A longitudinal surgical systems strengthening research program for medical students: the exploration of a model for global health education

Gregory L Peck,Carlos Morales,Joseph S Hanna,Zina Model,Zachary Berlant,Carlos A Ordoñez,Vicente H Gracias,Javier Escobar,Elizabeth E Ginalis,Dhaval Mehta,Erin M Scott,Fernando Ferrera,Deesha Sarma

doi:10.1186/s41256-021-00214-2

Abstract

BackgroundIn response to the staggering global burden of conditions requiring emergency and essential surgery, the development of international surgical system strengthening (SSS) is fundamental to achieving universal, timely, quality, and affordable surgical care. Opportunity exists in identifying optimal collaborative processes that both promote global surgery research and SSS, and include medical students. This study explores an education model to engage students in academic global surgery and SSS via institutional support for longitudinal research.ObjectivesWe set out to design a program to align global health education and longitudinal health systems research by creating an education model to engage medical students in academic global surgery and SSS.Program design and implementationIn 2015, medical schools in the United States and Colombia initiated a collaborative partnership for academic global surgery research and SSS. This included development of two longitudinal academic tracks in global health medical education and academic global surgery, which we differentiated by level of institutional resourcing. Herein is a retrospective evaluation of the first two years of this program by using commonly recognized academic output metrics.Main achievementsIn the first two years of the program, there were 76 total applicants to the two longitudinal tracks. Six of the 16 (37.5%) accepted students selected global surgery faculty as mentors (Acute Care Surgery faculty participating in SSS with Colombia). These global surgery students subsequently spent 24 total working weeks abroad over the two-year period participating in culminating research experiences in SSS. As a quantitative measure of the program’s success, the students collectively produced a total of twenty scholarly pieces in the form of accepted posters, abstracts, podium presentations, and manuscripts in partnership with Colombian research mentors.Policy implicationsThe establishment of scholarly global health education and research tracks has afforded our medical students an active role in international SSS through participation in academic global surgery research. We propose that these complementary programs can serve as a model for disseminated education and training of the future global systems-aware surgeon workforce with bidirectional growth in south and north regions with traditionally under-resourced SSS training programs.

Highlights

In response to the staggering global burden of conditions requiring emergency and essential surgery, the development of international surgical system strengthening (SSS) is fundamental to achieving universal, timely, quality, and affordable surgical care
Program design and implementation: In 2015, medical schools in the United States and Colombia initiated a collaborative partnership for academic global surgery research and SSS
Six of the 16 (37.5%) accepted students selected global surgery faculty as mentors (Acute Care Surgery faculty participating in SSS with Colombia)

Summary

Objectives

Academic collaboration through participatory action research is essential to the development of surgical system science necessary for data-driven health system strengthening and promotion of sustainable global public health activities [9]. It is important to recognize that by design, students accepted into these programs are self-selected, highly motivated individuals, and for the CGS students, already have a track record demonstrating their global public health priorities (i.e., international scholastic experiences) While this cohort’s engagement and productivity may not be reflective of those achieved by a wider, less experienced audience, the demonstrated value is in the opportunities for mentorship and research afforded for nascent development of SSS, and the participatory educators and researchers [18]. It is our hope that the creation of additional longitudinal global health tracks such as these will facilitate the identification of UME models that may contribute to the expansion of medical school global health education for proposed U.S Liaison Committee on Medical Education (LCME) credit hour requirements [24]

Background

Findings