Policies

Admission to a Feinberg School of Medicine global health rotation/program is contingent upon a medical student's continued academic success. Should a medical student's admission be revoked as a result of poor academic performance or based on a recommendation from the Student Promotions Committee (SPC), Northwestern University and the Institute for Global Health will not be responsible for refunding any expenses incurred in preparation for the intended time abroad.

Student Standards

Membership in an academic community requires mutual respect, consideration and concern for the well-being of others, as well as a significant degree of personal integrity and maturity. Students who have engaged in misconduct or other unethical behavior, as determined by SPC, may be precluded from participation in a Feinberg global health rotation/program. SPC actions may include reprimand, suspension or dismissal of a student whose actions are found to be inconsistent with the qualities of a good physician. These vital qualities include:

• Sound judgment
• Personal insight or perception
• Motivation
• Personal integrity and accountability
• Responsibility to patients
• Ability to recognize personal limitations
• Ability to function under pressure

Information concerning medical student conduct is made available to the Institute for Global Health and will be considered when reviewing a student's application. It may be considered a determining factor for a medical student's continued eligibility in a Feinberg global health rotation/program.

Students who have been put on disciplinary probation or suspension or who have been reprimanded by SPC are ineligible to participate in a Feinberg global health rotation/program during the period of their probation, suspension or reprimand. Students who have been suspended, withdrawn or dismissed from the university are ineligible to participate in a Feinberg global health rotation/program. Should a student's admission to a Feinberg global health rotation/program be revoked as a result of disciplinary action or conduct violation, Northwestern University will not be responsible for refunding any expenses incurred in preparation for the intended time abroad.

Applicants for Feinberg's global health rotations/programs are evaluated on academic record (i.e., good standing status with the registrar), recommendations from the FSM Office of Medical Education and appropriate academic and clinical preparation (prior experience and familiarity with global health issues and ability to contribute within a clinical environment). The Institute for Global Health reserves the right to approve, waitlist and/or deny any medical student application. Feinberg global health rotations/programs are not open to Northwestern undergraduate students or to other medical and/or graduate students at other universities.

Participating students and faculty will abide by the policies, rules and regulations in effect at the host institution as stated in the student handbook of the respective institutions. Students whose academic work or behavior is deemed not suitable may be terminated from participation by the program director of the host institution, who has sole authority to suspend and/or terminate the rotation and/or program of the visiting student. If, in the opinion of the program director at Feinberg's affiliated institution, a student's behavior presents an imminent threat to the student's physical or emotional health, safety or well-being or the health, safety or well-being of others, the maintenance of public order or the effective continuation of the educational process, the program director may immediately suspend the student from the program prior to any formal disciplinary proceeding. The director shall promptly advise the Institute for Global Health of the circumstances of the suspension. The student will be responsible for returning and for making alternative housing arrangements on their own and at their own cost.

To ensure a safe and fun experience when traveling abroad, it is important to understand the extent of your insurance coverage. Students should review the Student Health Insurance policy. Students who are not enrolled in Northwestern-sponsored insurance should speak with their insurance provider to learn about coverage while abroad.

GeoBlue Insurance

Northwestern University offers its students, faculty and staff supplemental GeoBlue travel insurance at an additional cost. Those participating in a Institute for Global Health–supported experience are required to be covered by GeoBlue insurance or another comparable travel insurance. GeoBlue covers primary care when traveling abroad for a nominal weekly fee. GeoBlue is not meant to be a substitute for domestic health insurance but covers an individual for certain services when outside of the U.S. Learn more about GeoBlue insurance.

The purpose of the Guidelines for Blood‐borne Pathogen Exposure and Post-Exposure Prophylaxis are to delineate recommended actions that should be taken in case of an occupational exposure of any member of the Feinberg School of Medicine to infected or potentially infected bodily fluid while at a global health field site (i.e. off-campus, non-U.S. site). The policy extends to Feinberg School of Medicine students.

The guidelines outlines Feinberg's recommendations. It does not replace individual choice. Each exposed person has the right to weigh the risks and benefits and make their own choice about when to take post‐exposure prophylaxis.

The Institute for Global Health understands that changing situations may occasionally cause students to be unable to participate in global health education experiences. If you cannot complete your scheduled rotation, please inform the Institute for Global Health staff and the affiliated program contact as soon as you know that you will be unable to travel. 

