O188: Progressive specialisation within General Surgery and minimally invasive techniques: how can we prepare today's surgeons for humanitarian work?

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Abstract Background General surgery has evolved from training a surgeon who was able to perform a variety of procedures to an increase in subspecialists and the narrowing of the specialty’s scope of practice. In contrast, the humanitarian field still demands a broad trained specialist who can work with limited resources, adapted to the cultural context. The present study aimed to explore this gap and propose solutions to the existing problem. Methods Qualitative approach using one-to-one semi-structured interviews with surgeons with various levels of experience in the humanitarian field. Results Thirteen humanitarian surgeons were interviewed. The main challenges of working in humanitarian environments were limited resources, diverse pathology or distinct presentation of common pathology, lack of referral systems and the decision-making process per se. The field demands a broad trained surgeon with experience in emergency procedures in various subspecialties. The learning process in the ground is more practical than the formal surgical education, therefore, adequate preparation is required prior to deployment. Individual and systemic approaches were suggested by the participants for training of surgeons, although barriers are still numerous. Surgeons who plan to have a humanitarian career must identify the gaps in their training and fulfil them accordingly, and organisations must take approaches to aid surgeons to satisfy these requirements. Conclusions There is urgent need to develop formal mechanisms of training and to ensure quality of care through professionalization of humanitarian surgery. Collaboration between organisations and leadership are essential for the establishment of training programmes and for the future of humanitarian surgery.