title: Benefits of surgical experience in a third-world country during residency.
abstract: OBJECTIVE
  Completion of a United States surgical residency enables the graduate to provide service in most populated areas. Graduates are technically well trained and efficient in performing most surgeries. United States-based teaching facilities are generally furnished with technically advanced supplies and equipment. Access to financial reserve is also available. Surgery in third-world countries, however, can be challenging. These countries, particularly in the outskirts, lack supplies and innovation, such as advanced equipment, medication, and personnel. Compounding the problem, patients tend to have advanced pathology and diminished financial means.
  
  
  METHODS
  The United States-based surgical team annually collaborated with a medical mission to provide service to a rural community of the Dominican Republic. A senior-level surgery resident accompanied the surgeon. Surgical supplies were donated and brought with the team. The average number of cases performed was approximately 37 per week. All procedures were performed for symptomatic pathology. All patients were preoperatively screened and evaluated for comorbidities.
  
  
  RESULTS
  No immediate complications occurred. Local physicians provide long-term follow-up. Pediatric procedures were not performed secondary to lack of postoperative resources.
  
  
  CONCLUSIONS
  Surgical experience is beneficial to the recipient community and the resident surgeon. The extent of pathology and lack of resources enforces efficiency and broadens skills. This opportunity can potentially prepare surgeons for the growing need of rural surgery.
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
authors.forename: Shun C
authors.initials: SC
authors.lastname: Young
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Mittal