Students that can no longer participate in the global health experience because of a schedule change will be responsible for any program fees owed, if applicable, or the cost of travel if already purchased. Each affiliated program has its own refund policy, so please inform your contact at the site as soon as possible. If a Global Health Initiative Award has already been dispersed to the student, they will be expected to return the funds to the Institute for Global Health.

In the case of illness or family emergency, students may be eligible for an exception to the rule above about program fees and travel costs, but must still return the Global Health Initiative Award. Please contact the Institute for Global Health staff as soon as possible to discuss your situation so we can best support you.

In the case of trips cancelled due to a safety concern (i.e., a new State Department travel warning or a natural disaster), students will not be responsible for travel or other program fees. 

The Havey Institute for Global Health allocates travel funds to select Feinberg School of Medicine students who wish to pursue a global health rotation/program at international sites. Travel awards are not guaranteed to every Feinberg student who applies.

I. Eligibility Requirements

• Applicants must be registered as full-time matriculated medical students at Feinberg to be eligible.
• The medical student must be in good standing at the time of proposed travel.
• GHE awards apply to clinical rotations and public health/research projects at affiliated partners and unaffiliated international sites that have been reviewed and approved by the institute.
• If awarded funding, a student must submit the appropriate financial paperwork and complete the institute's required application, orientation and evaluation steps.
• Students must submit the institute's online evaluation, an evaluation from their preceptor if receiving elective credit, and/or a scholarly paper for research projects to the Havey Institute for Global Health upon completion of the project.
• Trainees are eligible for a maximum of two GHE awards, during their training programs.

II. Funding Restrictions

Students may not receive funding from more than one source from Northwestern University for the same rotation/project. Sponsored Northwestern travel sources for students include, but are not limited to, the Global Health Experience fund, the Program in Public Health, the Medical Student Summer Research Program and the Office of International Relations.

Travel funds may not be deferred and must be used for the approved rotation/project within the same academic year that the award is issued.

III. Taxable Income

Scholarship payments issued by Northwestern University may be considered taxable income by the IRS depending on a student’s individual financial situation. No taxes will be taken out of the scholarship payment at the time of payment if processed by Northwestern’s Payroll Department, but trainees should be aware that they will need to report this during the following year’s tax season on Worksheet 1-1. This is solely the responsibility of the award recipient. If you would instead like taxes withheld from your award, please fill out the W4 form with Payroll on the 1st floor of Abbott hall.

IV. How Do I Receive My Travel Funds?

For Students: All scholarship awards must be processed via Payroll. Once an award letter is received, you will be provided with instructions and forms to complete the Payroll process. Paperwork submitted by the 1st of the month will generally be processed by the end of the month, while paperwork submitted after the 1st will be processed at the end of the subsequent month. Please allow four to six weeks for processing. Please note that all such timelines are an approximation and that students may have to wait longer periods of time depending on individual financial circumstances. 

For Residents: In order to receive your GHE funding, you must contact your residency program coordinator to discuss the required steps for the reimbursement process and fill out the appropriate paperwork for the GME office.

Global Health Experience awards are distributed as a reimbursement for residents. Allowable expense categories for reimbursement include:

• Market rate international ticket (coach class)
• Program fees (i.e., ay required fees paid to host institution)
• Immunization and travel medicine
• Visa application fees
• Housing expenses at destination
• Per diem (at discretion of the department)

GHE awards will NOT cover local fares (i.e. taxis, public transportation) or other transportation expenses in the U.S. or abroad nor will they reimburse for medical supplies, individual meal expenses, shared housing arrangements, or unplanned medical expenses. Rotation expenses paid with reward program credits or paid by anyone other than the awardee are similarly ineligible for reimbursement. Each award will be made up to a maximum dollar amount to be reimbursed after travel is complete. If additional receipts are submitted with totals that exceed the maximum award amount, the additional expenses will not be reimbursed. Awards are contingent upon prior approval of the rotation by your respective program director and the McGaw Medical Center.

See here for more information about international elective GME rotations.

