An academic career in global surgery: a position paper from the Society of University Surgeons Committee on Academic Global Surgery

Krishnaswami, Sanjay; Stephens, Caroline; Yang, George P.; Nwomeh, Benedict C.; Swaroop, Mamta; Nadler, Evan P.; Holterman, Ai Xuan; Simeone, Diane M.; Kingham, T. Peter; Merchant, Nipun B.; Orloff, Susan L.

doi:10.1016/j.surg.2017.10.019

Cited by 32 publications

(26 citation statements)

References 35 publications

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“…Global surgical endeavours may fail to include an educational component for transferring knowledge (clinical, structural or otherwise) or skills to LMIC communities. 4 Visiting surgical trainees may be requested to work in settings of limited supervision which may be inappropriate for their skill level. 12 15 17 27 28 32 35 47 49 58 60-62 Preparedness of trainees to work in host communities:…”

Section: Results Descriptive Analysismentioning

confidence: 99%

“…Visiting trainees may be unfamiliar with surgical diseases or presentations in hosting communities and their added complexity; visiting trainees may lack insight or preparedness to deal with cultural and linguistic challenges in unfamiliar environments. 4 The presence of visiting global surgical trainees may detract from learning opportunities for local trainees. 17 20 30 50 58 reciprocity of global surgical training programmes:…”

Section: Results Descriptive Analysismentioning

confidence: 99%

“…13 Research performed in LMICs may be done for the benefit of another external population and may be unlikely to benefit local populations. 4…”

Section: Results Descriptive Analysismentioning

confidence: 99%

“…An estimated of 5 billion people worldwide lack timely access to safe and affordable surgical care, and 143 million surgical procedures worldwide are required to make up this shortfall. 2 The international academic community has responded to this healthcare crisis with increasing participation in global surgical initiatives and collaborations, as evidenced by an increasing number of publications on the topic, 3 the development of academic positions in global surgery, 4 the growth of formalised education programmes in international surgery, 5 and the recognition of international surgical electives by BMJ Global Health the Accreditation Council for Graduate Medical Education. 6 Despite this growing attention to the field of global surgery, little has been published to critique or guide the ethics of global surgical endeavours.…”

Section: Introductionmentioning

confidence: 99%

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Ethical considerations in global surgery: a scoping review

et al. 2020

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IntroductionAn unmet burden of surgical disease exists worldwide and is disproportionately shouldered by low-income and middle-income countries (LMICs). As the field of global surgery grows to meet this need, ethical considerations need to be addressed. Currently, there are no formal guidelines to help inform relevant stakeholders of the ethical challenges and considerations facing global surgical collaborations. The aim of this scoping review is to synthesise the existing literature on ethics in global surgery and identify gaps in the current knowledge.MethodsA scoping review of relevant databases to identify the literature pertaining to ethics in global surgery was performed. Eligible articles addressed at least one ethical consideration in global surgery. A grounded theory approach to content analysis was used to identify themes in the included literature and guide the identification of gaps in existing literature.ResultsFour major ethical domains were identified in the literature: clinical care and delivery; education and exchange of trainees; research, monitoring and evaluation; and engagement in collaborations and partnerships. The majority of published literature related to issues of clinical care and delivery of the individual patient. Most of the published literature was published exclusively by authors in high-income countries (HICs) (80%), and the majority of articles were in the form of editorials or commentaries (69.1%). Only 12.7% of articles published were original research studies.ConclusionThe literature on ethics in global surgery remains sparse, with most publications coming from HICs, and focusing on clinical care and short-term surgical missions. Given that LMICs are frequently the recipients of global surgical initiatives, the relative absence of literature from their perspective needs to be addressed. Furthermore, there is a need for more literature focusing on the ethics surrounding sustainable collaborations and partnerships.

