This study compared the operative case log experience between rotations during General Surgery residency in the United States and an international rotation in India. A resident from the General Surgery residency program at University of Nebraska Medical Center participated in an international rotation in Surgical Oncology at Mehdi Nawaz Jung Institute of Oncology in Hyderabad, India for 3 months in 2009. The operative case log of this resident (INT) was compared to those of another resident (US) on a rotation in surgical oncology at the parent institution during the same time period. Both institutions were tertiary care centers. We noted that the INT resident performed a greater number of cases (132) when compared to the US resident (61). The INT resident also performed cases in a wider variety of disease categories such as: head and neck (26 %), gynecology (19 %), breast (14 %) and urology (4 %). In contrast, abdominal cases accounted for 68 % of the cases performed by the US resident with fewer cases in the other categories. The INT resident performed 98 % of the cases by the open approach, whereas the US resident performed only 81 % of cases by the open approach, with the remaining 19 % of cases performed by the laparoscopic approach. The results demonstrate that the INT resident performed a greater number of operative cases when compared to a resident (US) at the parent institution, and performed cases in more diverse disease categories with an emphasis on the open operative approach.

The aim of this study was to compare the incidence of the different histopathologic types of esophageal carcinoma between the United States of American (US) and India. The Surveillance Epidemiology and End Result (SEER) database was analyzed to determine the incidence of different types of esophageal carcinoma in US. A retrospective review was conducted of all the patients that underwent resection for esophageal carcinoma at a regional oncology center in India from 2001 to 2007. Data relating to histopathologic variables was collected and compared to the patients in the SEER database for the same time period. Esophageal adenocarcinoma accounts for the majority of newly diagnosed cases in the US. Although squamous cell carcinoma is the dominant type of esophageal carcinoma in India, we noted a small but gradual increase (0 % in 2001 to 28 % in 2007) in the incidence of esophageal adenocarcinoma. The results of our study demonstrate a geographic variation in the histopathologic type of esophageal carcinoma. A recent increase in the incidence of esophageal adenocarcinoma in India was also demonstrated. Analysis of risk factors known to be associated with esophageal adenocarcinoma, in the context of India, can provide targets for implementing public health measures.

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