V.  When Travel Funds Must Be Returned

Feinberg students may be required to return travel funds that are awarded to support a global health experience if any one of the following conditions occurs:

• A trainee is dismissed from a visiting rotation or medical education program at an international site by the host institution’s program director for unprofessional or unethical behavior.
• A trainee leaves a visiting rotation or medical education program early and without prior permission from both the host institution and Feinberg.
• Unforeseen emergencies, natural disasters or another force majeure causes the cancellation of a visiting rotation or medical education program before the rotation/program begins. In such cases, it is the student’s responsibility to contact airlines, travel agents and places of residence where they intend to stay to cancel reservations and request refunds as soon as reasonably possible.  Cancellations that occur due to emergencies, natural disasters or force majeure during a rotation/program at an international site will be handled on a case-by-case basis and under such circumstances students should contact the Havey Institute for Global Health as soon as possible.
• A student completes the rotation/medical education program and Feinberg later learns that the student acted in an unprofessional or unethical manner and is consequently disciplined by the Student Promotions Committee.

If any of these situations occur, the funds must be returned by the student to the Havey Institute for Global Health within 30 days of the request and before graduation, whichever date comes first.

The Feinberg School of Medicine’s Institute for Global Health established the following policy for Feinberg students participating in all clinical away-rotations and medical education programs at international sites. It became effective in January 2011 and was revised in January 2018.

• Application Steps for Global Health Experiences for Feinberg Students
• Request for Elective International Medical Rotation to Non-IGH Institution (PDF)

Common Preparation Requirements for Global Health Rotations/Programs

General Considerations

The Havey Institute for Global Health (Havey IGH) at the Feinberg School of Medicine (FSM) in conjunction with Dean’s Administration retains the right to review, approve and/or deny clinical electives, research and public health projects, and/or medical education programs at both affiliated and independent institutions at international sites for all medical trainees including medical, physical therapy, physician assistant and all other FSM students as well as FSM student organizations. A committee of FSM faculty and administrators review, approve, suspend, and/or deny school-sponsored global health education proposals. This committee annually reviews each affiliated site for the quality of experience, supervision, safety, risk and liability.

Approved international rotations for research or clinical education must be a minimum of four consecutive weeks in duration. Special exceptions to this minimum duration will be considered for unique professional development opportunities, such as select research projects for FSM students, to be considered on a case-by-case basis by the Havey IGH and Dean’s Administration.

This policy is in place to ensure standard criteria are met regarding safety, risk and liability, sustainability and organizational mission, and proper supervision by a licensed medical professional.

Supervision

In order to be eligible for elective credit or FSM funding for an international clinical rotation, public health and/or research project at an independent institution, FSM students must be supervised by an appropriately licensed medical professional to be in compliance with the Supervision Policies of the Augusta Webster Office of Medical Education for medical students and the McGaw Medical Center for residents and fellows.

Education Programs for Academic Credit vs. Vacation

In order to receive academic credit and/or funding for a clinical rotation at an affiliated or independent site, approvals must be received in advance from both the clinical clerkship director/faculty supervisor and the Institute for Global Health and all steps below must be complete. To receive academic credit and/or funding for a research rotation at an affiliated or independent site, approvals must be received in advance from both the FSM faculty supervisor and the Havey Institute for Global Health and all steps below must be complete.

Short-term medical missions, non-approved research or volunteer work, and other non-credit programs where students do not receive credit and which are not supported by FSM funding are considered vacation /non-school sanctioned travel.

In order to obtain academic credit for an international clinical rotation or research elective, each of the application and preparation steps detailed in this policy must be completed in advance of the rotation. Rotations at international settings not previously approved by the Institute for Global Health and Dean’s Administration (in accordance with the steps below) are considered vacation/non-school sanctioned travel.

Rotations that may be considered for academic credit include approved clinical elective rotations, Area of Scholarly Concentration research projects, long-term Global Health Experience funded research projects, and public health field experiences at any one of the global partner institutions or similar rotations at any independent international institutions.

All international rotations that provide academic credit must be formally approved in advance of the rotation by the process outlined in this policy. Rotations or other international programs not approved via this process are considered vacation/non-school sanctioned travel.

Definitions

An affiliated institution/site is defined as any university, teaching hospital, medical school, clinic, and/or nonprofit or nongovernmental organization, either foreign or domestic, that has a formal legal agreement or signed memo of understanding with Northwestern University.

