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Hock L, Zahl M, Woolley PM, Dejean CB, Pean CA, Israelski R. Haitian State Hospital Orthopedic Grand Rounds Series: A Virtual Curriculum to Address Global Surgery Needs. Ann Glob Health 2023; 89:86. [PMID: 38077263 PMCID: PMC10705029 DOI: 10.5334/aogh.4304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023] Open
Abstract
Background Orthopedic Relief Services International (ORSI), in partnership with the Foundation for Orthopedic Trauma and the department of Orthopedic Surgery of La Paix University Hospital in Haiti, has developed a year-round Orthopedic Grand Round series. This series is moderated by Haitian faculty, features presentations by American orthopedic surgeons, and is broadcast to major state hospitals in Haiti for residents and attendings. Objective To introduce clinical concepts and increase knowledge in an area that is medically underserved, especially in the field of orthopedics, through lectures that tailor to the educational needs of Haiti. Methods Topics for lecture series are requested by Haitian attending orthopedic surgeons and residents in collaboration with American orthopedic surgeons to meet the educational needs of the residents in Haiti. These lectures reflect the case mix typically seen at state hospitals in Haiti and consider the infrastructural capacity of participating centers. Grand rounds are held an average of twice per month for an hour each, encompassing an educational lesson followed by an open forum for questions and case discussion. Feedback is taken from Haitian residents to ensure the sessions are beneficial to their learning. Findings and Conclusions To date 95 sessions hosted by 32 lecturers have been completed over Zoom between the US and Haiti. The fourth year of the lecture series is currently ongoing with an expansion of topics. In an underserved medical area such as Haiti, programs that educate local surgeons are crucial to continuing the growth and development of the medical community. Programs like this have the potential to contribute to the educational infrastructure of countries in need, regardless of the specialty. The model of this program can be used to produce similar curricula in various specialties and areas around the world.
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Affiliation(s)
- Lindsay Hock
- Touro College of Osteopathic Medicine, Middletown, NY, United States
| | - Melissa Zahl
- Touro College of Osteopathic Medicine, Middletown, NY, United States
| | - Pierre-Marie Woolley
- Department of Orthopaedics, HUP La Paix State University Hospital, Port-au-Prince, Haiti
| | - Christina Barau Dejean
- Department of Orthopaedics, HUP La Paix State University Hospital, Port-au-Prince, Haiti
| | - Christian A. Pean
- Department of Orthopaedic Trauma Surgery, Duke University School of Medicine, Durham, NC, United States
| | - Ronald Israelski
- Orthopedic Relief Services International (ORSI), United States
- Department of Orthopaedic Surgery, Touro College of Osteopathic Medicine, Middletown, NY, United States
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Worden CP, Stephenson ED, Senior BA. Optimizing international otolaryngology service trips: Perceptions from learners versus volunteers. Laryngoscope 2019; 130:E305-E310. [DOI: 10.1002/lary.28218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/28/2019] [Accepted: 07/16/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Cameron P. Worden
- Department of Otolaryngology–Head and Neck SurgeryUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
| | - Elizabeth D. Stephenson
- Department of Otolaryngology–Head and Neck SurgeryUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
| | - Brent A. Senior
- Department of Otolaryngology–Head and Neck SurgeryUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
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Dupret-Bories A, Jean-Gilles P, Malebranche R, Charpiot A, Hémar P, Gentine A, Boidevezi D, Rohmer D, Debry C, Cadet JC, Bodin F, Bailly P. A 19-Year Record of Training Haitian Residents in Otorhinolaryngology and Cervicofacial Surgery. JOURNAL OF SURGICAL EDUCATION 2015; 72:1068-1076. [PMID: 26111821 DOI: 10.1016/j.jsurg.2015.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/12/2015] [Accepted: 05/16/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Since 1996, 1 to 4 annual training missions have been carried out to train Haitian otorhinolaryngology (ENT) and cervicofacial surgery residents by the association Liens Otorhinolaryngology Ayti (LOA). Until 1996, ENT was practiced and taught by ophthalmologists. The aim of this article is to describe the contributions and limitations of LOA in training of Haitian resident physicians and the creation of the ENT specialty in Haiti. DESIGN Retrospective analysis of clinical consultation and surgical interventions records and didactics carried out during missions from 1996 through 2014. PARTICIPANTS A total of 37 missions were made during the 19-year period in which 29 senior ENT specialists participated, with an average of 3.37 missions per physician. RESULTS A total of 10,300 consultations and 173 surgical procedures were made jointly by a senior LOA physician and a Haitian resident physician. Totally 16 Haitian ENT residents were trained, 81% of whom are still practicing in Haiti. ENT became a surgical specialty in 2001 after the nomination of a Haitian ENT specialist as Assistant Director of the ENT-Ophthalmology service. The latter benefitted from dual training by LOA in Haiti and abroad. CONCLUSION The Haitian population experiences significant difficulties with access to medical care owing to very low number of resident medical personnel. LOA's work has contributed over 19 years to the training of ENT physicians now practicing in Haiti and to the creation of a local ENT specialty.
