Global surgery opportunities for U.S. surgical residents: an interim report.
BACKGROUND
In 2011, the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Surgery developed guidelines that allowed time spent and cases performed outside of the United States by surgical residents from ACGME-accredited training programs to be applied toward program completion. We hypothesized that the number of programs with global surgical rotations would have increased after that important development. We also sought to determine the characteristics that led to sustainment of such programs.


METHODS
An Institutional Review Board-approved electronic survey was sent to all 253 program directors of ACGME-approved general surgery residencies requesting information on international rotations available to residents. Responses were requested from program directors with extant rotations. Survey questions focused on locations, funding, nature of the rotations, faculty involvement, keys to success, and the barriers to overcome during program development and sustainment.


RESULTS
The survey reported 34 surgery residency programs offering global surgery rotations, up from 23 just 5 years previously. Of these reporting programs, 25 have been approved by the ACGME. Most rotations occur in the postgraduate year 3 or 4 and are primarily clinical rotations. Africa is the main destination. Resident supervision is provided by a mixture of host and home surgeons. A dedicated faculty is considered to be the most important element for success while funding remains a major impediment.


CONCLUSIONS
The interest in global surgery continues to increase, and general surgical programs will strive to meet the expectations of residents looking for international exposure. Collaboration could facilitate resident opportunities and potentially be more cost-effective.
Department of Surgery, University of California, San Francisco General Hospital and Trauma Center, San Francisco, California.
M Margaret
MM
Knudson
Department of Surgery, Vanderbilt University, Nashville, Tennessee. Electronic address: margaret.tarpley@vanderbilt.edu.
Margaret J
MJ
Tarpley
Department of Surgery Emerita, SUNY Upstate Medical University, Syracuse, New York.
Patricia J
PJ
Numann
D001291:Attitude of Health Personnel; D013502:General Surgery / Q000193:education*; D014943:Global Health / Q000193:education* / Q000639:trends; D007393:International Educational Exchange / Q000639:trends; D007396:Internship and Residency; D014481:United States
Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; global surgery; graduate medical education; international medical education; international surgical rotations; surgery education; surgery electives