An independent institution/site is defined as any university, teaching hospital, medical school, clinic, and/or nonprofit or nongovernmental organization, either foreign or domestic, that does not have a formal legal agreement or signed memo of understanding with Northwestern University.

Education Programs at Global Health Partners

FSM students are strongly encouraged to take advantage of the university’s official global partners.

• Review application checklist
• Schedule advising meeting with global health education staff at the Institute for Global Health, or attend an information session
• Complete Global Health Experience online application
• Complete Havey IGH pre-departure preparation process, including but not limited to:
  • Attendance at three required global health seminars
  • Review of  Canvas orientation tools
  • Submission of a 2-3 page analytic memo on a local health issue
• Register for GeoBlue international travel insurance
• Visit travel clinic as necessary
• Review FSM Student Handbook for Global Health
• Request elective credit from Records & Registration Office prior to travel (M3s/M4s)
• Acquire away elective evaluation from on-site preceptor (M3s/M4s)
• Complete Havey IGH online evaluation (upon return)

Education Programs at Non-Global Health Partners/Independent International Sites

• Pre-Departure Preparation Checklist
• Request for Elective International Medical Rotation to Non-IGH Institution

Although rotations at global health partners are recommended, research and clinical rotations at independent institutions outside the US will be considered if they a) provide professional development opportunities in health related fields not otherwise readily available at FSM or with FSM affiliated partners in Chicago or abroad; and b) the independent institution has a mission that relates to the health professions and emphasizes improving public, community, and/or global health.

New proposals will be considered by a global health committee on a case-by-case basis and should contain distinction from current rotations available at FSM partner universities.  Formal approval by the Committee and Dean’s Administration must be received prior to departure. 

Rotations at non-affiliated sites that do not provide or have acceptable research and/or educational content, supervision, infrastructure, safety procedures and policies, or are of limited duration of less than four-weeks will not be approved.

Insurance & Liability

• All FSM students are required to meet the standards and laws set by local, state, and/or national regulations that apply to the independent institution to ensure that all proper licensure and insurance requirements are met before any clinical or research rotation begins. Particular attention should be given to requirements for medical licenses, registration with the ministry of health, liability insurance, etc.

• All FSM students are required to document their travel through the Office of Global Safety and Security's International Travel Registry.

Health, Safety & Security

• FSM places great importance on the safety and security of its students. Proper contingency planning and risk assessment must be made and documented detailing what emergency medical and transportation facilities and resources exist within the community where a FSM student plans to complete the off-site rotation/program.

• FSM students will comply with the posted Guidelines for Blood-borne Pathogen Exposure and Post-Exposure Prophylaxis at Global Health Field Sites

• Feinberg students should consult with their primary care physician and are required to make proper preparations and obtain appropriate medical resources regarding their personal health before travel. In addition to a visit to a primary care physician, these preparations may include a visit to an authorized travel clinic for consultation, review of prior immunization records, review of the host country’s entrance requirements particularly regarding immunizations, and ensuring that there will be access to prescription medications and care for emergencies and/or pre-existing conditions. 

Travel Policy

Northwestern University’s Feinberg School of Medicine (FSM) encourages its students to participate in a wide variety of global health education programs, via clinical electives, global public health field experiences, and research projects. To minimize health and safety risks, FSM has adopted the following policies and procedures to govern travel for education opportunities and experiences abroad with affiliated institutions  or unaffiliated sites in locations subject to a U.S. Department of State (DOS) Travel Advisory Level 3 or Level 4 as well as a Centers for Disease Control and Prevention Travel Notice Warning Level 3 (CDC Warning). Program directors or students may apply for special Travel Permission through the following review procedures.

• Participation in unaffiliated opportunities or experiences abroad in locations under a DOS Travel Advisory Level 3, Level 4 and/or a CDC Warning 3 is prohibited without exception.
• Individual requests to participate in affiliated education opportunities and experiences abroad in locations under a DOS Travel Advisory Level 3, Level 4 and/or a CDC are prohibited. Exceptions to this policy may be granted following the procedures below.

Students travel to any international destination, restricted or unrestricted by Northwestern that is not directly connected to authorized university activities will be consider personal, leisure travel. Benefits such as GeoBlue international medical insurance and Drum Cussac evacuation coverage do not apply to personal, leisure travel.

