title: Building a global surgery initiative through evaluation, collaboration, and training: the Massachusetts General Hospital experience.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Massachusetts General Hospital, Boston, MA, USA and Mbarara Regional Referral Hospital, Mbarara, Uganda
  
  
  METHODS
  Members of the MGH and MRRH Departments of Surgery including faculty, fellows, and residents
  
  
  RESULTS
  The MGH GSI steering committee identified 4 steps for sustaining a robust global surgery program: (1) administer a survey to the MGH departmental faculty, fellows, and residents to gauge levels of experience and interest, (2) catalog all ongoing global surgical efforts and projects involving MGH surgical faculty, fellows, and residents to identify areas of overlap and opportunities for collaboration, (3) establish a longitudinal partnership with an academic surgical department in a limited-resource setting (Mbarara University of Science and Technology (MUST) at Mbarara Regional Referral Hospital (MRRH)), and (4) design a formal curriculum in global surgery to provide interested surgical residents with structured opportunities for research, education, and clinical work.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: tchao@mgh.harvard.edu.
authors.forename: Tiffany E
authors.initials: TE
authors.lastname: Chao
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Johanna N
authors.initials: JN
authors.lastname: Riesel
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Anderson
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: John T
authors.initials: JT
authors.lastname: Mullen
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Doyle
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Briggs
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lillemoe
authors.affiliation: Kartis, Inc., Cambridge, Massachusetts.
authors.forename: Chris
authors.initials: C
authors.lastname: Goldstein
authors.affiliation: Mbarara University of Science and Technology, Mbarara, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Kitya
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: James C
authors.initials: JC
authors.lastname: Cusack
mesh_terms: D003479:Curriculum; D013502:General Surgery / Q000193:education*; D014943:Global Health / Q000193:education*; D007391:International Cooperation; D007396:Internship and Residency; D008404:Massachusetts; D011795:Surveys and Questionnaires; D014454:Uganda
keywords: LMIC partnership; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; academic global surgery; cross-country collaboration; global surgery; mapping; surgical education