Motivations and impact of international rotations in low- and middle-income countries for orthopaedic surgery residents: Are we on the same page?

the COACT Resident Rotation Study Group

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Despite interest among North American orthopaedic residents to pursue rotations in resource-limited settings, little is known regarding resident motivations and impact on host surgeons. Methods: Surveys were distributed to North American orthopaedic surgeons and trainees who participated in international rotations during residency to assess motivations for participation and to orthopaedic surgeons at partnering low- and middle-income country (LMIC) institutions to assess impact of visiting trainees. Results: Responses were received from 136 North American resident rotators and 51 LMIC host surgeons and trainees. North American respondents were motivated by a desire to increase surgical capacity at the LMIC while host surgeons reported a greater impact from learning from residents than on surgical capacity. Negative aspects reported by hosts included selfishness, lack of reciprocity, racial discrimination, competition for surgical experience, and resource burdens. Conclusions: The motivations and impact of orthopaedic resident rotations in LMICs need to be aligned. Host perceptions and bidirectional educational exchange should be incorporated into partnership guidelines.

Original languageEnglish (US)
JournalAmerican journal of surgery
DOIs
StateAccepted/In press - 2020

Bibliographical note

Funding Information:
John Dawson, Baylor College of Medicine Program, United States, John.Dawson@bcm.edu . Brian Davis, Baylor College of Medicine Program, United States, Brian.Davis2@bcm.edu . Alan Daniels, Brown University Program, United States, alandanielsmd@gmail.com . Milton Little, Cedars-Sinai Medical Center Program, United States, Milton.Little@cshs.org . John Garlich, Cedars-Sinai Medical Center Program, United States, john.garlich@cshs.org . Chad Coles, Ross Leighton, Dalhousie University, Canada, coles@dal.ca , r.k.leighton@ns.sympatico.ca . Michael Maceroli, Emory University School of Medicine Program, United States, mmacerol@gmail.com . Sandra Hobson, Emory University School of Medicine Program, United States, sandralhobson@gmail.com . Chris Bray, Greenville Health System/University of South Carolina Program, United States, Christopher. Bray@prismahealth.org . Duretti Fufa, Hospital for Special Surgery/Cornell Medical Center Program, United States, FufaD@hss.edu . Sariah Khormaee, Hospital for Special Surgery/Cornell Medical Center Program, United States, sariah.khormaee@gmail.com . Brian Mullis, Roman M Natoli, Indiana University School of Medicine Program, United States, bmullis@iupui.edu , rnatoli@IUHealth.org . Babar Shafiq, Johns Hopkins University Program, United States, bshafiq2@jhmi.edu . Jimmy Mackenzie, Johns Hopkins University Program, United States, jmacken6@jhmi.edu . Danny Wongworawat, Lee Zuckerman, Loma Linda University Health Education Consortium Program, United States, dwongworawat@llu.edu , lzuckerman@llu.edu . Joshua Speirs, Loma Linda University Health Education Consortium Program, United States, Jspeirs@llu.edu . Charles F. Carr, Michael Mackechnie, Mary Hitchcock Memorial Hospital/DartmouthHitchcock Program, United States, charles.f.carr@hitchcock.org , michael.mackechnie@gmail.com . George Dyer, Melvin Makhni, Massachusetts General Hospital/Brigham and Women's Hospital/Harvard Medical School Program, United States, gdyer@mgh.harvard.edu , mmakhni@bwh.harvard.edu . Kiran Agarwal-Harding, Massachusetts General Hospital/Brigham and Women's Hospital/Harvard Medical School Program, United States, kiran.agarwalharding@gmail.com . Brandon Yuan, Mayo Clinic College of Medicine and Science (Rochester) Program, United States, Yuan.Brandon@mayo.edu . Matt Beal, McGaw Medical Center of Northwestern University Program, United States, mbeal@nm.org . Danielle Chun, McGaw Medical Center of Northwestern University Program, United States, Danielle-Chun@northwestern.edu. Andrew Furey, Memorial University of Newfoundland, Canada, afurey99@gmail.com . Brad Petrisor, McMaster University, Canada, petrisb@mcmaster.ca . Yongjung Kim, New York Presbyterian Hospital (Columbia Campus) Program, United States, yk2299@cumc.columbia.edu . Ken Egol, New York University School of Medicine/NYU Langone Orthopedic Hospital Program, United States, Kenneth.Egol@nyulangone.org . Christian Pean, Blake Schultz, New York University School of Medicine/NYU Langone Orthopedic Hospital Program, United States , christian.pean@nyulangone.org , blakeschultzmd@gmail.com . Darin Friess, Zach Working, Oregon Health & Science University Program, United States, friessd@ohsu.edu , workingz@ohsu.edu . Grant Sun, Oregon Health & Science University Program, United States, grant.s.sun@gmail.com . Henry Boateng, Penn State Milton S Hershey Medical Center Program, United States, hboateng@pennstatehealth.psu.edu . Michael Gardner, Stanford Health CareSponsored Stanford University Program, United States, michaelgardner@stanford.edu . Malcolm Debaum, Blake Schultz, Stanford Health CareSponsored Stanford University Program, United