The Feinberg International Risk Assessment Committee (FIRAC) administers this policy, under the direction of its chair, Julie Anne Friend, Director, Office of Global Safety and Security (OGSS). The Committee’s recommendations will be considered binding for the medical school, once approved by the Dean of Feinberg.

FIRAC is comprised of nine members:

• The Director of the Office of Global Safety and Security (Chair)
• The FSM Vice Dean of Education
• FSM’s Associate Dean for Student Programs and Career Development
• The Associate Chair for Education for the Department of Pediatrics
• The Co-Directors of the Center for Global Health Education, Institute for Global Health
• The Senior Associate Director, Institute for Global Health
• The Vice President for International Relations
• A representative from the Office of General Counsel
• A representative from the Office of Risk Management

Program Suspension/Revocation of Travel Permission/Withdrawal

FSM reserves the right to withdraw its approval at any time should conditions presented in an application for approval change materially. The Director of OGSS and the Associate Director – Institute for Global Health (AD-IGH), and the students are responsible for monitoring conditions in approved travel locations. The AD-IGH will communicate information and an assessment with affected individuals when there is a sudden change of condition.

Sudden Change of Condition

In addition to reviewing requests for Travel Permission under this policy, FIRAC is responsible for recommending whether or not to suspend an ongoing or previously approved education abroad opportunity if a significant health, safety or security concern is raised regarding that experience. In making this assessment, the Committee will consider the risk management plan for the students, staff or faculty involved in the program or experience and the balance between the value of the academic experience in that specific location versus the risks associated with that location/activity.

Though uncommon, it is possible that a specific program, activities in a specific location (city, region, or country), or all activities abroad would need to be modified or suspended by the FSM due to a health or safety concern. This concern may arise if a new/revised DOS Travel Advisory or CDC Warning is issued for a location or if conditions presented in a Travel Permission request change materially.

In such cases, the AD-IGH will consult with the Director of Global Safety and Security to conduct a timely assessment, and then make a recommendation to the FIRAC. Typical recommendations may include but are not limited to: a) no material program changes; b) modifications to program housing, activities, or schedule; c) or suspension and withdrawal/evacuation.

In circumstances where students are perceived to be in imminent danger and the window of opportunity for action is short, the Director of OGSS, the Director and AD of the Institute for Global Health and FSM Vice Dean of Education, have the authority to suspend the affected program(s) immediately and initiate evacuation proceedings. If time permits, they may consult (though it is not required) with other members of the FIRAC, –any on-site faculty or staff, U.S. Department of State’s Overseas Security Advisory Council staff analysts, Northwestern faculty/staff regional experts, peer institutions’ international health, safety and security specialists, consultants from security information service providers, and/or other appropriate individuals, as available, to determine an appropriate course of action.

Travel Permission Application Process

Requests for permission to engage in a new medical education experience abroad in a location subject to a U.S. DOS Travel Advisory Level 3, Level 4 and/or CDC Warning are made first in writing and then in person (or via remote conference services) to the FIRAC.

All review materials must be submitted at least three months prior to the envisioned start of the experience to the FIRAC Chair. Due to the limited number of times the FIRAC meets each year and the complexity involved in making a quality Travel Permission application, applicants should plan on the entire review process taking up to six months. Failure to allow sufficient time for review may result in a denied application and/or a delayed program start. Please note that permission to operate a program will only apply to the specific program or experience approved, not to a country or region.

In cases where a new Level 3 or Level 4 Advisory (or CDC Warning) is issued less than 12 weeks before an already approved program’s student application deadline, every effort will be made to facilitate an emergency meeting of the FIRAC to conduct a thorough and timely review of the situation.

Application Materials: Complete [electronic] applications should be submitted to FIRAC Chair at least 10 days prior to the Committee meeting. Most importantly, the application should discuss the academic value of the program and the necessity of its location (as opposed to an alternate location) and how the structure of the program and the safety procedures in place on-site mitigate the concerns raised by a DOS Travel Advisory Level 3, Level 4 and/or CDC Warning.

