There I was, in a sparse hotel conference room packed to the rafters with medical students from around the world, flitting from group to group trying to convince them that widening access to medical education was an issue they should care about.
This was the March meeting of the International Federation of Medical Students Associations, an organisation which very few medical students have heard of in the UK. This is surprising given it claims a membership of 1.3 million medical students globally, and has seats at the table at the World Health Organisation and United Nations Civil Society meetings, making it an arguably significant voice in Global Health. The organisation revolves around biannual general assemblies, with the most recent involving a 6-day soirée in Puebla, Mexico. Exotic or what?
In March (in Malta, not Mexico, sad times) I had the pleasure of attending as part of the delegation from Medsin-UK. I’ve talked about Medsin before in its role as a global health student network, but it also serves as the UK national member organisation of the IFMSA, which gives it a certain unique status. Medsin in the past has managed to put Global Health at the centre of the IFMSA’s vision and mission, which is pretty darn important for an organisation with a significant level of influence on global health issues.
The IFMSA revolves around the creation and enaction of policy – essentially written statements outlining what the organisation stands for, why it takes that stance and how it intends to take action on that particular issue. While it is debatable how useful these statements are, they serve a purpose of triggering debate and allow a vast organisation with a potentially endless remit to focus on several core issues.
One of the main goals of our delegation in Malta was to see a policy statement we had created on widening access to medical education become official IFMSA policy. This statement dealt with the huge barriers faced by individuals from lower-socioeconomic backgrounds in accessing medical education, and steps that could be taken to improve this situation globally (if you’re particularly keen the whole thing can be read here)
In order for a policy to be accepted by the IFMSA, it has be supported by a simple majority of delegates in a single collective vote. This is easier said than done, as the IFMSA encompasses nearly 127 voting members with very disparate aims and objectives.
There is a whole extra post to be written on the dynamics between these delegations, but it is important to note the extent to which politics plays a role in determine what succeeds and what fails.
For instance, regional voting blocks were very common – as an example, the majority of Middle Eastern voting members would generally follow a party line set by a senior country in the region, and certain Western countries would generally support each other without question.
In addition, traditional national enmities often spilt over into who was allowed to support what and be associated with whom, and home government policy often limited the actions that could be taken by certain delegations on unfortunately controversial topics such as gender equality. This is remarkably similar to the dynamics you can find in your standard international negotiations, which is part of what makes the IFMSA such a valuable educational experience.
Together these issues made guiding a seemingly harmless policy statement through the voting process a real challenge. Our policy was also limited by a lack of data on access to medical education from countries outside of the west – an issue some delegations unfortunately interpreted as evidence that the problem didn’t exist in their country. A more acceptable criticism (in my opinion) would be how much this issue should be prioritised – For instance, a country such as Sierra Leone with 0.02 doctors per 1000 has huge issues related to medical education, but arguably widening participation might not be a priority when core services aren’t available.
However, there’s a happy ending – after lots of lobbying, corridor chatting, debating and discussion, we managed to surprisingly get the motion passed. Hurray! Much kudos has to be given to Claire Nugent, the original author and main advocate, who is now pursuing a deservedly awesome career as an Academic Foundation Year 1 doctor in Global Health.