Researchers estimated 30% of all diseases globally require surgical care and expertise, yet global surgeons based in academic health centers (AHCs) often face institutional barriers that make it difficult for them to take the time to offer their services in low- and middle-income countries (LMICs).

However, a new position paper from the Association of Academic Surgeons (AAS) Global Affairs Committee, surgeons from AHCs has much to gain, including professional education, research experience, and an opportunity to enhance their institution's reputation when AHCs support academic global surgeons from their institutions.  The study was published in the Journal of the American College of Surgeons.

Making a case for Global Surgeons

The task force that developed the position paper sent a survey to 62 U.S. academic global surgeons to get a sense of who global surgeons are and how they spend their time.  The results showed that global academic surgeons typically have appointments at U.S. medical schools and spend dedicated time working with underserved populations, focusing on research, education, and health equity to improve surgical care globally.

Surgical Departments

The task force argues that global surgeons can add strategic value to AHCs and surgical departments, but leadership at these institutions may need guidance on what it means to support and meaningfully engage in this emerging field as increasing numbers of trainees aim to establish careers in global surgery.

To help legitimize the field of global academic surgery, the position paper includes the following recommendations:

  1. Global surgery is a defined academic surgical specialty and avenues for promotion should be delineated within the field.
  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 is ripe for productivity in all academic spheres.
  3. U.S. academic surgical departments should provide support for global academic surgeons. There are many ways to show support. Protected time and funding are the two greatest needs for global surgeons. 

They need to see more and more institutions support global surgery to show that it can be done, and how it can be done, in a way that's accommodating and welcoming to everyone.  Academic global surgeons face particular challenges in advancing their careers at AHCs because, as the authors note, the standard metrics for promotion in academic surgery translate poorly to an academic global surgery setting. 

Global surgeons, because they are working in different cultures, may work better with others, may have more cross-disciplinary collaborations, and may be more likely to be interested in cost-effective or cost-reducing innovations.

Unifying the Efforts of Global Surgery

A related challenge facing the field of global surgery is that there has been no unifying force to coordinate the efforts of different groups working to bring LMICs access to surgery.  There is a growing interest from academic surgeons as well as residents and students to participate in global surgery.

The problem has been that these efforts have been uncoordinated. They are trying to create a platform where academic global surgery programs can join hands and work together so we can better utilize resources and avoid duplication of efforts

As we develop more training hubs, we will welcome contributions of academic global surgery programs and encourage them to join hands.