Skip to main content
SpringerLink
Log in

Incorporation of a Global Surgery Rotation into an Academic General Surgery Residency Program: Impact and Perceptions

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Introduction

Global surgery is increasingly recognized as a vital component of international public health. Access to basic surgical care is limited in much of the world, resulting in a global burden of treatable disease. To address the lack of surgical workforce in underserved environments and to foster ongoing interest in global health among US-trained surgeons, our institution established a residency rotation through partnership with an academic hospital in Kijabe, Kenya. This study evaluates the perceptions of residents involved in the rotation, as well as its impact on their future involvement in global health.

Materials and methods

A retrospective review of admission applications from residents matriculating at our institution was conducted to determine stated interest in global surgery. These were compared to post-rotation evaluations and follow-up surveys to assess interest in global surgery and the effects of the rotation on the practices of the participants.

Results

A total of 78 residents matriculated from 2006 to 2016. Seventeen participated in the rotation with 76% of these reporting high satisfaction with the rotation. Sixty-five percent had no prior experience providing health care in an international setting. Post-rotation surveys revealed an increase in global surgery interest among participants. Long-term interest was demonstrated in 33% (n = 6) who reported ongoing activity in global health in their current practices. Participation in global rotations was also associated with increased interest in domestically underserved populations and affected economic and cost decisions within graduates’ practices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Calland JF, Petroze RT, Abelson J et al (2013) Engaging academic surgery in global health: challenges and opportunities in the development of an academic track in global surgery. Surgery 153:316–320

    Article  PubMed  Google Scholar 

  2. Meara JG, Leather AJ, Hagander L et al (2015) Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Surgery 158:3–6

    Article  PubMed  Google Scholar 

  3. Holmer H, Lantz A, Kunjumen T et al (2015) Global distribution of surgeons, anaesthesiologists, and obstetricians. Lancet Glob Health 3(Suppl 2):S9–S11

    Article  PubMed  Google Scholar 

  4. Hoyler M, Finlayson SR, McClain CD et al (2014) Shortage of doctors, shortage of data: a review of the global surgery, obstetrics, and anesthesia workforce literature. World J Surg 38:269–280. https://doi.org/10.1007/s00268-013-2324-y

    Article  PubMed  Google Scholar 

  5. Ozgediz D, Wang J, Jayaraman S et al (2008) Surgical training and global health: initial results of a 5-year partnership with a surgical training program in a low-income country. Arch Surg (Chicago, Ill.: 1960) 143:860–865 (discussion 865)

    Article  Google Scholar 

  6. Klaristenfeld DD, Chupp M, Cioffi WG et al (2008) An international volunteer program for general surgery residents at Brown Medical School: the Tenwek Hospital Africa experience. J Am Coll Surg 207:125–128

    Article  PubMed  Google Scholar 

  7. Meara JG, Greenberg SL (2015) The Lancet Commission on Global Surgery Global surgery 2030: evidence and solutions for achieving health, welfare and economic development. Surgery 157:834–835

    Article  PubMed  Google Scholar 

  8. Jayaraman SP, Ayzengart AL, Goetz LH et al (2009) Global health in general surgery residency: a national survey. J Am Coll Surg 208:426–433

    Article  PubMed  Google Scholar 

  9. Henry JA, Groen RS, Price RR et al (2013) The benefits of international rotations to resource-limited settings for U.S. surgery residents. Surgery 153:445–454

    Article  PubMed  Google Scholar 

  10. Drain PK, Primack A, Hunt DD et al (2007) Global health in medical education: a call for more training and opportunities. Acad Med J Assoc Am Med Coll 82:226–230

    Article  Google Scholar 

  11. Schecter WP, Farmer D (2006) Surgery and global health: a mandate for training, research, and service—a faculty perspective from the UCSF. Bull Am Coll Surg 91:36–38

    PubMed  Google Scholar 

  12. Knudson MM, Tarpley MJ, Numann PJ (2015) Global surgery opportunities for U.S. surgical residents: an interim report. J Surg Educ 72:e60–e65

    Article  PubMed  Google Scholar 

  13. Tarpley M, Hansen EN, Tarpley JL (2013) Early experience in establishing and evaluating an ACGME-approved international general surgery rotation. J Surg Educ 70(6):709–714

    Article  PubMed  Google Scholar 

  14. Pollock JD, Love TP, Steffes BC et al (2011) Is it possible to train surgeons in rural Africa? A report of a successful international program. World J Surg 35(3):493–499. https://doi.org/10.1007/s00268-010-0936-z

    Article  PubMed  Google Scholar 

  15. Pa Harris, Taylor R, Thielke R et al (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf 42:377–381

    Article  Google Scholar 

  16. MacDonagh R, Jiddawi M, Parry V (2002) Twinning: the future for sustainable collaboration. BJU Int 89(Suppl 1):13–17

    Article  PubMed  Google Scholar 

  17. Powell AC, Casey K, Liewehr DJ et al (2009) Results of a national survey of surgical resident interest in international experience, electives, and volunteerism. J Am Coll Surg 208:304–312

    Article  PubMed  Google Scholar 

  18. Leow JJ, Kingham TP, Casey KM et al (2010) Global surgery: thoughts on an emerging surgical subspecialty for students and residents. J Surg Educ 67:143–148

    Article  PubMed  Google Scholar 

  19. Cintolo-Gonzalez JA, Bedada AG, Morris J et al (2016) An international surgical rotation as a systems-based elective: the Botswana-University of Pennsylvania surgical experience. J Surg Educ 73:355–359

    Article  PubMed  Google Scholar 

  20. Donley DK, Graybill CK, Fekadu A et al (2017) Loma Linda global surgery elective: first 1000 cases. J Surg Educ 74(6):934–938

