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This Week in The Lancet

  • Volume 377 1719 (2011)
  • May 21, 2011

Internships at the World Health Organisation

 Gauri Verma and Amitava Banerjee discuss WHO internships from a student and doctor perspective

A student perspective
During a clinical placement in Chandighar, North India, I attended a paediatric outpatient clinic. After observing case after case of children presenting with severe conditions, which were easily preventable and frankly unheard of in the UK, my interest turned to curiosity.

This curiosity drove me to investigate  international health organisations. I soon came across the internships for students and professionals that WHO offers at their headquarters in Geneva.  How better to gain insight into the workings of an organisation than to work there? In my second year of medical school, I applied for, and was offered, a 6-week internship in the non-communicable diseases department. 

Internships are between 6 and 12 weeks, and are unpaid.  Travel costs, travel arrangements, and accommodation must be arranged independently. I was successful in gaining funding from Bristol University and the British Society of Haematology. Information on applications can be found at http://www.who.int/employment/internship/interns/en/

Interns work under a supervisor, who delegates a project depending on the work focus of the particular department. My assignment was the WHO Research In to Global Hazards of Travel (WRIGHT) project. I conducted a literature review on DVTs and their link to air travel, presenting my findings as a report.

Two years on when I reflect on the experience, my insights gained go beyond DVT and air travel. Being at this international policy-making headquarters allowed me to sample the inner workings of global health policy. Inadequate funding presents practical problems extending far and wide. Internships are unpaid, which explains the under-representation from developing countries. The majority of interns were from Western countries.  Where policies are being drafted for the health of many different countries and cultures, it is essential that wide, representative input is received, so that practical, achievable policies are drawn up.  The minimal representation from low income countries was disappointing.  Nevertheless the internship was an incredibly enjoyable experience owing to the work I did and the people I met.  My understanding of global health has benefited from a realistic perspective.  The internship has enhanced my interest in international health, and has confirmed it is an area I will strive to pursue as a professional.

A doctor’s perspective
The role of the WHO and other non-governmental bodies in global health governance is a hotly debated topic in both the mainstream and the medical media, and is often poorly understood, even by health professionals training in public health. My exposure to public health came mainly after medical school, and culminated in a Masters in Public Health at Harvard University. My main interest was in preventive cardiology, particularly in the Indian subcontinent, and I had completed 2 years of clinical training in the UK before my WHO internship. During my MPH, I wanted to find out more about the role of international policy-making in international cardiology. There was a 2-month break before I started my SHO rotation back in Oxford, so I contacted the Division of Cardiovascular Diseases in the Department of Chronic Diseases and Health Promotion at WHO headquarters in Geneva (the names of the departments really are that bewildering).

For 6-weeks, I was an intern working on two separate projects. I worked on “Infobase”, a predictive tool, using global epidemiological data regarding chronic diseases and their risk factors to formulate projections of future disease. My work concentrated on country-specific tobacco consumption data. My other project was to review the evidence for links between poverty, development and cardiovascular health. Thus, I was able to experience work within a team at the WHO and conduct independent work on a separate project at the same time.

In the summer, Geneva bustles with interns from all the international organizations and it is an incredible experience to meet students and professionals from different disciplines and all corners of the globe. And that also in a picturesque city like Geneva, with all its nearby tourist attractions. There is undoubtedly over-representation by the Western countries but this is probably as much due to the high cost of living in Geneva, as well as flaws in the WHO’s selection procedures.

Pursuing an internship early on in your medical training means you are exposed early in your training to international health, and it is definitely easier to apply for funding as a student. However, it may be more difficult to decide which department to apply to and to see “the wood from the trees” in an organization as complicated as the WHO without further medical training. The reality is that there is no right time and there are interns there of all ages and at all stages in their medical careers. I might have benefited as a “doctor intern” because I could be more specific in my request for a department, and I was able to be more focused in my projects. Other interns in specialities from psychiatry to ophthalmology echoed these sentiments. It is possible to undertake internships in WHO’s regional offices and to be involved in more “implementation-end” projects.

We had the privilege as interns of attending a personal meeting with the WHO Director-General, Lee Jong-Wook, who himself described a diagram of the organisation’s structure as “like spaghetti”. This has huge consequences on the speed and efficiency of any initiative which the WHO implements. I left the WHO headquarters feeling that the “whole could be more than its component parts”. I was also struck by the “publish or perish” ethic even within an institution initially set up to safeguard global health.

Even with the multiplicity of players and stakeholders in international health, there is a large role for the WHO with its amazing concentration of experts from across the world. My internship definitely inspired me to continue my interest in preventive cardiology, and I have been able to continue working as a temporary advisor to the Division of Cardiovascular Diseases, alongside my clinical work.

Gauri Verma
4th year medical student, University of Bristol
gv3652@bristol.ac.uk

And
Amitava Banerjee
 Clinical Research Fellow
 Stroke Prevention Research Unit
 University of Oxford

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