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Section: Results Descriptive Analysismentioning

confidence: 99%

Section: Results Descriptive Analysismentioning

confidence: 99%

“…13 Research performed in LMICs may be done for the benefit of another external population and may be unlikely to benefit local populations. 4…”

Section: Results Descriptive Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ethical considerations in global surgery: a scoping review

et al. 2020

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“…15 In a Canadian survey of general surgery and orthopedic residents, half of the respondents stated that the presence of a global surgery program would positively influence their choice of residency program. 13 As focus on global surgery increases in the international community, the academic value of global surgical participation will continue to be recognized, 12,16 and careers centered on global surgery will be increasingly celebrated. This sentiment was reflected in the present study, with most residents recognizing global neurosurgery as a legitimate career path, on par with scientist and educator roles.…”

Section: Motivating Factorsmentioning

confidence: 99%

Interest and participation in global neurosurgery: a survey of Canadian neurosurgery residents

Westwick

Elkaim

Obaid

et al. 2020

Neurosurgical Focus

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OBJECTIVEThe lack of access to primary neurosurgical care presents a significant burden for patients in low- and middle-income countries (LMICs). Efforts to decrease the inequities in access to surgical care have become an increasing focus of initiatives and advocacy within the international neurosurgery community. Although residents may represent highly active members of international teams, the extent of their availability for and interest in global neurosurgery opportunities remains unclear. The objectives of this study were to assess the degree of participation, the level of interest, and the perceived barriers for residents of Canadian neurosurgery programs in engaging in neurosurgery initiatives in LMICs.METHODSA cross-sectional survey was administered to 144 residents from all accredited Canadian neurosurgery residency programs. The survey was used to determine the level of participation and interest in global neurosurgery initiatives.RESULTSThe survey response rate from residents at Canadian neurosurgery programs was 45/144 (31%), although not all respondents answered every question; thus, the denominator for each question is not always 45. Most neurosurgery residents (n = 30, 68%) were unaware of any global neurosurgery opportunities available during residency. Despite 64% of residents having an interest in participation (strongly agree/agree; n = 28), with most residents planning on participating as attending staff (strongly agree/agree; n = 28, 64%), only 3 residents (7%) had taken part in LMIC neurosurgery initiatives. The most cited perceived limitations for participation were lack of time (n = 37, 84%) and finances (n = 26, 59%).CONCLUSIONSAmong surveyed residents from Canadian neurosurgery programs, there was a low participation rate in global neurosurgery initiatives and limited knowledge of available opportunities, despite relatively high interest. Many respondents identified time and financial constraints as barriers to participation. Many residents felt that interest could increase were there a structured program dedicated to global neurosurgery available in their residency program.

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Shaping the Path for a Global Oncology Academic Career

2019

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Global oncology is the area of study, research, and practice that aims to improve cancer care and achieve equity in cancer outcomes worldwide. This field has gained momentum over the past decades with an increasing focus on the worldwide burden of noncommunicable diseases. Low-and middle-income countries account for more than two-thirds of cancer deaths globally. By 2030, cancer will be the primary cause of deaths in low-and middle-income countries. 1 Many academic institutions in the United States have played a key role in fostering international collaborations and partnerships to tackle the burden of cancer in low-and middle-income countries leading to the emergence of "global oncologists." These faculty, fellows, and residents specialize in outreach, clinical care, education, and research within the realm of global oncology.While the barriers to an academic career in global oncology have been well-documented, 2 little has been published on establishing a successful career pathway with defined metrics for promotion. An informal investigation among institutions with global oncology programs (Duke University, Harvard University, the University of Pennsylvania, and the University of North Carolina) suggests a lack of standard promotion policies for global oncologists.Despite the fact that global oncologists may derive health care insights and innovations that benefit both international and domestic sites, this added value is rarely assessed or formally rewarded. Similarly, the international opportunities for trainees and colleagues derived from global work while bolstering the international reputation of an institution is rarely qualified as a personal career achievement. Finally, despite the fact that global oncology programs may also help to attract and retain a diverse workforce, no formalized metrics recognize this implication.Because of the new and peculiar nature of this type of career in oncology, we believe there is a pressing need to formalize the criteria for academic progress and promotion. Without a clear means for promotion, budding global oncologists are stalled at instructor and/or assistant professor levels, and potentially decide to abandon worthwhile endeavors.A few publications addressing promotion pathways in global surgery, 3 emergency medicine, 4 and radiation oncology 5 concur that metrics for promotion should include traditional measures such as scholarship, education and mentorship, and procurement of grant support. Within global oncology, novel methods of education, for instance, via international web conferences, should also be acknowledged and rewarded as grants or publications. In addition, evidence of infrastructure development at the international site 5 and

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An academic career in global surgery: a position paper from the Society of University Surgeons Committee on Academic Global Surgery

Cited by 32 publications

References 35 publications

Ethical considerations in global surgery: a scoping review

Ethical considerations in global surgery: a scoping review

Interest and participation in global neurosurgery: a survey of Canadian neurosurgery residents

Shaping the Path for a Global Oncology Academic Career

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