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Global Surgery Fellowship General Info

About the Program

The Coronavirus Pandemic

The pandemic has delayed and postponed some of our fellowship activities. We will accept applicants for a starting date of July 1, 2023. Assuming that travel restrictions are lifted by that date all below is accurate.

Structure

First 7 - 9 Months: Omaha, Nebraska.

Possible clinical rotations on:

  • Extensive Cadaver Laboratory
  • Pediatric Anesthesia
  • Neonatal Intensive Care
  • Ultrasound & Simulation
  • Obstetrics and Gynecology
  • Dentistry/Oromaxillofacial Surgery
  • Adult Anesthesia
  • Orthopedics
  • Urology

Plus a one-week hernia trip to Dominican Republic.

During the first 7 - 9 months of fellowship, the fellow will be taught operations in Omaha and medical care not learned in a general surgery residency, but necessary in a developing country. The rotations and their length will be tailored to the fellows’ previous experience and the needs of the second-year fellowship site. If a one month burn rotation is necessary it will be conducted at the Maricopa County Burn Center in Phoenix Arizona.

Last 15 - 17 months: First-level hospital in an underserved country
There the fellow will operate and train qualified local professionals to perform surgery. The level of professional and emotional support for the fellow and their family will be developed to make the experience valuable to the fellow and the community served. The long term intent is to help the fellow pursue a global surgery career.

The location will be chosen carefully to assure safety, adequate surgical volume, local training, an opportunity to complete a local capacity building project and a good start for the fellow’s career pathway.

The fellowship is categorized under “additional training” and is non-American College of Graduate Medical Education (ACGME) approved.

Years After
At completion of the Creighton University Global Surgical Fellowship, the fellow will be assisted in finding employment that will allow them to continue their global surgery quest.

Needs and Value Added

The Need

In the “Disease Control Priorities” third edition published by the World Bank Group, they describe the need for essential surgery at first-level hospitals. The U.S. has one general surgeon per 15,000 people. In rural Tanzania there is one surgeon for 1.2 million people. In the fellowship, U.S.-trained surgeons will provide high quality surgery to patients without access and train talented in country professionals to perform much needed surgical procedures.

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Surgeon to Population Ratio - U.S. 1-to-15 thousand / Tanzania 1-to-1.2 million

First-level hospitals in low-income countries have insufficiently trained personnel, with non-physicians doing many of the operations. The hospitals often lack laboratory services, a supply chain, maintenance systems, a referral system, training standards, monitored guidelines and checklists, data systems, in addition to lack of affordable/reliable patient transportation.

System-Level Change: How We Will Address the Need

Fully qualified traumatologists, obstetricians and general surgeons are not needed in every hospital for effective operations. This program will provide personnel training so that needed services can be provided at low cost on-site. For example, with this training, family practitioners and non-physician clinicians with midwives and nurse anesthesiologists can successfully manage many obstetrical emergencies.

To develop infrastructure, we are initiating a site-specific systems analysis, followed by expert consultation and gradual project implementation. For system change sustainability, when possible another program fellow will succeed the previous fellow and focus on host country responsibility.

Value Added

  • First 7 - 9 Months Goal: Perform 200 operations and 200 procedures
  • Last 15 - 17 Months Goal: 300-400 major operation in Low Income Country (LIC) that would otherwise not be performed, with complication rates no more than twice that observed in the United States
  • Complete a capacity building local project
  • Catalyst experience for lifelong surgical career in a developing country
  • Collect Patient outcome data
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Months 1 through 7-9 goal: 200 Operations, 200 Procedures / Months 8-10 through 24 goal: 300 Major Procedures

Salary and Benefits

Fellows will receive compensation equivalent to a House Staff PGY 6 & PGY 7 salary.

See complete salary and benefit information at Graduate Medical Education.