Ozgediz Doruk, Roayaie Kayvan, Debas Haile, Schecter William, Farmer Diana
Global Health Sciences, and Department of General Surgery, University of California-San Francisco, 513 Parnassus, San Francisco, CA 94143, USA.
Arch Surg. 2005 Aug;140(8):795-800. doi: 10.1001/archsurg.140.8.795.
A surgical elective in a developing country setting is an essential new component in academic residency training.
A survey of residents and faculty within the Department of Surgery at the University of California-San Francisco, and a collaborative program piloted between the Department of Surgery at the University of California-San Francisco and Makerere University in Kampala, Uganda, including a 6-week clinical elective.
Mulago and Nsambya hospitals in Kampala, Uganda.
Two residents and three faculty advisors at the University of California-San Francisco.
Development of a 6-week pilot clinical surgical elective.
Assessment of the level of interest in international health in an academic surgery program; pathology and case variety, diagnostic methods, and surgical and anesthetic resources and techniques in a pilot developing country.
Forty percent of residents enter residency with prior international health experience whereas 90% express interest in a developing country elective. Twenty-five percent of faculty participate in voluntary international surgical service and research projects. As a result of the survey and the level of interest in our program, two visits to Uganda were made and a residency elective rotation was successfully created. This resulted in exposure of residents to the educational benefits of learning in a resource-constrained setting: a broader scope of surgical conditions and pathology, greater reliance on history-taking and physical examination skills in a low-technology environment, and sociocultural aspects of care provision. Greater questions about global health equity, access to information, and the role of surgery in public health are raised along with potential challenges in international collaboration.
A developing country surgical experience complements the academic mission of service, training, and research, and should be an essential component of surgical training programs. There is interest among residents and faculty in such a program as well as a need for greater commitment to north-south collaborations among academic surgical institutions and societies, as has been successfully implemented abroad. More generally, surgery is an integral part of public health and health systems development worldwide.
在发展中国家进行外科选修课程是学术住院医师培训中必不可少的新组成部分。
对加州大学旧金山分校外科系的住院医师和教员进行调查，并在该校外科系与乌干达坎帕拉的马凯雷雷大学之间开展一个合作项目试点，其中包括为期6周的临床选修课程。
乌干达坎帕拉的穆拉戈医院和恩桑比亚医院。
加州大学旧金山分校的两名住院医师和三名教员顾问。
制定为期6周的试点临床外科选修课程。
评估学术外科项目中对国际卫生的兴趣程度；试点发展中国家的病理学和病例种类、诊断方法以及外科和麻醉资源与技术。
40%的住院医师在开始住院医师培训前有过国际卫生方面的经历，而90%表示对发展中国家的选修课程感兴趣。25%的教员参与了自愿性国际外科服务和研究项目。基于调查结果以及对我们项目的兴趣程度，安排了两次对乌干达的访问，并成功创建了一个住院医师选修轮转项目。这使住院医师有机会在资源有限的环境中学习，获得教育收益：接触到更广泛的外科病症和病理学知识，在低技术环境中更依赖病史采集和体格检查技能，以及了解护理工作中的社会文化方面。同时也引发了关于全球卫生公平、信息获取以及外科在公共卫生中的作用等更多问题，以及国际合作中潜在的挑战。
在发展中国家的外科经历补充了服务、培训和研究的学术使命，应成为外科培训项目的重要组成部分。住院医师和教员对这样一个项目感兴趣，并且需要学术外科机构和团体加大对南北合作的投入，就像在国外已成功实施的那样。更广泛地说，外科是全球公共卫生和卫生系统发展不可或缺的一部分。
