On April 29, the David Satcher Global Health Equity Institute at Atlanta-based Morehouse School of Medicine (MSM) hosted an online presentation and discussion on an investigation regarding barriers and opportunities for underrepresented groups to enter global health careers. The Enhancing Diversity in Global Health Equity (EDGE) research project was supported by the Fogarty International Center (FIC) at the National Institutes of Health (NIH). A team of investigators from MSM, Emory University, Vanderbilt University, and Cornell University developed and implemented the EDGE study.

Kofi A. Kondwani, Ph.D., who led the introduction, explained the term HUGS, which stands for Historically Underrepresented Groups in Science. The survey focused on determining which pathways were successful and what propelled participants to their current career trajectories. Additionally, investigators wanted to determine which aspects of existing career development programs were helpful.

Kondwani explained that the HUGS surveyed were currently or previously enrolled in, or for any reason, didn’t get into, the Global Health Program for Fellows and Scholars, Launching Future Leaders in Global Health Research Training Program (LAUNCH). This program supports one-year mentored research training in global health at established biomedical and health research institutions and project sites in Low—and Middle-Income Countries (LMICs).

Riley Hunt from Emory University conveyed that one of the barriers study participants faced was a lack of knowledge and experience concerning research and global health. “Many of them did not know how to acquire a grant; they didn’t know a lot of the research elements or kind of what that job entails,” Hunt shared regarding the study results. They did not have many connections they could turn to when it came to guidance and support.

Program participants expressed suffering from imposter syndrome. “There were a lot of them questioning themselves and their capabilities while they were in the program and just feeling like they were out of place,” Hunt said. Additionally, participants mentioned the lack of support and mentorship, as well as access to mental health services. To get into this field, Hunt says, HUGS would like to see other HUGS represented to help them get a foot in the door.

Hunt explained that some applicants felt discouraged during the application process. Professors and peers advised that this may not be the field for them due to a lack of relevant background experience. Participants related this to their own cultural background.

Another significant barrier, said Hunt, is the travel burden associated with a career in global health, such as acquiring a visa and organizing details in the home country, as well as being away from relatives. Some participants brought up how they had to separate a colonial or Western mindset from what modern global health work is. They didn’t really know what modern global health work looks like, Hunt described.

While in the program, Hunt relayed, participants hadn’t anticipated the struggles with balancing family and career and adjusting to different social norms. Some expressed experiencing discrimination. This, Hunt added, disproportionately affected the African American participants.

Hunt said that every study participant brought up the barrier of financial cost. “They didn’t know how to acquire funding for a global research project,” Hunt explained.” [T]hen insufficient salary was a big one because most of these participants were financially supporting their immediate family and their extended family.” Hunt elaborated that there isn’t much transparency regarding pay during the application stage and a lack of financial guidance. Once they got in the field, Hunt remarked, participants said that many HUGS-focused research projects were challenging to find funding for.

Peter Kilmarx, M.D., FIC’s acting director, underscored the need for support, mentioning the untapped interest in global health. Indeed, said UnJa Hayes, Ph.D., FIC’s program director, “There’s the outreach and letting people know there’s an opportunity, but….the application itself is a process that many of these people are not used to, and it’s a little intimidating.”

One hundred people participated in the survey, which contained approximately 70 questions.


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