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International Surgical Electives: Intellectual Capital, Authorship, and Capacity Building

International Surgical Electives: Intellectual Capital, Authorship, and Capacity Building There is increasing interest among general surgery resident physicians to pursue international electives.1-4 However, there are 2 causes for concern that are worthy of mention and suggest that due caution be exercised to ensure the favorable establishment of relationships with institutions outside of the United States. These relationships should bear the commitment to equity that reflects the altruism with which the endeavor was originally intended, so as not to inadvertently exacerbate any preexisting disparities. First, in collaborative exchanges and capacity building, efforts should be made to advance the academic careers and opportunities of surgical trainees from institutions in low- and middle-income countries that are the recipients of the exchange. These exchanges should not, for example, serve to solely benefit the members of the visiting team. This should also be reflected in authorship of work that stems from collaborative research endeavors. Sub-Saharan Africa, for instance, provides the substratum for a plethora of biomedical publications, particularly those on the global infectious disease burden. Indeed, indigenously led institutions like Kenya Medical Research Institute, for example, are at the forefront of continental vaccine research in malaria and human immunodeficiency virus therapy.5 Authorship of some publications, derived from research based in Africa, often fails, however, to reflect the collaborative input of the indigenous contributors. Second, the legitimacy of establishing relationships at an institutional level cannot be overstated. Admittedly, these relationships are borne of the passion and enthusiasm of single individuals. Nevertheless, if solely driven by the charisma and energy of a single stakeholder(s), these affiliations may be less durable and more susceptible to collapse with the withdrawal or distraction of that single researcher. A memorandum of understanding drawn between the 2 institutions allows for a higher level of involvement and investment that may allow greater durability and perpetuation of the relationship beyond the interest of any single individual. Ultimately, these relationships are best established on a foundation of trust and mutual respect. A careful, almost literal attention must therefore be paid to adherence to the very meaning and spirit of the word exchange. In this manner, the experience may foster mutual gain and not unilateral benefit for either team, promoting an equitable and mutually beneficial experience that will most effectively mitigate the exacerbation of the preexistent disparities that fuelled the exchange in the first place. Correspondence: Dr Hayanga, Department of General Surgery, University of Michigan Medical Center, 500 E Medical Center Dr, Ann Arbor, MI 48109 (jhayanga@med.umich.edu). Financial Disclosure: None reported. References 1. Powell ACMueller CKingham PBerman RPachter HLHopkins MA International experience, electives, and volunteerism in surgical training: a survey of resident interest. J Am Coll Surg 2007;205 (1) 162- 168PubMedGoogle ScholarCrossref 2. Ozgediz DWang JJayaraman S et al. Surgical training and global health: initial results of a 5-year partnership with a surgical training program in a low-income country. Arch Surg 2008;143 (9) 860- 865PubMedGoogle ScholarCrossref 3. Ozgediz DRoayaie KDebas HSchecter WFarmer D Surgery in developing countries: essential training in residency. Arch Surg 2005;140 (8) 795- 800PubMedGoogle ScholarCrossref 4. Hayanga AJ Volunteerism in general surgical residency: fostering sustainable global academic partnerships. Arch Surg 2007;142 (6) 577- 579PubMedGoogle ScholarCrossref 5. Uthman OAUthman MB Geography of Africa biomedical publications: an analysis of 1996-2005 PubMed papers. Int J Health Geogr 2007;646PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

International Surgical Electives: Intellectual Capital, Authorship, and Capacity Building

Archives of Surgery , Volume 144 (3) – Mar 16, 2009

International Surgical Electives: Intellectual Capital, Authorship, and Capacity Building

Abstract

There is increasing interest among general surgery resident physicians to pursue international electives.1-4 However, there are 2 causes for concern that are worthy of mention and suggest that due caution be exercised to ensure the favorable establishment of relationships with institutions outside of the United States. These relationships should bear the commitment to equity that reflects the altruism with which the endeavor was originally intended, so as not to inadvertently exacerbate any...
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Publisher
American Medical Association
Copyright
Copyright © 2009 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.2008.565
Publisher site
See Article on Publisher Site

Abstract

There is increasing interest among general surgery resident physicians to pursue international electives.1-4 However, there are 2 causes for concern that are worthy of mention and suggest that due caution be exercised to ensure the favorable establishment of relationships with institutions outside of the United States. These relationships should bear the commitment to equity that reflects the altruism with which the endeavor was originally intended, so as not to inadvertently exacerbate any preexisting disparities. First, in collaborative exchanges and capacity building, efforts should be made to advance the academic careers and opportunities of surgical trainees from institutions in low- and middle-income countries that are the recipients of the exchange. These exchanges should not, for example, serve to solely benefit the members of the visiting team. This should also be reflected in authorship of work that stems from collaborative research endeavors. Sub-Saharan Africa, for instance, provides the substratum for a plethora of biomedical publications, particularly those on the global infectious disease burden. Indeed, indigenously led institutions like Kenya Medical Research Institute, for example, are at the forefront of continental vaccine research in malaria and human immunodeficiency virus therapy.5 Authorship of some publications, derived from research based in Africa, often fails, however, to reflect the collaborative input of the indigenous contributors. Second, the legitimacy of establishing relationships at an institutional level cannot be overstated. Admittedly, these relationships are borne of the passion and enthusiasm of single individuals. Nevertheless, if solely driven by the charisma and energy of a single stakeholder(s), these affiliations may be less durable and more susceptible to collapse with the withdrawal or distraction of that single researcher. A memorandum of understanding drawn between the 2 institutions allows for a higher level of involvement and investment that may allow greater durability and perpetuation of the relationship beyond the interest of any single individual. Ultimately, these relationships are best established on a foundation of trust and mutual respect. A careful, almost literal attention must therefore be paid to adherence to the very meaning and spirit of the word exchange. In this manner, the experience may foster mutual gain and not unilateral benefit for either team, promoting an equitable and mutually beneficial experience that will most effectively mitigate the exacerbation of the preexistent disparities that fuelled the exchange in the first place. Correspondence: Dr Hayanga, Department of General Surgery, University of Michigan Medical Center, 500 E Medical Center Dr, Ann Arbor, MI 48109 (jhayanga@med.umich.edu). Financial Disclosure: None reported. References 1. Powell ACMueller CKingham PBerman RPachter HLHopkins MA International experience, electives, and volunteerism in surgical training: a survey of resident interest. J Am Coll Surg 2007;205 (1) 162- 168PubMedGoogle ScholarCrossref 2. Ozgediz DWang JJayaraman S et al. Surgical training and global health: initial results of a 5-year partnership with a surgical training program in a low-income country. Arch Surg 2008;143 (9) 860- 865PubMedGoogle ScholarCrossref 3. Ozgediz DRoayaie KDebas HSchecter WFarmer D Surgery in developing countries: essential training in residency. Arch Surg 2005;140 (8) 795- 800PubMedGoogle ScholarCrossref 4. Hayanga AJ Volunteerism in general surgical residency: fostering sustainable global academic partnerships. Arch Surg 2007;142 (6) 577- 579PubMedGoogle ScholarCrossref 5. Uthman OAUthman MB Geography of Africa biomedical publications: an analysis of 1996-2005 PubMed papers. Int J Health Geogr 2007;646PubMedGoogle ScholarCrossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Mar 16, 2009

Keywords: authorship,surgical procedures, operative

References