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Background: Globalization results in a rapidly diversifying population, increased inequities, and more complex health problems affecting populations. This forces medical schools to integrate global health (GH) into the training of health-care professionals from curriculum development to practical learning activities, here and abroad. Approach: The approach aims at enriching existing programs in GH competencies in an interdisciplinary context. The goal is to ensure that all health-science students develop a certain level of GH competency. The main actions are the mobilization of key stakeholders, the development of a competency framework (CF) to perform gap analysis, tool formalization, and monitoring and evaluation activities. Subsequent to scoping review and stakeholder consultations, ten principles are identified and used to guide the enrichment process. Results: Actual outputs cover a broad scope, from key decision-makers’ support and endorsement to the formalization of tools and the consolidation and creation of activities such as service-learning activities, rotations among underserved populations, and training for international rotations. Conclusion: While this unique approach is proving to be a major challenge, the preliminary results are well worth the effort. The project’s tangible impacts on health-sciences teaching, the GH competence of graduates, and care delivery are topics of interest for future investigation.

Contexte : Les activités d’apprentissage par le service dans la communauté (ASC) sont intégrées au sein des facultés de médecine depuis plusieurs années. Toutefois, peu de données existent permettant de comprendre les retombées de ce type d’activités sur les personnes étudiantes et les milieux communautaires. Cette recherche visait à explorer les perceptions des retombées d’une activité de formation ASC offerte aux personnes étudiantes en médecine. Méthodes : Une étude qualitative descriptive interprétative a été menée. Elle incluait des entrevues semi-dirigées pré et post stage, menée auprès des personnes étudiantes ayant participé aux activités d’ASC (pré n=21, post n=7), de même que des groupes de discussion focalisée auprès d’intervenants ou responsables d’organismes communautaires (n=17). Résultats : Les expériences vécues au sein de milieux socioéconomiques et culturels pluriels ont contribué à améliorer la compréhension par les personnes étudiantes du concept de vulnérabilité sociale et du vécu des personnes vivant en contexte de vulnérabilité. L’ASC a également généré une meilleure perception de la compréhension de l’importance des organismes communautaires dans l’aide à ces personnes en situation de vulnérabilité. Conclusion : Dans le cadre de l’ASC, une meilleure compréhension des facteurs contribuant au développement de compétences touchant la pratique en contexte de vulnérabilité s’avère nécessaire pour permettre une expérience significative et souvent transformative chez les futurs médecins.

Objective: The study was designed to document the experiences of people affected by hepatitis C with respect to prevention, screening and treatment to more clearly understand the determinants of health trajectories and access to the health system.Methods: Based on an evaluative research, we conducted a thematic qualitative analysis of four focus group interviews with people affected by hepatitis C. Two interviews (n = 3) consisted of people at risk of contracting hepatitis C, the third interview (n = 6) concerned people diagnosed HCV positive but not treated and the fourth interview (n = 6) targeted people who had access to treatment (n = 6).Results: We identified the drivers, barriers and facilitating factors, trajectories of health and care of people affected by hepatitis C in two periods of life: from the injection to HCV screening and from HCV diagnosis to treatment. Life trajectories in relation to hepatitis C are the product of many influences: the personal life experience, the attitude of healthcare staff, the organization of the health system and contingent factors.Conclusion: Understanding the life experience of people affected by hepatitis C is essential to identify potential levers of change and new ways to organize the health system in order to more effectively reach these people.