Objective: We surveyed Orthopaedic Surgery Residency (OSR) programs to determine international opportunities by the academic institutional region within the United States, location of the international experience, duration, residency program year (PGY), funding source, and resident participation to date. Design: We emailed a survey to all OSR programs in the United States to inquire about global opportunities in their residency programs. Further contact was made through an additional e-mail and up to three telephone calls. Data were analyzed using descriptive and chi-square statistics. This study was institutional review board exempt. Setting: This research study was conducted at the University of Nebraska Medical Center, a tertiary care facility in conjunction with the University of Nebraska Medical Center College of Medicine. Participants: The participants of this research study included program directors and coordinators of all OSR programs (185) across the United States. Results: A total of 102 OSR programs completed the survey (55% response rate). Notably, 50% of the responding programs offered a global health opportunity to their residents. Of the institutions that responded, those in the Midwest or South were more likely to offer the opportunity than institutions found in other US regions, although regional differences were not significant. Global experiences were most commonly: in Central or South America (41%); 1 to 2 weeks in duration (54%); and during PGY4 or PGY5 (71%). Furthermore, half of the programs provided full funding for the residents to participate in the global experience. In 33% of the programs, 10 or more residents had participated to date. Conclusions: Interest in global health among medical students is increasing. OSR programs have followed this trend, increasing their global health opportunities by 92% since 2015. Communicating the availability of and support for international opportunities to future residents may help interested students make informed decisions when applying to residency programs.

Objective: This study is conducted to investigate characteristics of patients with xanthogranulomatous pyelonephritis (XGP) who undergo nephrectomy and to identify ways to optimise outcomes for these patients. Materials and methods: 1587 patients were queried from our institutional electronic medical records. 12 patients who underwent nephrectomy with preoperative diagnoses of XGP in the operative note were identified. Associations were analysed with Kendall’s τb. p < 0.05 was statistically significant. Results: All patients were hemodynamically stable on day of surgery. Two patients died on postoperative days 1 and 3 from septic shock. Both had surgery during inpatient admission rather than electively, received relatively short duration of preoperative antibiotics (8 and 10 days), and both were on hemodialysis preoperatively. There was possible association between decreased glomerular filtration rate (τb = −0.550, p = 0.032) and death postoperatively. Among patients who lived, there was no significant association between duration of antibiotic therapy after intervention and duration of postoperative hospitalisation. Conclusion: These findings could suggest a possible association between declining renal function and mortality in our case series; and performing nephrectomy electively after a longer course of antibiotics may be associated with improved outcomes compared to nephrectomy performed during hospitalisation with a shorter course of antibiotics. Level of evidence: Level 4