    Article  PubMed  Google Scholar 

  21. Zhang LP, Silverberg D, Divino CM et al (2016) Building a sustainable global surgical program in an academic department of surgery. Ann Glob Health 82:630–633

    Article  PubMed  Google Scholar 

  22. Finlayson SR (2013) How should academic surgeons respond to enthusiasts of global surgery? Surgery 153:871–872

    Article  PubMed  Google Scholar 

  23. Tannan SC, Gampper TJ (2015) Resident participation in international surgical missions is predictive of future volunteerism in practice. Arch Plast Surg 42:159–163

    Article  PubMed  PubMed Central  Google Scholar 

  24. Riviello R, Ozgediz D, Hsia RY et al (2010) Role of collaborative academic partnerships in surgical training, education, and provision. World J Surg 34:459–465. https://doi.org/10.1007/s00268-009-0360-4

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ng-Kamstra JS, Greenberg SLM, Abdullah F et al (2016) Global surgery 2030: a roadmap for high income country actors. BMJ Glob Health 1:e000011

    Article  PubMed  PubMed Central  Google Scholar 

  26. Price R, Makasa E, Hollands M (2015) World Health Assembly Resolution WHA68.15: “strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage”—addressing the public health gaps arising from lack of safe, affordable and accessible surgical and anesthetic services. World J Surg 39(9):2115–2125. https://doi.org/10.1007/s00268-015-3153-y

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Study data were collected and managed using REDCap electronic data capture tools hosted at Vanderbilt University Medical Center. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for importing data from external sources.

Author information

Authors and Affiliations

  1. Vanderbilt University Medical Center, Medical Center North Suite CCC-4312, 1161 21st Avenue South, Nashville, TN, 37232-2730, USA

    Michael Thomas LeCompte & Kyla P. Terhune

  2. Nashville, USA

    Michael Thomas LeCompte

  3. Vanderbilt University, 3101 West End Ave, Nashville, TN, 37203, USA

    Connor Goldman

  4. Vanderbilt Institute for Global Health, Vanderbilt Department of Surgery, AIC Kijabe Hospital, Kijabe, Kenya

    John L. Tarpley & Margaret Tarpley

  5. Bethany Kids – Kijabe Hospital, PO Box 20, Kijabe, 00220, Kenya

    Erik N. Hansen

  6. Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA

    Erik N. Hansen

  7. Plastic, Reconstructive, and Hand Surgery, AIC Kijabe Hospital, PO Box 20, Kijabe, 002200, Kenya

    Peter M. Nthumba

  8. Surgical Society of Kenya, Kijabe, Kenya

    Peter M. Nthumba

  9. Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, 597 Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA

    Rondi M. Kauffmann

Authors
  1. Michael Thomas LeCompte
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Connor Goldman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John L. Tarpley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Margaret Tarpley
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Erik N. Hansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Peter M. Nthumba
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kyla P. Terhune
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rondi M. Kauffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Thomas LeCompte.

Ethics declarations

Conflicts of interest

The authors have no conflicts of interest to disclose in the conduct, data collection or publication of this study.

Appendices

Appendix 1

  • Note: participation in this survey is voluntary, and all responses are anonymous.

Kijabe rotation survey

  1. 1.

    In what year did you begin residency at Vanderbilt?

  2. 2.

    In what year did you travel to Kenya?

  3. 3.

    What is your gender?

  4. 4.

    What percentage of your practice is currently focused on global surgery? (scale 0–100%)

  5. 5.

    What is your practice setting? (private practice, academic practice, hybrid private/academic practice)

  6. 6.

    Do you travel outside of the continental United States for purposes of participating in clinical surgery, research, or education?

  7. 7.

    If you travel outside of the continental United States for surgical practice, is it predominantly to perform surgery, conduct research, engage in education, or other?

  8. 8.

    If you travel outside of the continental United States for surgical practice, to which regions to you travel? (Central/South America, Pacific Islands, Canada, Asia, Western Europe, Eastern Europe, Middle East, North Africa, Sub-Saharan Africa, South Africa)

  9. 9.

    Are you fluent in a language other than English?

  10. 10.

    If yes, which one?__________________

  11. 11.

    What percentage of your practice is focused on underserved groups within the continental United States? (scale 0–100%)

  12. 12.

    What was your interest in global surgery prior to coming to Vanderbilt? (scale 0–100, with 100 = very high, 0 = very low)

  13. 13.

    What was your interest in global surgery after rotating in Kijabe? ? (scale 0–100, with 100 = very high, 0 = very low)

  14. 14.

    To what extent to you agree with the following statement: I came to Vanderbilt because of the global surgery focus/opportunities (scale 0–100, with 100 = strongly agree, 0 = strongly disagree)

  15. 15.

    To what extent to you agree with the following statement: My experience in Kijabe strengthened my interest in global surgery (scale 0–100, with 100 = strongly agree, 0 = strongly disagree)

  16. 16.

    To what extent to you agree with the following statement: If I had not rotated in Kijabe, Kenya, my interest in global surgery would be low (scale 0–100, with 100 = strongly agree, 0 = strongly disagree)

  17. 17.

    To what extent to you agree with the following statement: My experience in Kenya has made me more cost-conscious in my daily practice. (scale 0–100, with 100 = strongly agree, 0 = strongly disagree)

Appendix 2

Kijabe alumni survey

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

LeCompte, M.T., Goldman, C., Tarpley, J.L. et al. Incorporation of a Global Surgery Rotation into an Academic General Surgery Residency Program: Impact and Perceptions. World J Surg 42, 2715–2724 (2018). https://doi.org/10.1007/s00268-018-4562-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-018-4562-5

Search

Navigation