Training Global Leaders in Perioperative Equity: An Evaluation of the CHESA Fellowship

Few programs exist to train learners in advancing equity in perioperative care. In response, the UCSF Center for Health Equity in Surgery and Anesthesia (CHESA) launched the CHESA Fellowship in 2021. This 18-month, non-ACGME fellowship uses asynchronous modules, expert-led seminars, mentored research, and community building to equip fellows with the skills to advance perioperative equity worldwide.

This report describes the fellowship's structure and evaluates its early impact on alumni career development. We conducted a mixed-methods fellowship evaluation comprising alumni and end-of-year surveys, focus groups, and a list of fellow-authored publications. Surveys assessed skill development, scholarly output, and satisfaction with curriculum elements. Qualitative data from focus groups were coded to highlight fellows' experiences and identify areas for improvement.

Since 2021, CHESA has trained 80 fellows across 18 countries and 12 specialties; 71.3% are from LMICs and 48.8% are female. Surveys demonstrated strong satisfaction with faculty mentorship, project work, and community-building. Fellows reported acquiring skills in academic writing, mentorship, and leadership, with 53.8% developing new collaborations with co-fellows and 75.0% integrating fellowship learning into their clinical practice. Among alumni, 76.5% reported advancement into new leadership roles or clinical positions. Across cohorts, alumni published 364 manuscripts during or after the fellowship, with 58.8% focusing on health equity. Fellow and faculty feedback identified needs for enhanced research support and faculty development, which were incorporated into subsequent program iterations.

The CHESA Fellowship offers an innovative model for building global perioperative leadership. The part-time, virtual format allows fellows to complete the program alongside clinical duties, while seed grants for LMIC fellows support locally driven scholarly projects. By prioritizing cross-border collaborations between fellows, building long-term partnerships with LMIC institutions, and ensuring diversity across geography, specialty, and sex, the fellowship balances accessibility with mentorship and community-building. Alumni report high satisfaction and translate their training into academic, clinical, and advocacy outcomes that advance perioperative equity.