title: Partnership in fellowship: Comparative analysis of pediatric surgical training and evaluation of a fellow exchange between Canada and Kenya.
abstract: BACKGROUND
  In pediatric surgery, significant differences in education and practice exist between developed and developing nations. We compared the training of senior fellows in a Canadian and a Kenyan pediatric surgery training program, and evaluated a fellow exchange between the programs.
  
  
  METHODS
  The study was performed six years after creation of the exchange program. Areas studied included case volume and distribution, length of training, curriculum, work hours, and an estimate of service to education ratio. Perceived strengths and challenges of the exchange were investigated using questionnaires.
  
  
  RESULTS
  Fellows at each site performed approximately 450 cases/year. Significant differences in case distribution were noted, with plastic surgery, urology and neurosurgery procedures being significantly more frequent in the Kenyan center, and neonatal, minimally invasive, and vascular access procedures being significantly more frequent in the Canadian center. All participants identified educational value in the exchange, although logistical challenges were significant.
  
  
  CONCLUSIONS
  Differences exist in the training experiences of pediatric surgical fellows in Canada and Kenya, reflecting the differences in health care environment, education, and surgical practice in the two countries. The exchange program of pediatric surgical fellows tapped into this rich diversity and may be applicable to other medical and surgical specialty training programs.
authors.affiliation: Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Baird
authors.affiliation: Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; BethanyKids, Africa.
authors.forename: Dan
authors.initials: D
authors.lastname: Poenaru
authors.affiliation: Tenwek Hospital, Bomet, Kenya.
authors.forename: Michael
authors.initials: M
authors.lastname: Ganey
authors.affiliation: AIC Kijabe Hospital, Kijabe, Kenya; Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Erik
authors.initials: E
authors.lastname: Hansen
authors.affiliation: Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: Sherif.Emil@McGill.ca.
authors.forename: Sherif
authors.initials: S
authors.lastname: Emil
mesh_terms: D000328:Adult; D002170:Canada; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D007391:International Cooperation; D007396:Internship and Residency / Q000458:organization & administration*; D007630:Kenya; D010372:Pediatrics / Q000193:education*; D019651:Plastic Surgery Procedures / Q000193:education*; D011795:Surveys and Questionnaires
keywords: Exchange; Fellowship; Global; Partnerships; Pediatric surgery