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Clinical Orthopaedics and Related Research®

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01-11-2013 | Clinical Research

What Is the Current Status of Global Health Activities and Opportunities in US Orthopaedic Residency Programs?

Authors: R. Carter Clement, MD, MBA, Yoonhee P. Ha, MSc, Bartholt Clagett, BA, Ginger E. Holt, MD, John P. Dormans, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 11/2013

Abstract

Background

Interest in developing national health care has been increasing in many fields of medicine, including orthopaedics. One manifestation of this interest has been the development of global health opportunities during residency training.

Questions/purposes

We assessed global health activities and opportunities in orthopaedic residency in terms of resident involvement, program characteristics, sources of funding and support, partner site relationships and geography, and program director opinions on global health participation and the associated barriers.

Methods

An anonymous 24-question survey was circulated to all US orthopaedic surgery residency program directors (n = 153) by email. Five reminder emails were distributed over the next 7 weeks. A total of 59% (n = 90) program directors responded.

Results

Sixty-one percent of responding orthopaedic residencies facilitated clinical experiences in developing countries. Program characteristics varied, but most used clinical rotation or elective time for travel (76%), which most frequently occurred during Postgraduate Year 4 (57%) and was used to provide pediatric (66%) or trauma (60%) care. The majority of programs (59%) provided at least some funding to traveling residents and sent accompanying attendings on all ventures (56%). Travel was most commonly within North America (85%), and 51% of participating programs have established international partner sites although only 11% have hosted surgeons from those partnerships. Sixty-nine percent of residency directors believed global health experiences during residency shape future volunteer efforts, 39% believed such opportunities help attract residents to a training program, and the major perceived challenges were funding (73%), faculty time (53%), and logistical planning (43%).

Conclusions

Global health interest and activity are common among orthopaedic residency programs. There is diversity in the characteristics and geographical locations of such activity, although some consensus does exist among program directors around funding and faculty time as the largest challenges.

Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–1136.CrossRefPubMed

Boyd NH, Cruz RM. The importance of international medical rotations in selection of an otolaryngology residency. J Grad Med Educ. 2011;3:414–416.CrossRefPubMed

Butler MW, Krishnaswami S, Rothstein DH, Cusick RA. Interest in international surgical volunteerism: results of a survey of members of the American Pediatric Surgical Association. J Pediatr Surg. 2011;46:2244–2249.CrossRefPubMed

Campagna AM, St Clair NE, Gladding SP, Wagner SM, John CC. Essential factors for the development of a residency global health track. Clin Pediatr (Phila). 2012;51:862–871.CrossRefPubMed

Coughlin RR, Kelly NA, Berry W. Nongovernmental organizations in musculoskeletal care: Orthopaedics Overseas. Clin Orthop Relat Res. 2008;466:2438–2442.CrossRefPubMed

Cummings SM, Savitz LA, Konrad TR. Reported response rates to mailed physician questionnaires. Health Serv Res. 2001;35:1347–1355.PubMed

Derkash RS, Kelly N. The history of orthopaedics overseas. Clin Orthop Relat Res. 2002:30–35.

Dey CC, Grabowski JG, Gebreyes K, Hsu E, VanRooyen MJ. Influence of international emergency medicine opportunities on residency program selection. Acad Emerg Med. 2002;9:679–683.CrossRefPubMed

Dormans JP. Orthopaedic surgery in the developing world—can orthopaedic residents help? J Bone Joint Surg Am. 2002;84:1086–1094.PubMed

10.

Drain PK, Holmes KK, Skeff KM, Hall TL, Gardner P. Global health training and international clinical rotations during residency: current status, needs, and opportunities. Acad Med. 2009;84:320–325.CrossRefPubMed

11.

Haskell A, Rovinsky D, Brown HK, Coughlin RR. The University of California at San Francisco international orthopaedic elective. Clin Orthop Relat Res. 2002;396:12–18.CrossRefPubMed

12.

Javidnia H, McLean L. Global health initiatives and electives: a survey of interest among Canadian otolaryngology residents. J Otolaryngol Head Neck Surg. 2011;40:81–85.PubMed

13.

Jayaraman SP, Ayzengart AL, Goetz LH, Ozgediz D, Farmer DL. Global health in general surgery residency: a national survey. J Am Coll Surg. 2009;208:426–433.CrossRefPubMed

14.

