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Incorporation of a Global Surgery Rotation into an Academic General Surgery Residency Program: Impact and Perceptions

Abstract

Introduction

Global surgery is increasingly recognized as a vital component of international public health. Access to basic surgical care is limited in much of the world, resulting in a global burden of treatable disease. To address the lack of surgical workforce in underserved environments and to foster ongoing interest in global health among US-trained surgeons, our institution established a residency rotation through partnership with an academic hospital in Kijabe, Kenya. This study evaluates the perceptions of residents involved in the rotation, as well as its impact on their future involvement in global health.

Materials and methods

A retrospective review of admission applications from residents matriculating at our institution was conducted to determine stated interest in global surgery. These were compared to post-rotation evaluations and follow-up surveys to assess interest in global surgery and the effects of the rotation on the practices of the participants.

Results

A total of 78 residents matriculated from 2006 to 2016. Seventeen participated in the rotation with 76% of these reporting high satisfaction with the rotation. Sixty-five percent had no prior experience providing health care in an international setting. Post-rotation surveys revealed an increase in global surgery interest among participants. Long-term interest was demonstrated in 33% (n = 6) who reported ongoing activity in global health in their current practices. Participation in global rotations was also associated with increased interest in domestically underserved populations and affected economic and cost decisions within graduates’ practices.

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Acknowledgements

Study data were collected and managed using REDCap electronic data capture tools hosted at Vanderbilt University Medical Center. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for importing data from external sources.

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Corresponding author

Correspondence to Michael Thomas LeCompte.

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Conflicts of interest

The authors have no conflicts of interest to disclose in the conduct, data collection or publication of this study.

Appendices

Appendix 1

  • Note: participation in this survey is voluntary, and all responses are anonymous.

Kijabe rotation survey

  1. 1.

    In what year did you begin residency at Vanderbilt?

  2. 2.

    In what year did you travel to Kenya?

  3. 3.

    What is your gender?

  4. 4.

    What percentage of your practice is currently focused on global surgery? (scale 0–100%)

  5. 5.

    What is your practice setting? (private practice, academic practice, hybrid private/academic practice)

  6. 6.

    Do you travel outside of the continental United States for purposes of participating in clinical surgery, research, or education?

  7. 7.

    If you travel outside of the continental United States for surgical practice, is it predominantly to perform surgery, conduct research, engage in education, or other?

  8. 8.

    If you travel outside of the continental United States for surgical practice, to which regions to you travel? (Central/South America, Pacific Islands, Canada, Asia, Western Europe, Eastern Europe, Middle East, North Africa, Sub-Saharan Africa, South Africa)

  9. 9.

    Are you fluent in a language other than English?

  10. 10.

    If yes, which one?__________________

  11. 11.

    What percentage of your practice is focused on underserved groups within the continental United States? (scale 0–100%)

  12. 12.

    What was your interest in global surgery prior to coming to Vanderbilt? (scale 0–100, with 100 = very high, 0 = very low)

  13. 13.

    What was your interest in global surgery after rotating in Kijabe? ? (scale 0–100, with 100 = very high, 0 = very low)

  14. 14.

    To what extent to you agree with the following statement: I came to Vanderbilt because of the global surgery focus/opportunities (scale 0–100, with 100 = strongly agree, 0 = strongly disagree)

  15. 15.

    To what extent to you agree with the following statement: My experience in Kijabe strengthened my interest in global surgery (scale 0–100, with 100 = strongly agree, 0 = strongly disagree)

  16. 16.

    To what extent to you agree with the following statement: If I had not rotated in Kijabe, Kenya, my interest in global surgery would be low (scale 0–100, with 100 = strongly agree, 0 = strongly disagree)

  17. 17.

    To what extent to you agree with the following statement: My experience in Kenya has made me more cost-conscious in my daily practice. (scale 0–100, with 100 = strongly agree, 0 = strongly disagree)

Appendix 2

Kijabe alumni survey

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LeCompte, M.T., Goldman, C., Tarpley, J.L. et al. Incorporation of a Global Surgery Rotation into an Academic General Surgery Residency Program: Impact and Perceptions. World J Surg 42, 2715–2724 (2018). https://doi.org/10.1007/s00268-018-4562-5

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  • DOI: https://doi.org/10.1007/s00268-018-4562-5