R.W. Davis is a seventh-year resident, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Y.A. Sherif is a fourth-year resident, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Acad Med. 2021 Mar 1;96(3):384-389. doi: 10.1097/ACM.0000000000003898.
The World Health Organization and the World Bank have identified improvement in access to surgical care as an urgent global health challenge and a cost-effective investment in public health. However, trainees in standard U.S. general surgery programs do not have adequate exposure to the procedures, technical skills, and foundational knowledge essential for providing surgical care in resource-limited settings.
The Michael E. DeBakey Department of Surgery at Baylor College of Medicine (BCM) created a 7-year global surgery track within its general surgery residency in 2014. Individualized rotations equip residents with the necessary skills, knowledge, and experience to operate in regions with low surgeon density and develop sustainable surgical infrastructures. BCM provides a formal, integrated global surgery curriculum-including 2 years dedicated to global surgery-with surgical specialty rotations in domestic and international settings. Residents tailor their individual experience to the needs of their future clinical practice, region of interest, and surgical specialty.
There have been 4 major outcomes of the BCM global surgery track: (1) increased exposure for trainees to a broad range of surgeries critical in resource-limited settings, (2) meaningful international partnerships, (3) contributions to global surgery scholarship, and (4) establishment of sustainable global surgery activities.
To better facilitate access to safe, timely, and affordable surgical care worldwide, global surgeons should pursue expertise in topics not currently included in U.S. general surgical curricula, such as setting-specific technical skills, capacity building, and organizational collaboration. Future evaluations of the BCM global surgery track will assess the effect of individualized education on trainees' professional identities, clinical practices, academic pursuits, global surgery leadership preparedness, and comfort with technical skills not encompassed in general surgery programs. Increasing availability of quality global surgery training programs would provide a critical next step toward contributing to the delivery of safe surgical care worldwide.
世界卫生组织和世界银行已将改善外科护理的可及性确定为一项紧迫的全球卫生挑战，也是公共卫生领域一项具有成本效益的投资。然而，美国标准普通外科培训项目的受训者并没有充分接触到在资源有限环境中提供外科护理所需的程序、技术技能和基础知识。
贝勒医学院（BCM）的迈克尔·E·德贝基外科系于 2014 年在其普通外科住院医师培训项目中创建了一个为期 7 年的全球外科轨道。个性化轮转为住院医师提供了必要的技能、知识和经验，以便在外科医生密度较低的地区开展手术，并建立可持续的外科基础设施。BCM 提供了正式的、综合的全球外科课程，包括 2 年专门用于全球外科，以及在国内和国际环境中的外科专业轮转。住院医师根据自己未来的临床实践、感兴趣的地区和外科专业需求，定制自己的个人经验。
BCM 全球外科轨道有 4 个主要成果：（1）增加了受训者接触资源有限环境中关键手术的机会；（2）建立了有意义的国际合作关系；（3）为全球外科学术做出了贡献；（4）建立了可持续的全球外科活动。
为了更好地促进全球范围内安全、及时和负担得起的外科护理，全球外科医生应该在目前不包括在美国普通外科课程中的专题方面追求专业知识，例如特定于环境的技术技能、能力建设和组织合作。对 BCM 全球外科轨道的未来评估将评估个性化教育对住院医师的专业身份、临床实践、学术追求、全球外科领导力准备情况以及对普通外科项目未涵盖的技术技能的舒适度的影响。增加高质量全球外科培训项目的可获得性将是朝着为全球提供安全外科护理做出贡献的关键下一步。
