A position paper based on survey responses from U.S. academic global surgeons demonstrates the cost and value of such work for academic health centers (AHCs) and surgical departments.

"This position paper posits that global surgery is a defined academic surgical specialty and avenues for promotion should be delineated within the field," said Dr. Jennifer Rickard of the University of Minnesota in Minneapolis.

"AHCs and surgical departments should recognize the value of academic global surgery. Academic surgical departments should provide support for global academic surgeons," said Rickard.

"Protected time and funding are the two greatest needs," she said by email. "However, administrative, logistical, and statistical support are also critical."

The position paper was developed by a task force of 10 surgeons representing the Association of Academic Surgery Global Affairs Committee and the Society for University Surgeons Committee on Global Academic Surgery.

The survey was sent to 62 active US academic global surgeons to learn more about them, their qualifications, trainee interactions, academic output, productivity challenges, and careers. The results were used to create the position paper on the value of these surgeons to AHCs.

As reported online August 20 in the Journal of the American College of Surgeons, the survey response rate was 58% (36 respondents).

The task force defines a global academic surgeon as someone with an appointment in a medical school who does any of the following: spends dedicated time in a low- or middle- income country (LMIC) (81%); spends vacation time doing mission work (58%); or works primarily in a LMIC (56%).

Survey responses indicate that most spend one to three months abroad annually, dedicating less than 25% of their time/effort to global surgery, including systems building, teaching, research, and clinical care.

Most are employed by universities; 65% report compensation is equivalent or greater than colleagues'. Their academic support includes administrative, protected time and funding.

Most institutions do not use specific global surgery metrics to measure productivity. Barriers to participation include funding, clinical responsibilities, and salary support.

The position paper makes the following recommendations:

1. Global surgery is a defined academic surgical specialty and avenues for promotion should be delineated;

2. U.S. AHCs and surgical departments should recognize the value of global academic surgery. Due to the large burden of global surgical disease, the field can be productive in all academic spheres.

3. U.S. academic surgical departments should provide support for global academic surgeons, including protected time, funding, and administrative, logistical and statistical support.

"Academic global surgeons spend a modest amount of time abroad, require minimal financial support, and represent a low-cost investment in an under-recognized scholarship area," the authors conclude.

Dr. Anthony Charles, Associate Professor of Surgery and head of the Malawi Surgical Initiative at UNC School of Medicine – UNC Chapel Hill, North Carolina commends the task force on the position paper and agrees with their conclusion.