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Affiliation(s)
- Agnès Dupret-Bories
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale. Hôpital Universitaire de Hautepierre, Strasbourg, France; Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale, Institut Universitaire du Cancer, Toulouse, France.
| | - Patrick Jean-Gilles
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale et d'Ophtalmologie, Hôpital de l'Université d'Etat d'Haïti, Port-au-Prince, Haïti
| | - Rodolphe Malebranche
- Service de Médecine Interne, Hôpital de l'Université d'Etat d'Haïti, Port-au-Prince, Haïti
| | - Anne Charpiot
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale. Hôpital Universitaire de Hautepierre, Strasbourg, France
| | - Patrick Hémar
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale. Hôpital Universitaire de Hautepierre, Strasbourg, France
| | - André Gentine
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale. Hôpital Universitaire de Hautepierre, Strasbourg, France
| | - Dominique Boidevezi
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale, Centre hospitalier de Mulhouse, Mulhouse, France
| | - Dominique Rohmer
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale. Hôpital Universitaire de Hautepierre, Strasbourg, France
| | - Christian Debry
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale. Hôpital Universitaire de Hautepierre, Strasbourg, France
| | - Jean-Claude Cadet
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale et d'Ophtalmologie, Hôpital de l'Université d'Etat d'Haïti, Port-au-Prince, Haïti
| | - Fréderic Bodin
- Service de chirurgie Plastique, Hôpital Universitaire Civil, Strasbourg, France
| | - Pierre Bailly
- Service d'Otorhinolaryngologie et Chirurgie Cervico-faciale, Centre hospitalier de Mulhouse, Mulhouse, France
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Swain JD, Matousek AC, Scott JW, Cooper Z, Smink DS, Bolman RM, Finlayson SRG, Zinner MJ, Riviello R. Training surgical residents for a career in academic global surgery: a novel training model. JOURNAL OF SURGICAL EDUCATION 2015; 72:e104-e110. [PMID: 25911458 DOI: 10.1016/j.jsurg.2015.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/23/2014] [Accepted: 01/16/2015] [Indexed: 06/04/2023]
Abstract
Academic global surgery is a nascent field focused on improving surgical care in resource-poor settings through a broad-based scholarship agenda. Although there is increasing momentum to expand training opportunities in low-resource settings among academic surgical programs, most focus solely on establishing short-term elective rotations rather than fostering research or career development. Given the complex nature of surgical care delivery and programmatic capacity building in the resource-poor settings, many challenges remain before global surgery is accepted as an academic discipline and an established career path. Brigham and Women's Hospital has established a specialized global surgery track within the general surgery residency program to develop academic leaders in this growing area of need and opportunity. Here we describe our experience with the design and development of the program followed by practical applications and lessons learned from our early experiences.
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Affiliation(s)
- JaBaris D Swain
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexi C Matousek
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - John W Scott
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Zara Cooper
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Trauma, Burns and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Douglas S Smink
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ralph Morton Bolman
- Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Michael J Zinner
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Robert Riviello
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Trauma, Burns and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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Abstract
Surgical mission work serves an important role in the education of plastic surgeons. Here, we examine the ways that participation in surgical mission work enhances resident education from the trainee's perspective.
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Kolkman P, Soliman M, Kolkman M, Stack A, Rao TS, Mukta S, Schmid K, Thompson J, Are C. Comparison of resident operative case logs during a surgical oncology rotation in the United States and an international rotation in India. Indian J Surg Oncol 2015; 6:36-40. [PMID: 25937762 DOI: 10.1007/s13193-015-0389-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 02/24/2015] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Paul Kolkman
- Division of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE USA
| | - Mohsin Soliman
- Division of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE USA
| | - Marcy Kolkman
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE USA
| | - Apollo Stack
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE USA
| | - T Subramanyeshwar Rao
- MNJ Institute of Oncology & Regional Cancer Center, Hyderabad, 500004 Andhra Pradesh India
| | - Srinivasulu Mukta
- MNJ Institute of Oncology & Regional Cancer Center, Hyderabad, 500004 Andhra Pradesh India
| | - Kendra Schmid
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, 984375 Nebraska Medical Center, Omaha, NE USA
| | - Jon Thompson
- Division of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE USA
| | - Chandrakanth Are
- Division of General Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE USA
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Shrime MG, Sleemi A, Ravilla TD. Charitable platforms in global surgery: a systematic review of their effectiveness, cost-effectiveness, sustainability, and role training. World J Surg 2015; 39:10-20. [PMID: 24682278 PMCID: PMC4179995 DOI: 10.1007/s00268-014-2516-0] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE This study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed. METHODS A systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included. RESULTS Surgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited. CONCLUSIONS Because the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.
