During the 2016-2017 academic year, Global Surgery at Yale took tremendous steps forward, seeing the development of global surgery scholarship through a concentrated effort to expand on multiple fronts including:
• Clinical outreach
• Education
• Research initiatives
• Multi-disciplinary symposium
• International reciprocity opportunities
Outreach
Dr. Doruk Ozgediz, Assistant Professor of Pediatric Surgery, and Dr. Tobias Carling, Section Chief of Endocrine Surgery led outreach efforts in pediatric surgery and endocrine surgery, respectively, in Uganda. All clinical outreach involved Yale trainees working alongside local colleagues to ensure skill transfer and proper peri-operative and post-operative care.
Due to the success of the programs, there are plans for Yale surgeons to return to Uganda in the 2017-2018 academic year.
Education
An ACGME/ABS approved rotation for general surgery residents was established for Yale residents to travel to Kampala, Uganda for 2-4 weeks for pediatric surgery rotations. Residents worked with both Yale and Ugandan faculty in the clinic, at tumor board, in the wards, and in the operating room to treat a broad range of congenital diseases, solid tumors, and pediatric emergency surgical care.
Additionally, a quarterly multidisciplinary journal club was started in 2016 to broaden exposure of Yale residents to the challenges and ethics of global surgery. Most recently the journal club has included Yale medical students, residents, and faculty from the departments of OB/GYN, anesthesia, and the surgical sub-specialties in addition to general surgery.
Research
In 2008, Global Partners in Anesthesia and Surgery, a non-governmental organization (NGO) formed by Dr. Doruk Ozgediz and his colleagues, initiated a trauma course in Uganda aimed at filling a scholarly gap and addressing a need for advanced training among practitioners due to the high burden of trauma and the associated high morbidity and mortality. This course was standardized in 2016 by surgery residents Dr. Maija Cheung and Dr. Michael DeWane, with expert local consensus added with solutions for low-resource settings.
Building on the Kampala Advanced Trauma Course, at the request of local providers, an operative trauma course was developed by Dr’s Cheung and DeWane with Assistant Professor, Dr. Kevin Pei from the Section of General Surgery, Trauma & Critical Care using cadaver-based didactics. These two courses and the research opportunities they provide regarding outcomes and education, were the recipient of an OHSE Grant for the current year to expand on these projects.
In partnership with local providers in Uganda, Yale residents and medical students have been actively engaged in collaborative research projects on topics such as:
- Epidemiology and outcomes of pediatric surgical conditions in Uganda
- Cost-effectiveness of building a pediatric operating room
- Disparity in access to care for a variety of pediatric surgical conditions (Wilms tumors, typhoid intestinal perforations, anorectal malformations, etc.)
- Met and unmet needs and economic impacts of the surgical burden of disease
Global Surgery Symposium
In April, Yale hosted its first Global Surgery Symposium to highlight work by faculty and residents in different sections and provide a forum to share experiences and build additional relationships. Dr. John Tarpley, currently working in Rwanda and formerly the Program Director at Vanderbilt, was the keynote speaker sharing his years of knowledge regarding education and capacity building. He was joined by multiple guest speakers including:
- Ms. Elisa Baring from the Ending Neglected Diseases Fund
- Mr. David Cunningham from ARCHIE Global Surgery
- Dr. Unni Karunakara from Doctors without Borders
- Dr. Thomas McIntyre from SUNY Downstate
- Dr. Mahmoud Hariri, a Syrian surgeon who spoke about his experiences as a surgeon in a conflict zone.
Reciprocity Opportunities
In addition to research and educational collaborations, Yale has hosted Ugandan colleagues Dr. Arlene Muzira (Pediatric Surgery) and Dr. Cathy Kilyewala (Endocrine Surgery) for three-month observerships. During this time they have the opportunity to round with the teams, participate in clinic, engage in educational opportunities, and observe in the operating rooms in order to gain further exposure and experience in their respective fields.
Future Plans
Building on the success of this past year, the department is committed to ongoing research and educational collaborations and continued clinical engagement and to becoming a leader in academic global surgery.
For more information please email Doruk.ozgediz@yale.edu.