The International Orthopaedic Health Elective at the University of California at San Francisco: The Eight-Year Experience

Abstract

It is estimated that half of the world's population lacks access to adequate primary health care and that two-thirds of the population lacks access to orthopaedic care1. While opportunities for orthopaedic surgeons to volunteer internationally have existed for many years, only a small percentage of practicing orthopaedic surgeons in the United States do so. One reason for this low rate of volunteerism is that physicians who have recently finished residency training face substantial loan burdens. In addition, recent graduates need to establish and build their practices2,3. Residents at the University of California at San Francisco (UCSF) may elect to participate in an overseas volunteerism program as early as their third postgraduate year. This program is rooted in the hope that early exposure will encourage future participation in similar activities throughout the residents' professional lives. While reports on the early experience of this elective have demonstrated a trend toward increased future participation in volunteerism, to date there have been no formal investigations of the long-term impact of this elective experience on orthopaedic surgery residents4,5. International health electives are believed to impact residents-in-training in three ways: providing professional development, affecting health-care resource use, and impacting outlooks and attitudes toward the delivery of health care6. A recent investigation conducted by the Department of Internal Medicine at Yale University examined the effects of its international elective on resident training. The study found that participants in an international elective were more likely than nonparticipants both to switch from subspecialty medicine to general medicine and to care for underserved populations7. While offering an international elective as a standard component of a residency training program may appear to benefit both residents and residency training programs, such electives require a substantial financial commitment from …