Global Surgery & Anesthesia

Here's an audio transcript for those who weren't able to attend.

The Academic Global Surgery Forum is on hiatus for the summer with plans to resume this fall.

The coordinators of the AGSF will start posting a brief summary after each session. Audio/videotapes of the sessions will be included online in the future.


Last April's discussion on international surgical rotations was interesting and productive, particularly as it is increasingly recognized that international rotations may attract medical students to an institution or even specialty.


April's forum started with an overview of the article " An International Volunteer Program for General Surgery Residents at Brown Medical School: The Tenwek Hospital Africa Experience" presented by Dr. Olu Faniyan, a student at the Harvard School of Public Health . The paper describes the history and goals of the Brown Medical School Department of Surgery surgical elective at Tenwek Hospital in Kenya. The authors surveyed the rotation participants and the entire surgical faculty at Brown on their past volunteer experiences and perceptions of clinical skill improvement amongst the participants in the rotation. The majority of faculty responded that residents in the program exhibited greater surgical competency on return from Africa. The AGSF participants appreciated that an evaluation of the rotation was done, as this information ...

The Academic Global Surgery Forum is on hiatus for the summer with plans to resume this fall.

The coordinators of the AGSF will start posting a brief summary after each session. Audio/videotapes of the sessions will be included online in the future.


Last April's discussion on international surgical rotations was interesting and productive, particularly as it is increasingly recognized that international rotations may attract medical students to an institution or even specialty.


April's forum started with an overview of the article " An International Volunteer Program for General Surgery Residents at Brown Medical School: The Tenwek Hospital Africa Experience" presented by Dr. Olu Faniyan, a student at the Harvard School of Public Health . The paper describes the history and goals of the Brown Medical School Department of Surgery surgical elective at Tenwek Hospital in Kenya. The authors surveyed the rotation participants and the entire surgical faculty at Brown on their past volunteer experiences and perceptions of clinical skill improvement amongst the participants in the rotation. The majority of faculty responded that residents in the program exhibited greater surgical competency on return from Africa. The AGSF participants appreciated that an evaluation of the rotation was done, as this information is important in obtaining support for existing and new surgery electives.

The AGSF participants wondered if other, standardized and possibly less subjective assessment tools could be utilized in future evaluations of such programs. The AGSF participants also would have liked to have seen a survey of the Kenyan host faculty, residents, and students regarding their impressions of the rotation.


The second half of the forum was spent reviewing the American Board of Surgery/ Residency Review Committee recently announced requirements for international surgical rotations. The diverse group of attendees (medical students, Ugandan and Nigerian physicians, surgery and anesthesia residents) felt the recommendations were important guidelines to ensure there is equity, accountability, and safety in the pursuit of training opportunities by American surgery residents at international host institutions.

Specific questions regarding the guidelines from the groups were:

1. What if any international certifications for host facility faculty supervisors are recognized? Requirements for ABS certification may hamper host faculty engagement.


2. What duration/level of faculty supervision is required? e.g. must the supervising faculty have a physical presence during the entire rotation vs. be present for all theatre cases vs. be a supervisor of the rotation from home, etc.?


3. Does requiring definition of the clinical experience (operative volume, ancillary services, outpatient experience) imply that there are minimums for these that the international rotation site should meet? Are there requirements for local or international certification of the hospitals where the rotations occur? 


4. Are the requirements for educational infrastructure resources (web-based journals/library), M&M, etc. a proxy for a recommendation on the type of center for the rotations? This requirement may limit rotations to large, high volume centers.


5. Who's responsibility is it to make sure requirements are met including evaluations done in the format requested- the resident, host faculty, or US-based program director?


6. Are rotations in clinical years other than 4-5 permitted? Do any requirements pertain to research residents?


7. Should the guidelines include a requirement that bilateral exchange be in place for approval of the rotation?


8. When does the counting of cases for credit from international rotations go in to effect?


Other notes:

1. AGSF participants would be interested in a "clearinghouse" website with all surgical rotations available to surgical residents being developed by the ACS, ABS, or RRC.

2. The new intern work hours may negatively affect the opportunity to take advantage of elective time and participate in international rotations.