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The Tsao Fellowship In Global Health: An Evolving Model For An Academic Institution's Development Of Leaders In Global Surgery
Jacqueline Stoneburner1, Eric S. Nagengast, MD1, Naikhoba C. O. Munabi, MD1, Allyn Auslander, MPH2, Caroline A. Yao, MD, MS3, William P. Magee, III, MD, DDS2.
1Keck School of Medicine of USC, Los Angeles, CA, USA, 2Children's Hospital Los Angeles, Los Angeles, CA, USA, 3University of Southern California, Los Angeles, CA, USA.

PURPOSE: The Lancet Commission on Global Surgery estimates that 5 billion people lack access to safe, affordable and timely surgical and anesthesia care. To increase access to global surgery, the National Surgical, Obstetric and Anesthesia Plan identifies six key components of the surgical ecosystem and its stakeholders, one of which is governance. Strong governance enables accountability and visibility of the national health plan but is dependent on robust leadership. One way to cultivate future leaders is through global surgery fellowships with the intent to strengthen cultural competency, technical skills and leadership skills. While the outcomes of short-term international surgical training have been documented in the literature, there is a need to evaluate the long-term implications of structured global surgical fellowships. In this study, we assess the long-term outcomes of the Operation Smile Global Surgery Fellowship, and how it has evolved since its inception in 2010.
METHODS: The fellowship is a formal, two-year international surgical fellowship for plastic and reconstructive surgery residents that operates through a partnership between Operation Smile, Children's Hospital Los Angeles and the University of Southern California. All seven fellowship matriculants and graduates between 2010 and 2019 were surveyed electronically in order to evaluate the educational experience and the impact of the fellowship on the fellows' careers. Additionally, an internal review was performed to identify program changes since its establishment.
RESULTS: Preliminary results were collected (Table 1). The fellowship has matriculated 7 and graduated 4. Of the graduates in practice, all 3 hold leadership positions in academia and have remained active in global surgery. A variety of subspecialties have or will be practiced, with 1 in burns, 1 in hand, 1 in microsurgery and 4 in craniofacial. Research performed during the fellowship to date has resulted in 26 peer reviewed publications and 46 conference presentations. From internal review, the program expanded from one to multiple fellows per cycle, took on an international fellow, and transitioned from a Master of Science degree to Master of Public Health degree. Though initially private, funding became integrated into the budget of Operation Smile, a nonprofit organization, after demonstrating proof of concept.
CONCLUSION: This formative, two-year global surgery fellowship has been successful in equipping fellows with experience in clinical research, international fieldwork in reconstructive surgery and a master's degree. Despite the fragmented state of global surgery, the fellows develop a strong, global network of collaborators to support their postgraduate endeavors. Our findings suggest that this growing, evolving international global surgery fellowship is effective in cultivating diverse, lasting leaders in global surgery.


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