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International Surgery: Closing the “New Generation” Gap

International Surgery: Closing the “New Generation” Gap "Delayed maturation . . . uncommitted . . . come and go . . . better quality of life . . . can we adapt?"1 Many “new generation” surgeons admit to the same frustrations as our mentors do. For those of us who endured the sudden restriction in work hours and responsibilities midway through our residencies, such labels were not in our vocabularies. Subsequently, many of us struggled with how best to serve our patients with a decreased workforce, increased workloads, and less time and fewer resources with which to get it all done. Shortly after completing my residency, I traveled to India and Pakistan to work as a surgeon. In a tiny rural hospital in post-earthquake Pakistan, a decreased workforce meant no scrub nurse; increased workloads meant working 24/7 (including C-sections) with no foreseeable time off; and less time and fewer resources meant no general anesthesia. The situation was comparable in rural India, despite the virtual explosion in the country's economic growth and technology. Even at the Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, a high-volume tertiary referral center in North India, disposable equipment is reused until it literally breaks. Surgical gastroenterology fellows (general surgeons who are pursuing further training in advanced gastrointestinal surgery) do not keep track of work hours during their 3-year fellowships and call their attending surgeons (both men and women) “sir.” In a city that has only 10 ventilators, there is a waiting list for the 9 that are located here. There is a lesson to be learned for surgeons who have the privilege of training in the United States. The newly developing field of international surgery might address the discrepancy in practice circumstances between physicians in our nation and those in the developing world. We at Oregon Health & Science University have partnered with the Sanjay Gandhi Postgraduate Institute of Medical Sciences to design a program that strives to foster knowledge expansion and cross-cultural understanding through faculty and resident exchange, collaborative research, and outreach. As for the high schoolers, biotechnology will still play an important role: telemedicine will hold the future of international educational collaboration. Will we adapt? Correspondence: Dr Perkins, Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L223, Portland, OR 97239-3098 (sperkins429@gmail.com). Financial Disclosure: None reported. References 1. Freischlag JA The new generation of surgeons: a panel discussion at the Pacific Coast Surgical Association. Arch Surg 2007;142 (8) 703PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

International Surgery: Closing the “New Generation” Gap

Perkins, R. Serene
Archives of Surgery , Volume 143 (4) – Apr 1, 2008
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International Surgery: Closing the “New Generation” Gap

Abstract

"Delayed maturation . . . uncommitted . . . come and go . . . better quality of life . . . can we adapt?"1 Many “new generation” surgeons admit to the same frustrations as our mentors do. For those of us who endured the sudden restriction in work hours and responsibilities midway through our residencies, such labels were not in our vocabularies. Subsequently, many of us struggled with how best to serve our patients with a decreased workforce, increased workloads, and...
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References (1)

Publisher
American Medical Association
Copyright
Copyright © 2008 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.143.4.425-a
Publisher site
See Article on Publisher Site

Abstract

"Delayed maturation . . . uncommitted . . . come and go . . . better quality of life . . . can we adapt?"1 Many “new generation” surgeons admit to the same frustrations as our mentors do. For those of us who endured the sudden restriction in work hours and responsibilities midway through our residencies, such labels were not in our vocabularies. Subsequently, many of us struggled with how best to serve our patients with a decreased workforce, increased workloads, and less time and fewer resources with which to get it all done. Shortly after completing my residency, I traveled to India and Pakistan to work as a surgeon. In a tiny rural hospital in post-earthquake Pakistan, a decreased workforce meant no scrub nurse; increased workloads meant working 24/7 (including C-sections) with no foreseeable time off; and less time and fewer resources meant no general anesthesia. The situation was comparable in rural India, despite the virtual explosion in the country's economic growth and technology. Even at the Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, a high-volume tertiary referral center in North India, disposable equipment is reused until it literally breaks. Surgical gastroenterology fellows (general surgeons who are pursuing further training in advanced gastrointestinal surgery) do not keep track of work hours during their 3-year fellowships and call their attending surgeons (both men and women) “sir.” In a city that has only 10 ventilators, there is a waiting list for the 9 that are located here. There is a lesson to be learned for surgeons who have the privilege of training in the United States. The newly developing field of international surgery might address the discrepancy in practice circumstances between physicians in our nation and those in the developing world. We at Oregon Health & Science University have partnered with the Sanjay Gandhi Postgraduate Institute of Medical Sciences to design a program that strives to foster knowledge expansion and cross-cultural understanding through faculty and resident exchange, collaborative research, and outreach. As for the high schoolers, biotechnology will still play an important role: telemedicine will hold the future of international educational collaboration. Will we adapt? Correspondence: Dr Perkins, Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L223, Portland, OR 97239-3098 (sperkins429@gmail.com). Financial Disclosure: None reported. References 1. Freischlag JA The new generation of surgeons: a panel discussion at the Pacific Coast Surgical Association. Arch Surg 2007;142 (8) 703PubMedGoogle ScholarCrossref

Journal

Archives of Surgery – American Medical Association

Published: Apr 1, 2008

Keywords: surgical procedures, operative,surgery specialty

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