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Core competencies for global surgery training: a scoping review
Roy A Hilzenrat1, Rachel J Livergant2, Catherine J Binda2
1From the Global Surgery Lab, Branch for Global Surgical Care, Department of Surgery, University of British Columbia, Vancouver, BC (Hilzenrat, Livergant, Binda, Adams, Chhor, Paiero-Keeler, Hsiao, Haji, Chin); the Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Hilzenrat); the Division of General Surgery, Department of Surgery, University of British Columbia, Vancouver, BC (Livergant); the Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, Ont. (Binda); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Chhor); the Faculty of Medicine, University of British Columbia, Vancouver, BC (Paiero-Keeler); the Health Sciences Library, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Petropoulos); the Department of Surgery, British Columbia Children's Hospital, Vancouver, BC (Haji); the Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC (Haji); the Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ont. (Chin) royhil@student.ubc.ca.
Background:
Despite calls from various global organizations for increased attention to global surgery, guidance on developing effective curricula is lacking. In this scoping review, we aimed to outline the necessary learning objectives and competencies for establishing sustainable, equitable, and noncolonialist academic global surgery programs.
Methods:
This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews. We used key terms to search 5 electronic databases and conducted a comprehensive grey literature search to identify universities, medical programs, and organizations offering academic global surgery programs. We categorized curricular objectives extracted from these sources into the 11 domains of global health defined by the Consortium of Universities on Global Health. We employed thematic analysis to further categorize these objectives into unique themes within each domain.
Results:
We found a total of 43 studies and 61 programs through database and grey literature searches, respectively. These sources yielded 333 unique curricular objectives, which we analyzed thematically, revealing 41 unique themes spanning various neglected areas in global surgery, such as Indigenous health, environments, chronic diseases, technology, and underserved populations like refugees, urban populations of low socioeconomic status, and racial and ethnic minority groups.
Conclusion:
This review outlines essential skills for effective engagement in modern global surgical care, emphasizing the emergence of nontraditional themes like bidirectional partnerships, sustainability, and self-governance over mission-based approaches. Integrating these forward-looking themes into global surgery curricula is vital for improving global surgical care standards and fostering a skilled, globally aware workforce.
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