Jense RJ, Howe CR, Bransford RJ, Wagner TA, Dunbar PJ. University of Washington orthopedic resident experience and interest in developing an international humanitarian rotation. Am J Orthop. 2009;38:E18–20.PubMed

15.

Klaristenfeld DD, Chupp M, Cioffi WG, White RE. An international volunteer program for general surgery residents at Brown Medical School: the Tenwek Hospital Africa experience. J Am Coll Surg. 2008;207:125–128.CrossRefPubMed

16.

Kolars JC, Halvorsen AJ, McDonald FS. Internal medicine residency directors perspectives on global health experiences. Am J Med. 2011;124:881–885.CrossRefPubMed

17.

Matar WY, Trottier DC, Balaa F, Fairful-Smith R, Moroz P. Surgical residency training and international volunteerism: a national survey of residents from 2 surgical specialties. Can J Surg. 2012;55:S191–199.CrossRefPubMed

18.

McKinley DW, Williams SR, Norcini JJ, Anderson MB. International exchange programs and US medical schools. Acad Med. 2008;83:S53–57.CrossRefPubMed

19.

Nelson BD, Lee AC, Newby PK, Chamberlin MR, Huang C-C. Global health training in pediatric residency programs. Pediatrics. 2008;122:28–33.CrossRefPubMed

20.

Noordin S, Wright JG, Howard AW. Global relevance of literature on trauma. Clin Orthop Relat Res. 2008;466:2422–2427.CrossRefPubMed

21.

Ozgediz D, Wang J, Jayaraman S, Ayzengart A, Jamshidi R, Lipnick M, Mabweijano J, Kaggwa S, Knudson M, Schecter W, Farmer D. Surgical training and global health: initial results of a 5-year partnership with a surgical training program in a low-income country. Arch Surg. 2008;143:860–865; discussion 865.CrossRefPubMed

22.

Powell AC, Mueller C, Kingham P, Berman R, Pachter HL, Hopkins MA. International experience, electives, and volunteerism in surgical training: a survey of resident interest. J Am Coll Surg. 2007;205:162–168.CrossRefPubMed

23.

Qureshi JS, Samuel J, Lee C, Cairns B, Shores C, Charles AG. Surgery and global public health: the UNC-Malawi surgical initiative as a model for sustainable collaboration. World J Surg. 2011;35:17–21.CrossRefPubMed

24.

Rovinsky D, Brown HP, Coughlin RR, Paiement GD, Bradford DS. Overseas volunteerism in orthopaedic education. J Bone Joint Surg Am. 2000;82:433–436.CrossRefPubMed

25.

Schultz SH, Rousseau S. International health training in family practice residency programs. Fam Med. 1998;30:29–33.PubMed

26.

Shearer D, Zirkle LG. Future directions for assisting orthopedic surgery in the developing world. Techniques in Orthopaedics. 2009;24:312–315.CrossRef

27.

Silva JF. The urgent need to train orthopaedic surgeons in Third World countries. Med Educ. 1979;13:28–30.CrossRefPubMed

28.

Silverberg D, Wellner R, Arora S, Newell P, Ozao J, Sarpel U, Torrina P, Wolfeld M, Divino C, Schwartz M, Silver L, Marin M. Establishing an international training program for surgical residents. J Surg Educ. 2007;64:143–149.CrossRefPubMed

29.

Spiegel DA, Gosselin RA, Coughlin RR, Kushner AL, Bickler SB. Topics in global public health. Clin Orthop Relat Res. 2008;466:2377–2384.CrossRefPubMed

30.

Young S, Lie SA, Hallan G, Zirkle LG, Engesaeter LB, Havelin LI. Low infection rates after 34,361 intramedullary nail operations in 55 low- and middle-income countries: validation of the Surgical Implant Generation Network (SIGN) online surgical database. Acta Orthop. 2011;82:737–743.CrossRefPubMed

Title: What Is the Current Status of Global Health Activities and Opportunities in US Orthopaedic Residency Programs?
Authors: R. Carter Clement, MD, MBA
Yoonhee P. Ha, MSc
Bartholt Clagett, BA
Ginger E. Holt, MD
John P. Dormans, MD
Publication date: 01-11-2013
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 11/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-013-3184-3

At a glance: The STEP trials

Springer Medicine

What Is the Current Status of Global Health Activities and Opportunities in US Orthopaedic Residency Programs?

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

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