Abstract

The Foundation for International Education in Neurological Surgery (FIENS) was founded in 1969, decades before globalization be camea worldwide phenomenon (1–3). Initially, efforts were focused on service delivery in under-resourced areas via short mission trips byindividual neurosurgeons. The wisdom of furthering the impact by creating sustainable training programs in partnership with h ostorganizations developed over time (3). FIENS is a neurosurgeons foundation working in partnership with various organizations toincrease global access to neurosurgery missions through the principle of “service through education (3).” FIENS shifted its f ocus from aservice delivery-centered approach to an approach centered on global health systems strengthening by emphasizing local neurosurgeryresident education and residency program development (3). It has become clear that the integration of neurosurgical efforts within thelocal health system amplifies the overall impact of FIENS initiatives by promoting sustainable change through collaborative action in theservice of local health system goals. From this point forward, initiatives coordinated by FIENS incorporated local stakeholders andworkforce in addition to mechanisms for service delivery, health infrastructure, information management, governance, and funding.

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