Applications must include the following:

1. Provide linkage to active ongoing Feinberg program at the international location
2. Links to the relevant DOS Travel Advisory, CDC country profile and/or other credible news/risk analysis sources such as security information subscription services.
3. A description of the potential health and/or safety risks as applied to this educational experience (and an explanation of any risks outlined in the Advisory or CDC Warning that that do not apply based on a lack of exposure due to location or other factors).
4. A summary of the efforts to mitigate applicable risks, including pre-departure health, safety, and security information/education;
5. Additional materials in support of the application or otherwise requested by the FIRAC Chair.

6. Proposed program should distinguish itself from other programs as global partner institutions with unique clinical, research, and/or public health training opportunities for FSM students.

Approval Criteria
The proposal must be strongly linked to academic program goals, and the safety issues raised in the application must be adequately addressed and documented. The FIRAC will only recommend approval of applications when there is a compelling justification for the program. 

In addition to the materials provided by the applicant, the Committee may also take into account in its discretion:

• Relationships with partner institutions abroad
• Consultations with on-site individuals, such as alumni, students, and staff and faculty of other programs as well as the nearest U.S. embassy or consulate
• Consultations with representatives from government agencies such as the U.S. Department of State, the Overseas Security Advisory Council (OSAC), and the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO)
• Consultations with other colleagues from other medical schools operating in the same location as well as peer institutions’ international health, safety and security specialists
• Travel warnings or advisories issued by other countries
• Other relevant material and advice

Approval Decisions
Applications for special travel permission are reviewed with a final determination made by FIRAC.

In addition to the expectation that all participating students will abide by the global health code of conduct/participation rules and regulations –including but not limited to submitting proof of GeoBlue insurance coverage, enrollment with the Smart Traveler Enrollment Program (STEP) (or an available substitute for travelers of other nationalities) and disclosure of specific travel details (flight itinerary, accommodations, local contact information, etc.). All FSM students accepted to programs that operate under special travel permission are required to submit a signed FIRAC Travel Release and Waiver at least six weeks prior to departure.

FIRAC Approval Recommendations
After reviewing the application materials and conducting its review, FIRAC will strive to come to a consensus on a determination for program approval, modification, or denial. If consensus cannot be reached, the determination will be made by a majority vote. FIRAC’s determination will be considered binding, once approved by the Dean of FSM. Possible determinations include:

1. Approval of participation at the location for a one-time specific education abroad program opportunity only.
2. Approved operation at an affiliated, FSM-approved program for a specific period of time. Such approval would be granted for up to three years, absent any material change in the DOS Travel Advisory or CDC Warning. At least 12 weeks prior to the approval’s expiration, a representative from the sponsoring academic unit may request continuation.
3. Approved indefinitely by FSM for continued medical education programs unless there is a significant change in the security and/or health environment at the host-institution.

FIRAC Denial Recommendations

In cases of a denial recommendation, the FIRAC will share its written determination and rationale with the Travel Permission applicant. FIRAC denials will be considered final and appeals will only be considered once there has been a substantive change to the security environment where the program is located, such as when a DOS Travel Advisory or CDC Warning is lifted.

Additions or Modification to Trips/Programs Approved by FIRAC

If a NU-sponsored non-credit group trip or global health education program operating with special permission under the Travel Policy adds a new experience or academic track that materially changes the security profile of the program, an explanation of how perceived risks may be mitigated is required. The program sponsor should consult with the AD-IGH to determine what is required for the FIRAC’s review.

Financial Responsibilities

Northwestern University does not assume responsibility for financial risks associated with participation in its education abroad opportunities. If the University cancels a program before departure or while the program is in progress for reasons beyond its control including, but not limited to, political unrest or danger to participant safety, changes to the DOS Travel Advisory or CDC Warning, only those recoverable fees or tuition refunded to the University by service providers and/or institutions will be returned to participants. The University will make reasonable efforts to obtain refunds from applicable service providers and/or institutions, but no refunds are guaranteed. In addition to lost fees and tuition, participants may incur additional travel expenses in connection with program cancellation. Participants may or may not receive academic credit if a program is canceled. The University assumes no responsibility for the financial or other losses of program participants resulting from program cancellation. 

Supplemental Insurance

Students, staff, and faculty are encouraged to consider supplemental insurance options to cover losses if programs or activities are canceled. Supplemental insurance is also helpful if a student needs to cancel participation in a program or return early due to unforeseen personal emergencies. Such insurance is not required by the University and must be purchased on an individual basis.