UNC Resident Physicians - Going Abroad

All UNC resident physicians are expected to matriculate through the Office of International Activities (OIA) in coordination with the GME Office. The GME Office must approve all international rotations and receive all required paperwork. We are happy to assist you with the planning of your international rotation to ensure that all GME Office and UNC policies are met and to help you navigate this process.  The first thing you should do is read over the UNC Resident International Rotation Policy. We want to ensure that you have a safe and enjoyable experience.  Please call for an appointment (962-6195), stop by our office, or ask us to meet you at Starbucks or another convenient location in the hospital! All forms should be turned into Kathryn Hill (kshill@unch.unc.edu) at the GME Office.  For a quick overview of what you need to do for the GME Office and for the OIA, see this flowchart.   Below the list of required forms is a step by step plan to help get you started.

Required Forms and Information Sheets for Residents
UNC Residents International Rotation Policy (overview of requirements, PDF sample of forms)

Letter of Agreement between UNC and Host Institution (template for letter mentioned in Section III of above rotation policy, obtain the signatures of your program director and host institution and return to the GME Office, which will obtain the signature of UNC Hospitals Vice President)

Release and Hold Harmless Agreement (template for release mentioned in Section III(C) and Section V of above rotation policy, sign and return to the GME Office)

Special Projects Professional Liability Form (required for all away rotations, obtain signature of department chair and return to the GME Office, which will obtain the signature of UNC Hospitals Vice President and Chair of the Liability Council)

Letter for Non-Clinical Away Rotations (only required if your rotation does not involve any direct patient care, return to the GME Office)

Resident Evaluation of International Rotation (complete and return by email to the OIA to serve as a resource for future residents. If a fillable PDF form does not open, try a different browser or request this form by email. You must have Adobe Reader 8 or a newer version to save your responses. You can download the free Adobe Reader here)

GME and OIA Process Flowchart for Residents (outlines requirements of the GME and role of the OIA)

Submit to GME: all required documents listed above (except the Resident Evaluation of International Rotation) and any other required paperwork

Submit to the OIA: fill out the online insurance form, complete required modules online through Sakai, turn in the evaluation of your international rotation to us after your trip

Step 1 - Get a clear understanding of what your options are for electives during residency at UNC

It might be helpful to look at these resources including the GHEC Residency Handbook and some of the national and international organizations that others at UNC have participated in. Also, we have access to other resources and several global health education listservs that we can use to help you find a site or organization. Planning any kind of international project takes a considerable amount of time and energy and its important to start the process early and to have your international elective approved by your program director and the GME office.  Moreover, sometimes a trip can fall through for a variety of reasons thus the earlier you plan, the more time you will have to work out the kinks or make other plans.

Step 2 - Plan ahead for your international elective

There are established opportunities in many countries, and you can always create your own opportunity as well. It is an RRC requirement that all resident physicians working abroad are directly supervised by a board certified physician and covered under UNC's malpractice policy.

Please note that all UNC students, residents and faculty must comply with UNC travel policies, which relies on the US State Department and the CDC to determine countries (and sometimes regions within countries) which are considered safe and appropriate for elective travel.  Residents must read and sign the "Release and Hold Harmless Agreement" in the GME International Rotations Policy regarding the risks of international travel. There is a current  list of countries that residents cannot travel to and others for which special waivers are needed maintained on the Office of Global Health site through the SPH. For more information or concerns, please contact OIA director Martha Carlough (martha_carlough@med.unc.edu).

Step 3 - Identify a faculty advisor in your department to work with

Identify a faculty advisor in your department to work with who will assist you in developing educational objectives and completing the UNC Resident International Rotation Policy.  The required forms will also have to be approved by your program director and forwarded to Kathryn Hill ((kshill@unch.unc.edu) at the GME Office. The OIA can assist you in finding faculty with an interest in global health and walking you through the required forms if you need additional support.

The University Center for Global Initiatives maintains a search engine of collaborative agreements and faculty involved in international projects which may be helpful as well.  Also check with the Institute for Global Health and Infectious Disease and the School of Public Health Office of Global Health for specific areas of interest and geographic experience of UNC faculty for ideas. Many faculty are willing to help with international electives.

Step 4 - Make a schedule of deadlines and required forms and review these with your faculty advisor

It is very easy, in the busyness of residency, to get overwhelmed with paperwork and arrangements and to miss deadlines for getting things done. Global health opportunities are usually well worth the effort, but do require staying on top of things.

Step 5 - Find and apply for funding $$$

Finding funding for going abroad generally comes from a combination of 3 sources: yourself (including your salary), scholarships or grants. In most situations, a global health elective is going to cost some money out of your pocket.  Funding is available for UNC/H resident physicians (and fellows under GME office) for global health electives on a competitive basis. Scholarships will be funded for up to $2000 per resident offered on a biannual funding cycle through the SOM Office of International Activities (awards in March and October each year). In order for a resident to apply, he/she must have completed at least the first year of postgraduate training, be in academic good standing, have the approval of the Program Director (including approval of away dates) and Departmental chair, and have completed all other requirements according to the Policy and Procedures of the GME office for international rotations. Electives must be a minimum of two weeks in duration and four weeks is encouraged. Applications are available here _{(link will be reactivated soon)} and will be considered according to the following schedule:

• Applications available  Jan 15^th and due  February 15^th, with decision by March 15^th
• Applications available August 15^th and due September 15^th with decision by October 15^th

For any questions about this process, please contact the Office of International Activities before completing the application.

The Dr. Charles A Sanders/Project HOPE International Residency Scholarship Program is open to medical residents from UNC/Chapel Hill, Duke University, East Carolina University, and Wake Forest University and awards funding for a one to two month supervised global health elective at a HOPE program site.