States, mdebaun@stanford.edu , blakeschultzmd@gmail.com . Saquib Rehman, Eric Gokcen, J. Milo Sewards, Temple University Hospital Program, United States, Saqib.Rehman@tuhs.temple.edu , Eric.Gokcen@tuhs.temple.edu , jmilo.sewards@tuhs.temple.edu . Nicholas Bernthal, UCLA David Geffen School of Medicine/UCLA Medical Center Program, United States, NBernthal@mednet.ucla.edu . Zachary Burke, Alex Upfill Brown, UCLA David Geffen School of Medicine/UCLA Medical Center Program, United States, ZBurke@mednet.ucla.edu , AUpfillBrown@mednet.ucla.edu . Melissa Esparza, University of Arizona College of Medicine-Phoenix Program (Banner), United States, melissa.esparza@gmail.com . Peter O'Brien, University of British Columbia, Canada, peter.obrien@vch.ca . David Stockton, University of British Columbia, Canada, djstockton@telus.net . Kevin Neal, University of Florida College of Medicine Jacksonville Program, United States, Kevin. Neal@nemours.org . Nathan O'Hara, University of Maryland Program, United States, NO'Hara@som.umaryland.edu . Arun Hariharan, University of Maryland Program, United States, ahariharan@som.umaryland.edu . Peter Cole, Ann Van Heest, Patrick Horst, University of Minnesota Program, United States, peter.a.cole@healthpartners.com , vanhe003@umn.edu , horst.patrick@gmail.com . Brandon Kelly, University of Minnesota Program, United States, kell1401@umn.edu . Mauricio Kfuri, University of Missouri-Columbia Program, United States, kfurim@health.missouri.edu . Karl Lalonde, University of Ottawa, Canada, karllalonde@toh.ca . Jaimo Ahn, Samir Mehta, University of Pennsylvania Health System Program, United States, Jaimo.Ahn@pennmedicine.upenn.edu , Samir.Mehta@uphs.upenn.edu . Matt Winterton, Luke Lopas, University of Pennsylvania Health System Program, United States, mattwinterton@gmail.com , lalopas04@gmail.com . James Kellam, University of Texas Health Science Center at Houston Program, United States, james.f.kellam@uth.tmc.edu . Thomas Higgins, University of Utah Program, United States, thomas.higgins@hsc.utah.edu . Iain Elliot, University of Utah Program, United States, elliott.iain@gmail.com . Paul Whiting, University of Wisconsin Hospitals and Clinics Program, United States, Whiting@ortho.wisc.edu . Jordan T Shaw, Nathaniel M Wilson, University of Wisconsin Hospitals and Clinics Program, United States. William Obremskey, Vanderbilt University Medical Center Program, United States, william.obremskey@vumc.org. Cassandra A. Lee, Wake Forest University School of Medicine Program, United States, casslee@ucdavis.edu. Keith Kenter, Joseph Weistroffer, Western Michigan University Homer Stryker MD School of Medicine Program, United States, joseph.weistroffer@med.wmich.edu , keith.kenter@med.wmich.edu . Josh Veenstra, David Knowles, Western Michigan University Homer Stryker MD School of Medicine Program, United States david.knowles@med.wmich.edu , joshua.veenstra@med.wmich.edu Devin Conway, Yale-New Haven Medical Center Program, United States, Devin.conway@yale.edu . Aung Thein Htay, Yangon Orthopedic Hospital, Myanmar, dr.ath.ypa@gmail.com . Myat Thu Wynn, Yangon Orthopedic Hospital, Myanmar, myatthuwynn@icloud.com . Dr. Peter Smitham PhD, FRCS, FRACS, Royal Adelaide Hospital, Australia. Dr. Dino Aguilar, MD, Hospital Antonio Lenín Fonseca de Managua, Nicaragua. Amanda J McCoy MD, MPH, Tenwek Mission Hospital, Kenya. Kiprono Koech MD, Tenwek Mission Hospital, Kenya. Ian Orwa MD, Tenwek Mission Hospital, Kenya. Marvin Wekesa MD, Tenwek Mission Hospital, Kenya. Francis Mbugua MD, AIC Kijabe Hospital, Kenya. Daniel D Galat MD, AIC Kijabe Hospital, Kenya. John Mandela MD, AIC Kijabe Hospital, Kenya. David Jomo MD, AIC Kijabe Hospital, Kenya. James Kinyua, CURE International Hospital Kenya, Kenya. Mbonisi Malaba, CURE International Hospital Kenya, Kenya. Felix Kuguru, CURE International Hospital Kenya, Kenya. Fasto Yugusuk, CURE International Hospital Kenya, Kenya. Pierre Woolley, La Paix Hospital, Haiti, pmwoolley06@icloud.com . Marc-Alain Pean MD, La Paix Hospital, Haiti, marcalainpean@hotmail.com . Dr. Billy Haonga, MD, Dr. Edmund Eliezer, Muhimbili Orthopaedic Institute, Tanzania, bhaonga@gmail.com , ndalama@yahoo.com . Dr. Samuel Hailu, Tikur Anbessa Teaching Hospital, Ethiopia, samiethio@gmail.com . Dr. Fre Alemseged, Tikur Anbessa Teaching Hospital, Ethiopia, friyatom@gmail.com . Linda Chokotho, Beit Cure International Hospital (Malawi), Malawi, lindachokotho@gmail.com . Allman Tinoco, MD, Hospital San Juan de Dios, Colombia, allmantinocolukez@gmail.com . Bibek Banskota, Hospital and Rehabilitation Centre for Disabled Children, Nepal. Scott Nelson, Hospital Adventiste d'Haiti, Haiti, scottnelsonmd@gmail.com . Francisco Alberto Hernandez Vargas, Hospital Escuela Antonio Lenin Fonseca, Nicaragua, franckohv@gmail.com .

Funding Information:
Dr. Miclau has received grant funding from the Wyss Medical Foundation for activities outside the submitted work. None of the other authors have any conflicts of interest to disclose.

Keywords

  • Education
  • Global surgery
  • International rotation
  • Low- and middle-income country
  • Orthopaedic residency

PubMed: MeSH publication types

  • Journal Article

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