Brown Kelsey E, Solaiman Rafat H, Flores Michael J, Nadone Haley, MacKechnie Madeline C, Shearer David W, Miclau Theodore
Institute of Global Orthopaedics and Traumatology, University of California San Francisco, San Francisco, California.
Warren Alpert Medical School, Brown University, Providence, Rhode Island.
J Bone Joint Surg Am. 2023 Apr 5;105(7):571-577. doi: 10.2106/JBJS.22.00801. Epub 2022 Nov 17.
In low and middle-income countries (LMICs), there are often not enough orthopaedic surgeons to treat musculoskeletal conditions. International volunteerism is 1 way that the orthopaedic community seeks to meet this need. This study explored the opportunities available for orthopaedic surgeons to volunteer overseas as offered by nonprofit organizations in the United States and Canada.
A systematic internet search was conducted using 2 distinct search strategies. A website was considered a "hit" if it was that of a U.S. or Canada-based nonprofit, volunteer, or non-governmental organization that had opportunities for international orthopaedic volunteerism. Duplicate hits were eliminated to identify distinct organizations. Data regarding the work and geographical reach of the organization, as well as changes to its volunteer programs as a result of COVID-19, were extracted from each hit.
Of the 38 distinct organizations identified in the U.S. and Canada, the most common orthopaedic subspecialties represented were pediatrics (37%), hand (24%), and arthroplasty (18%). Foot and ankle (4 organizations; 11%), sports medicine (2 organizations; 5%), and oncology (1 organization; 3%) were the least represented subspecialities. The most common regions for volunteer trips included Latin America and the Caribbean, followed by West and East Africa. Twelve organizations (32%) were identified as having a religious affiliation. For most organizations, the trip duration was a minimum of 1 week. All volunteer organizations included operative or clinical experiences as part of their trips, and the majority of organizations (58%) reported that their trips included opportunities for training local surgeons. Many organizations (71%) reported having resumed trips after halting them during the COVID-19 pandemic.
Many opportunities exist for orthopaedic surgeons to volunteer their time and skills abroad. Future directions for the improvement of international volunteer efforts among the orthopaedic community could include expanding the number of existing volunteer opportunities and assessing the ethics, safety, efficacy, and longevity of these programs.
在低收入和中等收入国家（LMICs），骨科医生往往不足以治疗肌肉骨骼疾病。国际志愿服务是骨科界满足这一需求的一种方式。本研究探讨了美国和加拿大的非营利组织提供的骨科医生海外志愿服务机会。
采用两种不同的搜索策略进行系统的互联网搜索。如果网站是美国或加拿大的非营利、志愿或非政府组织，且有国际骨科志愿服务机会，则该网站被视为“命中”。消除重复命中以识别不同的组织。从每个命中的网站中提取有关该组织的工作和地理覆盖范围的数据，以及由于COVID-19导致其志愿项目的变化。
在美国和加拿大确定的38个不同组织中，最常见的骨科亚专业是儿科（37%）、手部（24%）和关节置换术（18%）。足踝（4个组织；11%）、运动医学（2个组织；5%）和肿瘤学（1个组织；3%）是代表最少的亚专业。最常见的志愿旅行地区包括拉丁美洲和加勒比地区，其次是西非和东非。12个组织（32%）被确定有宗教背景。对于大多数组织来说，旅行时间至少为1周。所有志愿组织都将手术或临床经验作为旅行的一部分，大多数组织（58%）报告说他们的旅行包括培训当地外科医生的机会。许多组织（71%）报告说在COVID-19大流行期间暂停旅行后已恢复旅行。
骨科医生有很多机会在国外贡献自己的时间和技能。骨科界改善国际志愿工作的未来方向可能包括增加现有志愿机会的数量，以及评估这些项目的伦理、安全、有效性和持续性。
