Availability of global health opportunities in North American Paediatric Orthopaedic Fellowship Programmes

Siy, Alexander B.; Lins, Laura A B; Dahm, James; Shaw, James; Simske, Natasha M.; Noonan, Kate; Whiting, Paul S.

doi:10.1302/1863-2548.12.180153

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…Multiple studies have investigated trainee perceptions to Global Surgery and many cited absence of funding, minimal support from home institutions, and lack of established partner sites as obstacles to undertaking an international placement. 7,9 The results from this analysis showed that a higher proportion of the fellowships offered to LMIC trainees included funding as opposed to those solely for HIC trainees. This seems encouraging if fellowships are to be financially viable for all.…”

Section: Local Infrastructure 1 Advocacymentioning

confidence: 88%

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Global Surgery Fellowships—An Investigation of Opportunities, Outcomes, and Applicants

Davison

Singh

Jemec

2021

Journal of Hand and Microsurgery

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Following the Lancet Commission on Global Surgery in 2015, the Global Surgery Fellowships have risen in popularity, advertised as formalized opportunities for surgical trainees who have an interest in international surgical care. There is currently no up-to-date review of all fellowships available and an urgently needed overview of these opportunities is presented, including critical appraisal of their accessibility, funding, and outcomes. Detailed searches were conducted on the web engine Google, using the term “global surgery fellowship” and iterations. From the 547 resulting links, after applying exclusion criteria, 69 relevant fellowships were included in analysis. The majority of fellowships based in the United States (55%) and arranged by non-governmental organizations (NGOs) or universities (>70%). Also, 60% of fellowships had a duration of 1 year or longer. Only a quarter of the fellowships was open solely to trainees from low- or middle-income countries (LMIC), with over 80% of these being full funded. But 40% of the fellowships were advertised as open to trainees from any country, though only one-third of these provided full funding. Key themes across the fellowships’ outcomes included “Professional Development,” “Research,” and “LMIC Quality Improvement.” Almost all of the fellowships (95%) stated international travel opportunities. Twelve of the fellowships offered higher degrees, with the most common being a Masters of Public Health. The global distribution of fellowships and reduced funding opportunities for trainees from LMIC limit accessibility of the Global Surgery Fellowships. It is, however, still promising that most of key themes and high rates of international work are in line with The Lancet Commission’s recommendations. This overview of the Global Surgery Fellowships highlights the need for collaboration between institutions and has illustrated points for consideration when introducing new and the value of established fellowships.

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Section: Local Infrastructure 1 Advocacymentioning

confidence: 88%

“…There is currently also a discrepancy between the rising interest in global surgery in trainees with the availability of placements, indicating the need for more accessible and effective appointments. [7][8][9] Global Surgery Fellowships Davison et al…”

Section: Discussionmentioning

confidence: 99%

Global Surgery Fellowships—An Investigation of Opportunities, Outcomes, and Applicants

Davison

Singh

Jemec

2021

Journal of Hand and Microsurgery

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“…The person has to come on a slightly regular basis, maybe once a year" 45 . Strong models of longitudinal partnerships in the orthopaedic literature [46][47][48][49] are considerate of LMIC capacity, including adequate surgical volume and faculty supervision to support visiting residents, and to ensure that residents operate within their training level 46,47,50,51 . These models rely on ongoing interest and investment of both LMIC and HIC orthopaedic faculty, and designated LMIC and HIC program director responsible for ongoing management 46,47,50,51 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Observership Opportunities in North America for International Orthopaedic Surgeons

