title: Global surgical electives in residency: The impact on training and future practice.
abstract: BACKGROUND
  The purpose of this study was to evaluate perceptions regarding the value of global surgical electives (GSEs) and pursuit of a career in global surgery amongst residents and surgeons.
  
  
  METHODS
  We sent an anonymous questionnaire to all current and former surgical residents of our tertiary-care, university-based institution from the years 2000-2013. Questions addressed the experience and value of practicing surgery in low or middle income countries (LMIC) in residency and as a career.
  
  
  RESULTS
  Twenty-three (40%) graduates (G) and 36 (84%) surgical residents (R) completed the survey. Thirteen residents (36%) and 13 (52%) graduates had delivered surgical care in a LMIC. Respondents stated that their experience positively impacted patient care (G = 80% vs R = 75%) and learning (G = 75% vs R = 90%). Of the 4 graduates still working in a LMIC, the majority (75%) were providing less than 2 months of care. Logistical reasons and family obligations were the most common barriers (n = 13).
  
  
  CONCLUSIONS
  Few graduates are able to incorporate global surgery into their practice despite interest. For enduring participation, logistical and family support is needed.
authors.affiliation: Temple University Hospital, Philadelphia, PA, USA. Electronic address: melike.harfouche@tuhs.temple.edu.
authors.forename: Melike
authors.initials: M
authors.lastname: Harfouche
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA. Electronic address: leandra.krowsoski@gmail.com.
authors.forename: Leandra
authors.initials: L
authors.lastname: Krowsoski
authors.affiliation: Temple University Hospital, Philadelphia, PA, USA. Electronic address: amy.goldberg@tuhs.temple.edu.
authors.forename: Amy
authors.initials: A
authors.lastname: Goldberg
authors.affiliation: Temple University Hospital, Philadelphia, PA, USA. Electronic address: zoe.maher@tuhs.temple.edu.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Maher
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D003906:Developing Countries; D005260:Female; D013502:General Surgery / Q000193:education*; D014943:Global Health / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D008493:Medical Missions / Q000706:statistics & numerical data; D008875:Middle Aged; D010465:Perception; D015143:Philadelphia; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D066231:Surgeons / Q000193:education / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Career; Competency; Global surgery; Surgical education; Sustainability