Optimizing US surgical trainees for global engagement

Utilizing a large consortium data set of resident operative performance ratings, Abbott et al. evaluated the technical competency of U.S surgical trainees to perform certain procedures deemed critical in low resource settings (LRS).1 The authors demonstrated variability in practice-ready ratings among 17 defined procedures, noting insufficient experience to perform nearly half of the recommended essential surgical procedures in LRS, including two of the three bellwether procedures as cited by the Lancet Commission on Global Surgery.2 While some of these procedures may fall outside the scope of US general surgery training, the authors challenge the surgical education community to utilize the noted deficiencies to improve opportunities for trainees in global surgery. [...]one might argue that a US-trained surgeon is better prepared technically than culturally. [...]of the COVID-19 pandemic, some of this can now be more easily achieved due to the rapid uptake and success of various online educational platforms which improve access and bidirectional learning in the global surgery space.7 With growing concern about graduating residents’ preparedness, transition to practice from trainee to independent surgeon is a focus in the US and not just global surgery.8 Many academic institutions and healthcare systems have established onboarding programs that include mentorship, leadership training, monitoring surgical outcomes, and proctoring.9 These programs aim for increased surgeon autonomy, graded responsibility, practice management skills, and senior surgeon mentorship.