggested by the Working Group on Ethics Guidelines for Global Health Training (WEIGHT). A total of 35 GHT programs were identified, and general information was obtained online. Semi-structured telephone interviews of key members of 19 programs were then conducted and transcribed. The interview guide was constructed using WEIGHT recommendations. Transcript data were grouped according to domains: reciprocity, trainee selection and preparedness, needs assessments, and ethical questions. Many programs expressed difficulty in building reciprocal relationships due to imbalanced power structures. Eleven programs reported no formal application process for selecting trainees. Twelve (63%) programs reported only a single day of preparation. Nine (47%) programs did not conduct a formalized needs assessment of partner sites. Ethical considerations varied from concerns for safety to inadequate training for residents. This study reveals the limited preparedness curricula and lack of formalized needs assessments among several programs. Although many programs make an effort to build reciprocal exchanges with host partners, experiences for foreign trainees within the United States are limited, and U.S. residents are often tasked with duties above their training level abroad. This study demonstrates the need to restructure how GHT programs are formed and operated.