Sherif Youmna A, Choudhury Taslima, Makasa Emmanuel, Rosengart Todd K, Davis Rachel W, Kaseje Neema
From the Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX (Sherif, Rosengart, Davis).
Emory Pediatric Residency, Atlanta, GA (Choudhury).
J Am Coll Surg. 2022 Feb 1;234(2):239-246. doi: 10.1097/XCS.0000000000000026.
Global surgery is a medical field dedicated to the facilitation of timely access to safe, affordable, and high-quality surgical healthcare worldwide, including support for necessary surgery and anesthesia infrastructure. Standard surgical training in the US does not provide necessary exposure to the range of surgical operations and nontechnical skills critical to practice in resource-limited contexts. Therefore, academic medical institutions have sought to bridge this training gap by establishing global surgery-focused rotations, fellowships, and integrated global surgery residencies. However, the presence of trainees pursuing education for careers in resource-variable settings presents an added layer of ethical complexity that must be carefully considered on the individual, programmatic, and institutional level. This article reviews the complexities relevant to global surgery trainees across these levels and offers potential mechanisms for addressing these ethical challenges.
全球外科是一个致力于在全球范围内促进及时获得安全、可负担且高质量外科医疗服务的医学领域，包括对必要的外科手术和麻醉基础设施的支持。美国的标准外科培训未能提供必要的机会，使学员接触到在资源有限环境中开展手术所需的各类手术操作和非技术技能。因此，学术医疗机构试图通过设立以全球外科为重点的轮转、奖学金项目以及综合性全球外科住院医师培训来弥补这一培训差距。然而，有学员在资源差异较大的环境中接受职业教育，这带来了额外一层伦理复杂性，必须在个人、项目和机构层面仔细加以考虑。本文审视了这些层面上与全球外科培训学员相关的复杂性，并提出应对这些伦理挑战的潜在机制。
