Journal of surgical education
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The Massachusetts General Hospital (MGH) Department of Surgery established the Global Surgery Initiative (GSI) in 2013 to transform volunteer and mission-based global surgery efforts into an educational experience in surgical systems strengthening. The objective of this newly conceived mission is not only to perform advanced surgery but also to train surgeons beyond MGH through international partnerships across disciplines. At its inception, a clear pathway to achieve this was not established, and we sought to identify steps that were critical to realizing our mission statement. ⋯ By organizing the collective experiences of colleagues, synchronizing efforts of new and former efforts, and leveraging the funding resources available at the local institution, the MGH GSI hopes to provide academic benefit to our foreign partners as well as our trainees through longitudinal collaboration. Providing additional financial and organizational support might encourage more surgeons to become involved in global surgery efforts. Creating a partnership with a hospital in a limited-resource setting and establishing a formal global surgery curriculum for our residents allows for education and longitudinal collaboration. We believe this is a replicable model for building other academic global surgery endeavors that aim to strengthen health and surgical systems beyond their own institutions.
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Wrong-site surgery (WSS) is considered a sentinel event by the Joint Commission. The education of spine surgery fellows on WSS is unknown. Our objective was to evaluate North American spine surgery fellows' education, awareness, and experience with WSS. ⋯ This is the first study evaluating spine surgery fellowship education on WSS. Among the spine surgery fellows, 30% had already experienced WSS and only 33% had formal fellowship didactics on WSS. Owing to the significant patient care and medicolegal ramifications from WSS, spine surgery fellowships should consider adding WSS prevention didactics to their curriculum.
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"Global surgery" is becoming an increasingly popular concept not only for new trainees, but also for established surgeons. The need to provide surgical care in low-resource settings is laudable, but the American surgical training system currently does not impart the breadth of skills required to provide quality care. We propose one possible model for a surgical fellowship program that provides those trainees who desire to practice in these settings a comprehensive experience that encompasses not only broad technical skills but also the opportunity to engage in policy and programmatic development and implementation. ⋯ Global surgery is a key word these days in attracting young trainees to academic surgical residency programs, yet they are subsequently inadequately trained to provide the required surgical services in these low-resource settings. Dedicated programmatic changes are required to allow those who choose to practice in these settings to obtain the full breadth of training needed to become safe, competent surgeons in such environments.
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To define the operations performed by surgical residents at a tertiary referral hospital in Rwanda to help guide development of the residency program. ⋯ The operative experience of surgery residents at CHUK primarily involves emergency and trauma procedures. Although this likely reflects the demographics of surgical care within Rwanda, more focus should be placed on elective procedures to ensure that surgical residents are broadly trained.