Step 6 - Get ready to travel safely and be prepared for emergencies

Travel insurance including evacuation is required for all UNC residents and faculty traveling outside of the US as part of work or residency experience.  Residents are required to purchase travel health insurance through UNC School of Medicine.

You MUST obtain insurance in order to complete an international elective during residency and/or or receive funding from UNC sources.

HTH (Highway to Health: http://www.hthstudents.com) is the provider of the UNC-sanctioned insurance. You must purchase this from Sam Hawes (shawes@med.unc.edu) in the Office of International Activities. The daily premium is $1.29/day. If you need coverage before or after the dates of your project, the premium is $2.56/day.  You will receive an insurance card directly from HTH that you should carry with you when you travel.  You can start the process of purchasing insurance by filling out the web form found here.

All residents participating in an international rotation MUST complete two online modules: “Travel Health and Safety” and “Cross-cultural Issues, Ethics and Professionalism for global health electives” prior to leaving the US. These modules are required. In addition, all residents who are engaged in the planning, conduct or analysis of research involving human subjects MUST complete CITI (Collaborative Institutional Training Initiative training (see http://research.unc.edu/offices/human-research-ethics) and have, or be included in, the IRB approval of any research. Residents who fail to comply with this policy will not be allowed to proceed with the international rotation.  To access the two required modules, you must first fill out the online insurance form (mentioned above). You will then receive an email granting you access to the GLBE999.MOD.1112 Sakai site where the modules and quizzes are located.  Please click here for more information about these modules.

UNC resident physicians traveling as part of their education, for research or other formal work, or those who have received funding through the University must all review the US State Department country-specific consular information and any travel warnings or alerts (www.travel.state.gov) as well as the information on the Center for Disease Control site (www.cdc.gov/travel.notices) prior to travel. Though there are inherent unpredictable risks with living and working globally, it is our intention that UNC SOM students, residents and faculty who are traveling for global health opportunities will have the information necessary to be as safe as possible and be prepared to respond in an emergency.

All UNC/H resident physicians travelling as part of their formal residency training (e.g. other than personal travel on vacation) should be aware of the travel restrictions of the UNC/Chapel Hill Office of the Provost and complete the “Release and Hold Harmless Agreement” for the GME office. UNC Office of the Provost closely follows the information from the US State Department (for political and civil unrest issues as well as natural disasters) and the Center for Disease Control (for health/epidemic issues) in making decisions about where UNC personnel can travel at any given time based on health and safety risks.  It is important to be aware that some countries are off limits for travel for academic/research purposes. The list of countries changes when new travel warnings and alerts are released by the State Department or CDC, and is kept up to date on the Provost website at: http://provost.unc.edu/policies/travel_warning

All UNC resident physicians must also purchase evacuation insurance as directed. If you would like to have additional coverage beyond the maximum coverage dates stated below, you can contact the insurance provider, Highway to Health, directly. For an overview of what this insurance covers, please see the HTH coverage information.

Highway to Health Website: http://www.hthtravelinsurance.com/
HTH brochure: https://www.med.unc.edu/oia/files/HTH%20coverage%20information.pdf

EMERGENCY PLANNING:
1. If you have a medical emergency (serious illness/hospitalization, illness, need for evacuation) that may need attention beyond what is locally available while you are out of the USA, contact the HTH Worldwide Assistance Services (800-254-4823) OR if for some reason you can’t reach anyone at this number, you should call: Robert Brooks, HTH Claims Administrator (1-800-394-2500 OR 703-830-5627).

2. If you have a non-medical emergency (know of a disappearance/kidnapping of another student or criminal assault or you are involved in a police action) contact the US embassy or consulate in the country where you are staying. If appropriate, embassy personnel will contact local police on your behalf. Embassy/Consulate information is available at: http://www.embassiesabroad.com/. Go to this website before you leave the US, and record this information for your country of travel so you have it easily available. Before you travel, you should also complete travel registration on the US Dept of State website at: https://travelregistration.state.gov/ibrs/ui/. This let’s the State Department know that you are traveling/staying in a particular country in case there is a need to find you.

Traveling to (country): __________________

Address and phone # of US Embassy or Consulate: ________________________________

3. If there is concern for serious political crisis or a national disaster (terrorist attack, flood, hurricane) in the country where you are staying, contact the US embassy who will have information available and a plan for US citizens living abroad for safety precautions and/or evacuation if necessary.

You should also always travel with name and contacts in the US in an emergency (e.g. family members, Program Director and/or Residency Coordinator, Department Chairman).

In all cases, be prepared to give information on the name of the person injured/ill or the situation that has occurred along with time, date and place, the telephone # of the person reporting the emergency and a time and # when further communication can take place about the emergency and preferred method (fax, phone, email)

PLEASE PRINT OUT THIS INFORMATION TO TAKE WITH YOU OR CLICK HERE FOR A PDF COPY. YOU SHOULD ALSO GIVE A COPY TO A CLOSE FAMILY MEMBER STAYING IN THE USA ALONG WITH YOUR PASSPORT INFORMATION, ITINERARY FOR TRAVEL AND EMERGENCY CONTACT INFORMATION

Checklist: Before you Go

•Have you completed the necessary paperwork for your residency program and the GME office?

•Have you received the necessary immunizations, etc.?

• Will you need a Visa for the country you are going to?

• Have you checked out the State Department warning for your country?

• Have you filled out the travel insurance forms, completed the required modules, and obtained a copy of your insurance card (provided electronically once process is complete)?

• If you are doing research, have you started the IRB process?

• Have you checked out the Centers for Disease Control's advice on medications, safe travel tips and immunizations for the country you are going to?