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Krishnaswami S, Stephens CQ, Yang GP, Nwomeh BC, Swaroop M, Nadler EP, Holterman AX, Simeone DM, Kingham TP, Merchant N, Orloff SL. An academic career in global surgery: a position paper from the Society of University Surgeons Committee on Academic Global Surgery. Surgery 2017; 163:954-960. [PMID: 29254606 DOI: 10.1016/j.surg.2017.10.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 10/02/2017] [Accepted: 10/14/2017] [Indexed: 02/07/2023]
Abstract
In recent years, as the high burden of surgical disease and poor access to surgical care in low- and middle-income countries have gained recognition as major public health problems, interest in global health has surged among surgical trainees and faculty. Traditionally, clinical volunteerism was at the forefront of the high-income country response to the significant burden of surgical disease in low- and middle-income countries. However, sustainable strategies for providing surgical care in low- and middle-income countries increasingly depend on bilateral clinical, research, and education collaborations to ensure effective resource allocation and contextual relevance. Academic global surgery creates avenues for interested surgeons to combine scholarship and education with their clinical global surgery passions through incorporation of basic/translational, education, clinical outcomes, or health services research with global surgery. Training in global health, either within residency or through advanced degrees, can provide the necessary skills to develop and sustain such initiatives. We further propose that creating cross-continental, bidirectional collaborations can maximize funding opportunities. Academic institutions are uniquely positioned to lead longitudinal and, importantly, sustainable global surgery efforts. However, for the individual global surgeon, the career path forward may be unclear. This paper reviews the development of academic global surgery, delineates the framework and factors critical to training global surgeons, and proposes models for establishing an academic career in this field. Overall, with determination, the academic global surgeon will not only carve out a niche of expertise but will define this critical field for future generations.
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Affiliation(s)
- Sanjay Krishnaswami
- Department of Surgery, Division of Pediatric Surgery, Oregon Health & Science University, Portland, OR, USA.
| | - Caroline Q Stephens
- Department of Surgery, Division of Pediatric Surgery, Oregon Health & Science University, Portland, OR, USA
| | - George P Yang
- Department of Surgery, Stanford University, Stanford, CA, USA; Palo Alto VA Health Care System, Palo Alto, CA, USA
| | - Benedict C Nwomeh
- Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - Mamta Swaroop
- Division of Trauma & Critical Care, Department of Surgery, Northwestern University, Chicago, IL, USA
| | - Evan P Nadler
- Department of Surgery, Division of Pediatric Surgery, Children's National Medical Center, Washington, DC, WA, USA
| | - Ai-Xuan Holterman
- Department of Surgery/Pediatric Surgery, Children's Hospital of Illinois, University of Illinois College of Medicine at Peoria, IL, USA
| | - Diane M Simeone
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - T Peter Kingham
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Nipun Merchant
- Department of Surgery, Division of Surgical Oncology, University of Miami, Miami, FL, USA
| | - Susan L Orloff
- Department of Surgery, Division of Abdominal Organ Transplantation/Hepatobiliary Surgery, Oregon Health & Science University, Portland, OR, USA
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Krishnaswami S, Nwomeh BC, Ameh EA. The pediatric surgery workforce in low- and middle-income countries: problems and priorities. Semin Pediatr Surg 2016; 25:32-42. [PMID: 26831136 DOI: 10.1053/j.sempedsurg.2015.09.007] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Most of the world is in a surgical workforce crisis. While a lack of human resources is only one component of the myriad issues affecting surgical care in resource-poor regions, it is arguably the most consequential. This article examines the current state of the pediatric surgical workforce in low- and middle-income countries (LMICs) and the reasons for the current shortfalls. We also note progress that has been made in capacity building and discuss priorities going forward. The existing literature on this subject has naturally focused on regions with the greatest workforce needs, particularly sub-Saharan Africa (SSA). However, wherever possible we have included workforce data and related literature from LMICs worldwide. The pediatric surgeon is of course critically dependent on multi-disciplinary teams. Surgeons in high-income countries (HICs) often take for granted the ready availability of excellent anesthesia providers, surgically trained nurses, radiologists, pathologists, and neonatologists among many others. While the need exists to examine all of these disciplines and their contribution to the delivery of surgical services for children in LMICs, for the purposes of this review, we will focus primarily on the role of the pediatric surgeon.
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Affiliation(s)
- Sanjay Krishnaswami
- Division of Pediatric Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Suite 300, Portland, Oregon 97239.
| | - Benedict C Nwomeh
- Division of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University School of Medicine. Columbus, Ohio
| | - Emmanuel A Ameh
- Division of Pediatric Surgery, National Hospital, Abuja, Nigeria
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