Mapping Global Health Education and Training: An Analysis of International Surgical Initiatives

Initiatives in workforce training and education have emerged as a key strategy to address the critical shortage of skilled surgical providers in low and middle-income countries (LMICs). Nonetheless, the scope and distribution of these initiatives remain poorly characterized within the global surgery literature. This bibliometric review identifies the most highly cited studies on international surgical workforce development to clarify current trends, synthesize areas of consensus, and highlight persistent gaps that limit sustainable capacity building.

A bibliometric analysis was conducted using Web of Science to identify the top 50 publications related to global initiatives in surgical workforce development. We employed a comprehensive search strategy to analyze citation trends, authorship patterns, geographic distribution, and institutional collaborations. The most frequently cited articles, journals, and research topics were also assessed to measure the scholarly impact of surgical workforce development efforts. We also examined the duration, training approaches, and stated objectives of each initiative to clarify the major themes represented in the literature.

A total of 50 publications were identified from 2000 to 2025. All publications were published within the last 10 years, reflecting a growing academic interest in global surgical education. Plastic surgery, neurosurgery, and multispecialty training programs were the most frequently represented domains, with notable emphasis on reconstructive procedures, microsurgical training, and cleft care. Authorship trends revealed a predominance of contributors from high-income countries, highlighting an imbalance in knowledge production and a need to elevate LMIC-led research. Although many initiatives were categorized as "ongoing," nearly 25% spanned less than 1 year, indicating an opportunity for improvement in the continuity and sustainability of workforce impact. Across studies, there was a clear consensus that long-term training partnerships and locally led educational models offered the most durable impact, yet few publications evaluated outcomes beyond the program period.

This bibliometric study offers insight into global surgical training programs, highlighting increasing research output, international collaboration, and concentrated efforts within select specialties. Findings point to an urgent need to strengthen long-term program sustainability, expand LMIC authorship leadership, and develop standardized metrics to assess educational and clinical outcomes. Advancing global surgical efforts will require establishing best practices for surgical mentorship and sustainable training models as well as promoting equitable research partnerships and enhancing LMIC representation.