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Affiliation(s)
- Mark G Shrime
- Harvard Interfaculty Initiative in Health Policy, 14 Story Street, 4th Floor, Cambridge, MA, 02138, USA,
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Vu MT, Johnson TR, Francois R, Simms-Cendan J. Sustained impact of short-term international medical mission trips: resident perspectives. MEDICAL TEACHER 2014; 36:1057-1063. [PMID: 25072942 DOI: 10.3109/0142159x.2014.920491] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To assess perspectives of residents: (1) who participated in short-term international medical mission trips (STIMMTs) as medical students regarding impact of the experiences on their professional development; and (2) who did not participate in STIMMTs regarding barriers to participation. METHODS Three hundred seventy-nine residents from 16 programs at two Florida institutions completed surveys requesting Participant and Trip Details and Impact of Participation (including items rating learning, cultural competency, and social responsibility). RESULTS One hundred thirty-one residents participated in at least one STIMMT. They identified improved adaptability to new healthcare settings, communication with patients and professionals from different backgrounds, and appreciation for the impact of culture on health as positive outcomes. Leading barriers to STIMMT participation included cost, timing, and lack of availability. CONCLUSIONS Years after participation in STIMMTs, residents perceived sustained benefits in cultural competency, communication skills, adaptability, and desire for service. Institutions may consider facilitating STIMMTs as one way to address standards specified by accrediting authorities to provide training in cultural competency, social responsibility, altruism, and understanding the importance of caring for underserved populations. Barriers to STIMMT participation may be reduced through availability of institution-sponsored scholarships, identification of external grant and scholarship opportunities, and coordination of fund-raising activities.
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Affiliation(s)
- Megan T Vu
- University of Central Florida College of Medicine , USA
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Abstract
Short-term medical service trips (MSTs) aim to address unmet health care needs of low- and middle-income countries. The lack of critically reviewed empirical evidence of activities and outcomes is a concern. Developing evidence-based recommendations for health care delivery requires systematic research review. I focused on MST publications with empirical results. Searches in May 2013 identified 67 studies published since 1993, only 6% of the published articles on the topic in the past 20 years. Nearly 80% reported on surgical trips. Although the MST field is growing, its medical literature lags behind, with nearly all of the scholarly publications lacking significant data collection. By incorporating data collection into service trips, groups can validate practices and provide information about areas needing improvement.
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Affiliation(s)
- Kevin J Sykes
- Kevin J. Sykes is with the Department of Health Policy and Management in the School of Medicine at the University of Kansas Medical Center, Kansas City
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Leeds IL, Hugar LA, Pettitt BJ, Srinivasan J, Master VA. International surgical clerkship rotation: perceptions and academic performance. Am J Surg 2013; 206:280-6. [PMID: 23481029 DOI: 10.1016/j.amjsurg.2012.10.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 08/30/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Concerns about international training experiences in medical school curricula include the effect on student learning. We studied the educational effect of an international elective integrated into a traditional third-year (M3) surgical clerkship. METHODS A 1-week surgical elective in Haiti was available to M3 students during the conventional 8-week surgical clerkship each year for the 4 academic years 2008 to 2011. The authors collected student and surgeon perceptions of the elective using a mixed-methods web-based survey. Statistical analysis compared the academic performance of participating M3s relative to nonparticipating peers. RESULTS Twenty-eight (100%) students (41 trip weeks) and 3 (75%) surgeons responded. Twenty-five (89%) students believed the elective provided appropriate clinical training. Surgeon responses were consistent with students' reported perceptions. Strengths included unique clinical experiences and close interactions with faculty. Criticisms included recurring overwhelming clinical responsibilities and lack of local provider involvement. Academic performance of participants versus nonparticipants in the same clerkship term were statistically insignificant. CONCLUSIONS This study demonstrates the feasibility of integrating global health experiences into traditional medical student clinical curricula. The effects on less tangible attributes such as leadership skills, fostering teamwork, and cultural competency require future investigation.
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Affiliation(s)
- Ira L Leeds
- Emory University School of Medicine, 1648 Pierce Dr NE, Atlanta, GA 30307, USA.
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Leow JJ, Groen RS, Kingham TP, Casey KM, Hardy MA, Kushner AL. A preparation guide for surgical resident and student rotations to underserved regions. Surgery 2012; 151:770-8. [PMID: 22652117 DOI: 10.1016/j.surg.2012.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
Abstract
Interest in global health among surgical residents and medical students is growing. There are numerous opportunities worldwide for both short- and long-term experiences. In order to maximize the learning potential, the authors present a practical guide for residents and students to prepare for a surgical visit, elective, rotation, or mission to an underserved region. The following steps will be outlined:
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