Global Health Elective Instructions

These instructions and applications are for trainees traveling outside of established program pathways or tracks. If you are traveling through an official global health pathway or track to a rotation site where residents or fellows visit regularly, you do not need to complete this application and can find more information on our Internal Medicine or Pediatrics Global Health Pathway Residents webpage.

All applications for resident and fellow global health electives (clinical, research, and language immersion) must be approved by your program director. The Global Health Program (GHP) assists GME in final approval for global health electives. Please note that proposed global health electives must be consistent with any regulations mandated by the Residency Review Committee for your specialty.

All application materials require submission to GHP four months prior to the start of the requested elective. Please email GHP with any questions. If you are seeking financial support for your elective, you can explore opportunities for funding through the GHP Travel Grant Program.

 

1) Review the application flowchart.

2) Review the COVID-19 framework.

3) Complete the Qualtrics global health elective application. (Please note that an updated application will be available the week of Feb. 13, 2023.)

  • Review the PDF application and sample goals and objectives, as Qualtrics may not allow you to save and return to the application once started.

  • Complete the Qualtrics application once you have prepared your responses.

  • Your completed application will be sent to you as a PDF.

4) Forward the application PDF to your program director for signature.

  • Program director sign-off confirms that the rotation has educational value with appropriate supervision and articulated goals for each of the ACGME competencies. The signed application should be sent back to you by your program director for submission to GHP.

5) All clinical global health electives require an Affiliation Agreement (AA) and a Program Letter Agreement (PLA) between UCLA and the host international institution. Your Program Director will work directly with the international host institution, the UCLA International Institute, the DGSOM Dean's Office, and the GME Office to complete the AA and PLA. For any questions regarding an AA and PLA, please see the the AA and PLA workflow below and/or email GHP

  • Language immersion and global health research experiences do not require AA/PLA.

6) Email the following documents to GHP at GMEGlobalHealthApp@mednet.ucla.edu:

  • Signed application as a PDF (with program director signature)
  • Signed Code of Conduct
  • Completed Health and Safety Quiz; please complete this quiz after reviewing the Health and Safety Video
  • Optional: ACGME letter of approval, if required by your specialty. (Surgical resident/fellows, please discuss with your Program Director.) Click on the appropriate PDF for "International Rotation Application Process."

After your submission is reviewed by GHP, the application and accompanying forms will be forwarded to the GME Office for final approval. Upon final approval, you and your program director will receive an email confirmation that your elective is approved.

  • Review any program-specific pre-departure materials (if available).
  • Discuss the need for local medical licensure with your UCLA faculty supervisor and begin the application process if necessary.
  • Visit UCLA Occupational Health or your primary care/travel medicine provider for a pre-travel visit at least 2–3 months prior to departure.
    • The potential need for Post Exposure Prophylaxis (PEP) should be discussed at this visit.
  • Review GHP's PEP Protocol.
  • Confirm availability of on-site access to PEP, and if unable to do so, bring full course of PEP. 
  • Register your trip with UC Travel (this will ensure you are covered by the CHUBB - AXA Global Travel Assistance).
  • Register your trip with the State Department’s Smart Traveller Enrollment Program (STEP).
  • Provide your UCLA faculty supervisor with in-country lodging and contact information as well as emergency contact information.
  • Continue to review resources on GHP’s Travel Health & Safety webpage that will be important for you while you are away.

1) Residency PD (or designee) obtains Global Health AA Template + PLA template and fills in the highlighted sections for both documents. The documents can be accessed on the GME Policies and Procedures webpage under the 'Global Health Electives' dropdown.

2) Residency PD signs PLA

3) Residency PD (or designee) sends PLA and AA to international institution for review and signature

  • If international institutions request edits to AA or PLA, ask them to "track changes" for any language they would like to amend.
    • PD (or designee) must then send proposed changes to Claire Yan, Senior Counsel, UCLA Health Sciences Office of Legal Affairs who will assist in amending the document

4) Upon receiving the returned signed PLA and AA from the international institution, program coordinator completes visual compliance and residency PD (or designee) contacts Morgan Fultz in the Dean’s Office to secure the signature of Dr. Soohoo, the Associate Dean for Graduate Medical Education on the PLA, and Drs. Dubinett and Fan on the AA. For questions regarding visual compliance, please contact: export.controls@research.ucla.edu. 

5) Morgan Fultz will send fully executed copies to the Global Health Program, Program Director and Program Coordinator, Marie Hugley in the GME Office and Kathryn Paul in VP Fan’s office.

 

6) Program Director (or designee) receives fully executed AA/PLA and sends to international institution:

  • AA + PLA will need to be renewed every 5 years
  • Each resident or fellow is expected to provide his/her program director with a minimum of one evaluation at the end of the rotation, which must address the extent to which the resident or fellow has successfully met the competency-based goals and objectives of the rotation.
  • Each resident or fellow is expected to complete an evaluation of the elective experience in MedHub.
  • Travel to regions or countries designated as Level 4 by the US State Department is not permitted.
  • Travel to regions or countries designated as Level 3 by the US State Department will be approved on a case-by-case basis.