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Initial Results of a 5-Year Partnership With a Surgical Training Program in a Low-Income Country

Doruk Ozgediz, MD, MSc; Jennifer Wang, MD; Sudha Jayaraman, MD; Alex Ayzengart, MD; Ramin Jamshidi, MD; Michael Lipnick, MD; Jacqueline Mabweijano, MD; Sam Kaggwa, MD; Margaret Knudson, MD; William Schecter, MD; Diana Farmer, MD

Arch Surg. 2008;143(9):860-865.

Hypothesis  Surgical trainees in the United States have a growing interest in both clinical experiences and structured training opportunities in global health. Global health training and exposure can be integrated into a surgical residency program.

Design  The global health activities of surgical residents and faculty in 1 department were evaluated from January 1, 1998, to June 1, 2008, using a survey and personal interviews.

Results  From January 1, 1998, to December 31, 2002, 4 faculty members made more than 20 overseas volunteer medical expeditions, but only 1 resident participated in global health activities. In 2003, a relationship with a surgical training program in a developing country was established. Ten residents and 12 faculty members have made overseas trips during the last 5 years, and 1 international surgeon has visited the United States. During their research block, 4 residents completed 1- to 3-month clinical rotations and contributed to mentored research projects. Three residents completed a university-based Global Health Clinical Scholars Program, and 3 obtained master's degrees in public health. A joint conference in injury-trauma research was also conducted. A faculty member is based overseas with clinical and research responsibilities, and another is completing a master's degree in public health.

Conclusions  Global health training and exposure for residents can be effectively integrated into an academic surgical residency program through relationships with training programs in low-income countries. Legitimate academic experiences improve the success of these programs. Reciprocity with collaborative partners must be ensured, and sustained commitment and funding remain a great challenge to such programs. The long-term effect on the development of global health careers is yet to be determined.

Author Affiliations: Departments of Surgery (Drs Ozgediz, Wang, Jayaraman, Ayzengart, Jamshidi, Knudson, Schecter, and Farmer), Global Health Sciences (Dr Ozgediz), and Physics (Dr Jamshidi), School of Medicine (Dr Lipnick), and Division of Pediatric Surgery/Fetal Treatment Center (Dr Farmer), University of California, San Francisco; and Department of Surgery, Makerere University, Kampala, Uganda (Drs Mabweijano and Kaggwa). Dr Lipnick is now with the Division of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

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