International Surgery Electives During General Surgery Residency: A 9-Year Experience at an Independent Academic Center.
OBJECTIVE
International experiences are an increasingly emphasized feature of general surgery residency programs. In 2008, an international elective (IE) was implemented for general surgery residents at our institution. This effort was augmented by the establishment of a pathway for formal approval of IEs by the American Board of Surgery and Accreditation Council for Graduate Medical Education in 2012.


DESIGN
A retrospective review of Accreditation Council for Graduate Medical Education case logs was completed. IE operative volumes were compared to home institution general surgery service volumes. An electronic survey of IE participants was conducted to assess preresidency goals, prior international exposure, overall experience on IEs, and current or planned engagement with international experiences, volunteerism, or global philanthropy.


SETTING
Independent Academic Medical Center.


PARTICIPANTS
Fourteen general surgery residents who participated in IEs from 2008 to 2017.


RESULTS
IE locations included the Dominican Republic (9), Ecuador (1), Ethiopia (3), and Nicaragua (1). IEs were a first-time international surgical experience for 10 (71%) residents. Nine (64%) reported that they would not or may not have participated in an IE during residency had established opportunities not been available. Ten residents had graduated at the time of this study and 3 of them have participated in international service. Median case volumes were 17 cases per week during IEs compared to 8 cases per week for residents on home institution rotations. Residents were exposed to a variety of first-time operations during IEs including open cholecystectomies, gynecologic procedures, thyroidectomies for goiter, and prostatectomies.


CONCLUSIONS
Incorporation of IEs into our general surgery residency has demonstrated numerous benefits. IE participation provides valuable operative experience in both volume and variety, and can be especially impactful for those who may not have elected to pursue such opportunities independently. These experiences have the potential to empower general surgery residents to invest in similar practices and acts of generosity in their future careers.
['Esquibel|Brendon M|BM|', "O'Heron|Colette T|CT|", 'Arnold|Elizabeth J|EJ|', 'Kallies|Kara J|KJ|', 'Jarman|Benjamin T|BT|']
D000046:Academic Medical Centers D003479:Curriculum D013502:General Surgery D007393:International Educational Exchange D007396:Internship and Residency D012189:Retrospective Studies D013997:Time Factors D014481:United States
Surgery residency Global health International rotation Interpersonal and Communication Skills Medical Knowledge Patient Care Professionalism Surgical procedures Systems-Based Practice