Surgical International Rotations: The Latin American Survey

Abstract

Over the last decades there has been a dramatic increase in the demand for global surgical experiences. While the perspectives of surgical mentors and trainees, typically from high income countries (HICs), have been explored, little is known about the perspectives and view of host surgeons from low and middle income countries (LMICs). Our objective was to explore the perspectives of mentoring host surgeons and host trainees from LMICs throughout Latin America (LA). METHODS: An online survey was used to explore perceptions of academic general surgeons, surgical fellows, and general surgery residents throughout LA, of such rotations from a host perspective; challenges and patient safety; perceived positives and negatives to the host nation beyond the trainee and ethical considerations. Participation was voluntary and confidential. RESULTS: Out of 488 physicians, 88 responded to the survey (18%) representing 13 LA countries: (65%) were academic surgeons, followed by general surgery residents (26%). Less than 50% of those surveyed work or train at an institution which currently provides an international rotation; 80% of LA surgeons felt similar opportunities for them to train in a HIC were denied due to financial limitations. Frustration was expressed at having only observer status when visiting a HIC whereas close to 40% of LA sites provided hands-on surgical training as well. Ethical concerns were significant in more than half of those surveyed. CONCLUSIONS: This survey identifies deficiencies regarding structure and supervision of trainees during international rotations. Lack of funding and paucity of reciprocity regarding clinical training extended to surgeons in host institutions are also opportunities identified.