Global arguments: breaking the borders for medicine

Its time to cut the crap surrounding IFMSA and make things happen, says Navin Chohan

Medical students are key in the globalisation of medicine, and can be at the forefront of this change through the International Federation of Medical Students Associations (IFMSA), provided political wrangling does not bring everything to a halt.

The federations 2002 mission statement is: “Our mission is to offer future physicians a comprehensive introduction to global health issues. Through our programming and opportunities, we develop culturally sensitive students of medicine intent on influencing the transnational inequalities that shape the health of our planet.”¹

“We are now in a world without walls,” Bill Clinton pointed out earlier this year.² The former US president labelled the new century an “age of interdependence” and questioned whether it was going to be good or bad for humanity. It depended on us all being able to “understand our obligations and responsibilities to each other.”

Everything is becoming global, including medicine. It is going to be up to the big international organisations, like the United Nations, the World Health Organization, and the International Federation of Medical Students Associations, to work effectively in this environment. They are going to have to make sure that the globalisation of health care is not obstructed by political wrangling and in-fighting and, as a body of future doctors, the federation is key in this process.

As Richard Smith, editor, and Tessa Richards, assistant editor, BMJ, said when discussing Clintons comments, “We need to look up from our often petty concerns and begin to recognise what global interdependence means for each of us.”³

The federation is an international network of smaller national member organisations all working with the same aims, both independently and through work shared under the IFMSA umbrella. There are 91 student organisations from 88 countries in the 51 year old organisation⁴ (A full list of members can be found on the IFMSA website).

In short, its a humanitarian organisation, a kind of student led United Nations or World Health Organization. The aim is to provide a broad global experience for medical students, be it political, educational, charitable, or just about anything else that may contribute to producing more skilled and open minded doctors. It happens to be through humanitarian projects that these objectives are achieved.

The list of projects and events run by the federation includes community health projects in Africa, a conference on child abuse, care work with young asylum seekers, and local education on AIDS and sexually transmitted infections.⁵ All are student led and coordinated, a demonstration of the power that future doctors the world over have in shaping global health care.

It would be foolish to claim that this work was purely altruistic, and, if it were, it would actually be a hindrance to pursuing the federations mission: to provide medical students with skills and experience—all good CV stuff.

There are professional and research exchange programmes for medical students to go to study in other member countries, writing and publishing opportunities, chances to gain skills unobtainable in standard medical training, and all with the possibility of working with organisations like the United Nations and the World Health Organization. Political opportunities are also available, all the more enticing for being on the big international playing field.

Some students are using the federation as an avenue to further their political careers: the executive board is a starting ground for those who want to work with the United Nations or similar organisations.

But politics is a bureaucratic business, full of procedure and hierarchy, and one that can lead to bickering and in-fighting. It only takes a look at a daily newspaper to see this happening within UK political parties, and it is certainly happening within the federation, if events at their meeting in March were anything to judge by.

Sadly, while formalised rules may make all things uniform, one set of rules is not suitable for everything. The result is that procedure is slowing many things down while giving a select few, in this case the executive board, a lot of control over proceedings.

As an organisation the federation does not stand out as being exceptionally bad compared to the likes of the United Nations, World Health Organization, and the Red Cross. Like most global organisations it is a political machine, being run from the top down. These organisations tend, however, to achieve things in the opposite way, from the bottom up: people at the roots are actually making things happen.

Other global organisations have executive boards formed by older people; the IFMSA is run by medical students, young and vibrant people, who are in a position to change the mechanism from politics, with its head in the clouds, to action.

The federation has admirable goals and glittering potential. It exists to provide an infrastructure for organisations from nearly 100 different countries to work effectively with each other. It has managed this well over its first half century in existence. Now it has the opportunity to be a leader in the field.

If the federation is to empower our future doctors to work at the forefront of globalisation of health care, then it must, as Greg Dyke, director general of the BBC, recently put it, “cut the crap and make it happen.”⁶ His aim was to stop politics and bureaucracy from killing good projects.

Medical Students International Network (MedSIN) is the UK member organisation of IFMSA. Their website is at www.medsin.org

IFMSAs website is at www.ifmsa.org

1. International Federation of Medical Students Associations. www.ifmsa.org/about/mission.htm (accessed 11 Apr 2002).
2. Clinton B. World without walls. Guardian Saturday Review 2002 Jan 26:1-2. www.guardian.co.uk/Archive/Article/0,4273,4342925,00.html (accessed 8 Apr 2002).
3. Richards T, Smith R. Medicine in the age of global interdependence. BMJ 2002;324:309-10. www.bmj.com/cgi/content/full/324/7333/309 (accessed 8 Apr 2002).
4. International Federation of Medical Students Associations. www.ifmsa.org/members/index.html (accessed 8 Apr 2002).
5. International Federation of Medical Students Associations: the Netherlands. www.ifmsa.nl/foreign.htm#activities (accessed 8 Apr 2002).
6. News. BBCi, 2002 Feb 7. http://news.bbc.co.uk/hi/english/entertainment/tv_and_radio/newsid_1806000/1806891.stm (accessed 8 Apr 2002).