57.05 Perception of Academic Global Surgery by Surgeons in Low- and Middle-Income Countries (LMICs).

Posted on April 24, 2024

A. Nwagbata3,6, R. Dutta1,2, A. Jayaram7, S. Jain2,4, N. Thivalapill5, I. Faria1, A. Mahajan2, S. Bandyopadhyay8,10, L. P. Aguilar-Franco9,10, A. K. Bah10, M. A. Hajhamed10, T. Lapeñas10, W. Burchards10, K. G. Zaykova10, I. Dos Santos Pereira10, A. O. Dokyi10, C. A. Agyeman10, S. Arora10, A. E. Nwagbata10, A. R. ZONGO10, N. Guzman10, J. Phowira10, J. M. Saca10, I. E. Carías10, J. Lesi10, A. N. Stanley10, N. Krishna10, B. G. Feres10, T. Shahriar10, T. J. Pierre10, L. Huang10, H. P. Nguyen Tuyen10, M. A. Olmedo10, R. S. Martins10, K. Sukhgerel10, J. Figueroa10, W. N. Kisaakye10, N. Jarrah10, A. R. Nascimento10, S. Choeni10, M. Ong10, C. K. Muoneke10, M. Djenontin-Agossou10, A. G. Rangel10, A. M. Guasch10, E. O. Sharashi10, C. Gonikman10, J. D. Niyonkuru10, D. Abdallah10, E. Nalianya10, Y. Jabbie10, K. Narkulova10, H. Essangri10, T. Khursheed10, R. Zahir10, M. Castellanos10, R. P. Nashidengo10, A. Neyazi10, Y. Djanwet10, A. Iradukunda10, J. Albahry10, S. F. Shaddood10, M. Al-Jorani10, N. Tsoeu10, A. Tidjane10, M. Korch10, A. Z. Contreras10, Š. Stefan10, A. Mahajan10, A. H. Olatunji10, M. J. Kanneh10, A. Souadka10, S. E. Salah Kacimi10, G. Etim10, T. Techapongsatorn10, A. B. Fissha10, M. Audry10, N. M. Bonilla10, A. Gadgil2, N. Roy2, N. Raykar1,3  1Harvard Medical School, Program In Global Surgery And Social Change, Department Of Global Health And Social Medicine, Boston, MA, USA 2World Health Organization, WHO Collaborating Centre For Research In Surgical Care Delivery In Low-Middle Income Countries, Mumbai, MAHARASHTRA, India 3Brigham and Women’s Hospital, Department Of Trauma, Burn, And Surgical Critical Care, Boston, MA, USA 4Dayanand Medical College and Hospital, Ludhiana, PUNJAB, India 5Northwestern University Feinberg School of Medicine, Chicago, IL, USA 6Harvard Medical School, Boston, MA, USA 7Beth Israel Deaconess Medical Center, Department Of Surgery, Boston, MA, USA 8University of Oxford, Nuffield Department Of Surgical Sciences, Oxford, OXFORDSHIRE, United Kingdom 9Beth Israel Deaconess Medical Center, Advanced Heart Failure Program, Boston, MA, USA 10Low- and Middle-Income Country Lead, -, -, USA

Introduction: There has been a surge in interest in ‘global surgery’ amongst academics and practitioners in high-income countries (HICs), but it is unclear how frontline practitioners of surgery in low-resource environments perceive the phrase or the field it represents. We aimed to assess perceptions of academic global surgery amongst surgeons in LMICs.

Methods: We performed a cross-sectional e-survey of surgical trainees and consultants in LMICs as defined by the World Bank in 2020. The survey was distributed through a network of 73 individuals in 62 countries. We analyzed the survey section that assessed ‘perception of academic surgery,’ and evaluated the association between practice type and responses using Pearson's Chi-square test. All analyses were completed using Stata 15.

Results: A total of 416 participants responded to the survey, including 173 consultants (41.6%), 221 residents (53.1%), 8 medical graduates (1.9 %), and 14 fellows (3.4%). 72 responses (17.3%) were from low-income countries, 137 (32.9%) from lower-middle-income countries, and 207 (49.8%) from upper-middle-income countries. 286 respondents (68.8%) practiced in urban areas, 34 (8.2%) in rural areas, and 84 (20.2%) in both rural and urban areas. Only 185 respondents (44.58%) were familiar with the term ‘global surgery.’ Of the respondents, 326 (79.3%) agreed that collaborating with high-income countries (HIC) surgeons for research projects is beneficial to being a global surgeon, 323 (78.8%) agreed that having a co-author from a HIC will improve their likelihood of publication in a reputable journal, 337 (81.6%) agreed that securing research funding is difficult in their country, 195 (47.3%) agreed that their institutions consider their research for promotion, 252 (61.0%) agreed that they are able to combine research and clinical practice, and 336 (82%) are willing to train medical students and residents from HIC institutions.

Conclusion: A majority of surgeons surveyed in LMICs were unfamiliar with the term 'global surgery' and noted limited academic incentives to perform research in the field. The academic global surgery community should take note and foster equitable collaborations to ensure that this critical segment of stakeholders are engaged and have fewer barriers to participation.