Barriers to participation in global surgery academic collaborations, and possible solutions: a qualitative study

Fallah, Parisa; Bernstein, Mark

doi:10.3171/2017.10.jns17435

Cited by 28 publications

(22 citation statements)

References 32 publications

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“…Respondents felt that involvement would be significantly easier had they been exposed to global surgery during their training. 9 They recognized that current structural limitations exist on how training programs are incentivized to involve residents in these programs, despite their immense value.…”

Section: Barriersmentioning

confidence: 99%

“…Anecdotal experience has suggested that there is growing interest in this field, but many younger neurosurgeons report difficulty engaging in this activity. 9 Therefore, a key step in developing an international educational infrastructure is to understand the current resident opinions and interest in global neurosurgery as well as the current state of international involvement, opportunities, and barriers in US residency training.…”

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confidence: 99%

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Current US neurosurgical resident involvement, interest, and barriers in global neurosurgery

Lundy¹,

Miller²,

Woodrow³

2020

Neurosurgical Focus

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OBJECTIVEIt is estimated that nearly 47 million preventable deaths occur annually due the current worldwide deficit in surgical care; subsequently, the World Health Organization resolved unanimously to endorse a decree to address this deficit. Neurosurgeons from industrialized nations can help address the needs of underserved regions. Exposure during training is critical for young neurosurgeons to gain experience in international work and to cultivate career-long interest. Here, the authors explore the opinions of current residents and interest in global neurosurgery as well as the current state of international involvement, opportunities, and barriers in North American residency training.METHODSAn internet-based questionnaire was developed using the authors’ university’s REDCap database and distributed to neurosurgical residents from US ACGME (Accreditation Council for Graduate Medical Education)–approved programs. Questions focused on the resident’s program’s involvement and logistics regarding international rotations and the resident’s interest level in pursuing these opportunities.RESULTSA 15% response rate was obtained from a broad range of training locations. Twenty-nine percent of respondents reported that their residency program offered elective training opportunities in developing countries, and 7.6% reported having participated in these programs. This cohort unanimously felt that the international rotation was a beneficial experience and agreed that they would do it again. Of those who had not participated, 81.3% reported interest or strong interest in international rotations.CONCLUSIONSThe authors’ results indicate that, despite a high level of desire for involvement in international rotations, there is limited opportunity for residents to become involved. Barriers such as funding and rotation approval were recognized. It is the authors’ hope that governing organizations and residency programs will work to break down these barriers and help establish rotations for trainees to learn abroad and begin to join the cause of meeting global surgical needs. To meet overarching international neurosurgical needs, neurosurgeons of the future must be trained in global neurosurgery.

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Section: Barriersmentioning

confidence: 99%

mentioning

confidence: 99%

Current US neurosurgical resident involvement, interest, and barriers in global neurosurgery

Lundy¹,

Miller²,

Woodrow³

2020

Neurosurgical Focus

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“…These challenges may be classified as individual, community, and system barriers. 10 Individual barriers include questions such as loss of income, family commitments, skepticism about global surgery, lack of sufficient professional experience, and concerns for physical and emotional well-being. Community barriers include insufficient mentorship and lack of knowledge about global surgery and lack of support from colleagues.…”

Section: Difficulties and Limitations Of The Different Modelsmentioning

confidence: 99%

“…Finally, system challenges include major limitations such as minimal time available, poor academic recognition, and lack of funding. 10 Most of the individual limitations may be minimized by educating surgeons about global surgery and its impact, and developing programs according to different time availability. Systemic barriers require more profound changes, however, including the development of an academic track in global surgery, with time specifically available for those activities, and an increased number of grants for global surgery projects.…”

Section: Difficulties and Limitations Of The Different Modelsmentioning

confidence: 99%

Global neurosurgery: models for international surgical education and collaboration at one university

Almeida

Velásquez

Karekezi

et al. 2018

Neurosurgical Focus

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OBJECTIVEInternational collaborations between high-income (HICs) and low- and middle-income countries (LMICs) have been developed as an attempt to reduce the inequalities in surgical care around the world. In this paper the authors review different models for international surgical education and describe projects developed by the Division of Neurosurgery at the University of Toronto in this field.METHODSThe authors conducted a review of models of international surgical education reported in the literature in the last 15 years. Previous publications on global neurosurgery reported by the Division of Neurosurgery at the University of Toronto were reviewed to exemplify the applications and challenges of international surgical collaborations.RESULTSThe most common models for international surgical education and collaboration include international surgical missions, long-term international partnerships, fellowship training models, and online surgical education. Development of such collaborations involves different challenges, including limited time availability, scarce funding/resources, sociocultural barriers, ethical challenges, and lack of organizational support. Of note, evaluation of outcomes of international surgical projects remains limited, and the development and application of assessment tools, such as the recently proposed Framework for the Assessment of International Surgical Success (FAIRNeSS), is encouraged.CONCLUSIONSActions to reduce inequality in surgical care should be implemented around the world. Different models can be used for bilateral exchange of knowledge and improvement of surgical care delivery in regions where there is poor access to surgical care. Implementation of global neurosurgery initiatives faces multiple limitations that can be ameliorated if systematic changes occur, such as the development of academic positions in global surgery, careful selection of participant centers, governmental and nongovernmental financial support, and routine application of outcome evaluation for international surgical collaborations.

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“…Healthcare inequities persist around the globe, with critical need for the development of sustainable, long‐term solutions for ensuring high‐quality and self‐sufficient local service delivery, governance, finance, workforce and a durable infrastructure. Efforts involving Academic International Medicine (AIM) to address these needs have exposed important opportunities for improvement that academic institutions, administrative leadership and clinicians can use to prioritize the agenda for change. The value of AIM to academic organizations has been difficult to quantify.…”

Section: Introductionmentioning

confidence: 99%

Training and accrediting international surgeons

Stawicki

Nwomeh

Peck

et al. 2019

British Journal of Surgery

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Background Formal international medical programmes (IMPs) represent an evolution away from traditional medical volunteerism, and are based on the foundation of bidirectional exchange of knowledge, experience and organizational expertise. The intent is to develop multidirectional collaborations and local capacity that is resilient in the face of limited resources. Training and accreditation of surgeons continues to be a challenge to IMPs, including the need for mutual recognition of competencies and professional certification. Methods MEDLINE, Embase and Google Scholar™ were searched using the following terms, alone and in combination: ‘credentialing’, ‘education’, ‘global surgery’, ‘international medicine’, ‘international surgery’ and ‘training’. Secondary references cited by original sources were also included. The authors, all members of the American College of Academic International Medicine group, agreed advice on training and accreditation of international surgeons. Results and conclusion The following are key elements of training and accrediting international surgeons: basic framework built upon a bidirectional approach; consideration of both high‐income and low‐ and middle‐income country perspectives; sourcing funding from current sources based on existing IMPs and networks of IMPs; emphasis on predetermined cultural competencies and a common set of core surgical skills; a decentralized global system for verification and mutual recognition of medical training and certification. The global medical system of the future will require the assurance of high standards for surgical education, training and accreditation.

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Barriers to participation in global surgery academic collaborations, and possible solutions: a qualitative study

Cited by 28 publications

References 32 publications

Current US neurosurgical resident involvement, interest, and barriers in global neurosurgery

Current US neurosurgical resident involvement, interest, and barriers in global neurosurgery

Global neurosurgery: models for international surgical education and collaboration at one university

Training and accrediting international surgeons

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