Carrillo

Segarra

Sabharwal

2020

Journal of Bone and Joint Surgery

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Introduction: Interest in clinical rotations in low-and middle-income countries (LMICs) has grown among high-income country (HIC) orthopaedic residents. This study addresses the following questions: (1) What motivates HIC surgical residents to rotate in LMICs? (2) What is the impact of rotations on HIC residents? (3) What are the LMIC partner perceptions of HIC collaboration? Materials and Methods: A search strategy of multiple databases returned 3,740 unique articles pertaining to HIC surgical resident motivations for participating in rotations in LMICs or the LMIC host perspective. Data extraction was dually performed using meta-ethnography, the qualitative equivalent of meta-analysis. Results: Twenty-one studies were included in the final analysis. HIC residents were primarily motivated to rotate in LMICs by altruistic intent, with greatest impact on professional development. LMIC partners mostly valued HIC sustained investment and educational opportunities for LMIC partners. From LMIC's perspective, potential harm from collaboration arose from system-level and individual-level discordance between HIC and LMIC expectations and priorities. HIC priorities included the following: (1) adequate operative time, (2) exposure to varied pathology, and (3) mentorship. LMIC priorities included the following: (1) avoiding competition with HIC residents for surgical cases, (2) that HIC groups not undermine LMIC internal authority, (3) that HIC initiatives address local LMIC needs, and (4) that LMIC partners be included as authors on HIC research initiatives. Both HIC and LMIC partners raised ethical concerns regarding collaboration and perceived HIC residents to be underprepared for their LMIC rotation. Discussion: This study synthesizes the available literature on HIC surgical resident motivations for and impact of rotating in LMICs and the LMIC host perception of collaboration. Three improvement categories emerged: that residents (1) receive site-specific preparation before departure, (2) remain in country long enough to develop site-specific skills, and (3) cultivate flexibility and cultural humility. Specific suggestions based on synthesized data are offered for each concept and can serve as a foundation for mutually beneficial international electives in LMICs for HIC orthopaedic trainees.

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Resident Rotations in Low- and Middle-Income Countries

et al. 2020

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Introduction: Interest in clinical rotations in low- and middle-income countries (LMICs) has grown among high-income country (HIC) orthopaedic residents. This study addresses the following questions: (1) What motivates HIC surgical residents to rotate in LMICs? (2) What is the impact of rotations on HIC residents? (3) What are the LMIC partner perceptions of HIC collaboration? Materials and Methods: A search strategy of multiple databases returned 3,740 unique articles pertaining to HIC surgical resident motivations for participating in rotations in LMICs or the LMIC host perspective. Data extraction was dually performed using meta-ethnography, the qualitative equivalent of meta-analysis. Results: Twenty-one studies were included in the final analysis. HIC residents were primarily motivated to rotate in LMICs by altruistic intent, with greatest impact on professional development. LMIC partners mostly valued HIC sustained investment and educational opportunities for LMIC partners. From LMIC's perspective, potential harm from collaboration arose from system-level and individual-level discordance between HIC and LMIC expectations and priorities. HIC priorities included the following: (1) adequate operative time, (2) exposure to varied pathology, and (3) mentorship. LMIC priorities included the following: (1) avoiding competition with HIC residents for surgical cases, (2) that HIC groups not undermine LMIC internal authority, (3) that HIC initiatives address local LMIC needs, and (4) that LMIC partners be included as authors on HIC research initiatives. Both HIC and LMIC partners raised ethical concerns regarding collaboration and perceived HIC residents to be underprepared for their LMIC rotation. Discussion: This study synthesizes the available literature on HIC surgical resident motivations for and impact of rotating in LMICs and the LMIC host perception of collaboration. Three improvement categories emerged: that residents (1) receive site-specific preparation before departure, (2) remain in country long enough to develop site-specific skills, and (3) cultivate flexibility and cultural humility . Specific suggestions based on synthesized data are offered for each concept and can serve as a foundation for mutually beneficial international electives in LMICs for HIC orthopaedic trainees.

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Availability of global health opportunities in North American Paediatric Orthopaedic Fellowship Programmes

Cited by 3 publications

References 16 publications

Global Surgery Fellowships—An Investigation of Opportunities, Outcomes, and Applicants

Global Surgery Fellowships—An Investigation of Opportunities, Outcomes, and Applicants

Clinical Observership Opportunities in North America for International Orthopaedic Surgeons

Resident Rotations in Low- and Middle-Income Countries

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