Background: The Lancet Commission on Global Surgery estimates 5 billion people who lack access to safe, timely, affordable surgical and anesthesia care. As part of the National Surgical, Obstetric, and Anesthesia Plans, governments and academic institutions have incentivized training leaders who can leverage cross-functional, cross-cultural teams for successful surgical system development. Despite significant interest in global surgery, less than one-third of surgical training programs offered clinical or educational opportunities, with even fewer in plastic surgery. The Operation Smile Global Surgery Fellowship (OS-GSF) was established in 2010 to meet the need for capacity building in low-resource settings. This study outlines the development and evolution of the program with focus on the role of academic plastic surgery residency programs in training future leaders in global plastic and reconstructive surgery.
Methods: The OS-GSF was initially designed as a 2-year program for plastic surgery residents with a focus on cleft-care, clinical research, global surgery field work, and structured coursework. The program evolved in 2018 to include international fellows from various clinical backgrounds. The experience of 25 fellows was reviewed through a mixed methods approach that included cross-sectional surveys and review of organizational records. Key themes and data were extracted regarding the fellowship’s impact on professional and personal development, and a framework was developed for the establishment of a global surgery fellowship embedded in a academic plastic surgery program.
Results: To date, 17 fellows have completed the OS-GSF, with 8 fellows in the current cohort. Fellows have come from a total of 13 different countries, 11 of which are low- and middle- income countries. While the majority trained in plastic surgery, there has been an increase in fellows pursuing anesthesia, general surgery, neurosurgery, and dentistry. Domains of fellowship focus include research, organizational project support, and global surgery advocacy. Academic productivity includes a total of 99 peer-reviewed papers, 111 conference presentations and 13 op-ed publications. Key factors to the fellowship development and sustainability include leadership buy-in, stable funding source, robust local and international partnerships, and active recruitment in diverse settings.
Conclusions: The OS-GSF, initially developed as a program for plastic surgery residents in 2010, has evolved to include international fellows from various clinical backgrounds who share an interest in addressing the global burden of surgical disease. Our 13-year experience with this program suggests this as an effective and sustainable fellowship model to into an international cross-disciplinary fellowship focused on developing leaders in addressing the global burden of surgical disease. Our 13-year experience to cultivate lasting leaders in global surgery.