 nternet
growth, wireless communications and relatively inexpensive
air travel, coupled with several decades of economic
growth, allow U.S. residents and medical students
to experience the world like never before. The above
factors have largely contributed to an economic,
personal and intellectual interconnectedness unlike
any in human history.
Academic centers serve this interconnectedness by
offering more undergraduate and graduate classes
on various global topics. At the University of Washington,
new programs and departments bearing names such
as “The Office of Global Affairs,” “Department
of Global Health,” “Institute for Inequality
and Social Structure” and “Global Health
and Justice Department” have started or grown
dramatically. We were interested in learning about
anesthesia residents’ interest in global health
and if they had any firsthand experience.
Dr. Jense created and delivered a survey instrument
by e-mail consisting of 17 questions to 104 University
of Washington anesthesiology residents and interns.
Sixty-six (63 percent) residents responded within
three weeks.
RESULTS
 |
Prior International
Experience
Almost half (49 percent) of the respondents
had already participated in international work
prior to entering residency. Most served for
greater than a month in a medical capacity,
and the majority worked in a Latin American
country. |
 |
Second Language
More than half (56 percent) of the respondents
stated that they speak another language. Of
those that speak another language, 24 (65 percent)
considered themselves fluent in that language.
Spanish was the most prominent second language
spoken (49 percent). |
 |
Interest and Location
The large majority (77 percent) of the respondents
were either interested, very interested or plan
on participating in an international medical
undertaking during their residency. Almost half
(49 percent) stated that the ideal duration
of the mission would be three to four weeks.
Most (81 percent) chose a Latin American country
as a site of interest, with 71 percent wishing
to participate as a fourth-year resident under
mild/limited supervision (85 percent). |
Conclusion
University of Washington anesthesiology residents
are interested in working overseas for a period of
time, and nearly half have previous experience in
doing so. The results support the notion that anesthesiology
residents have been, and continue to be, very interested
in global health. To our surprise, a large number
of residents already participated in some sort of
international health mission, and many consider themselves
fluent in another language. These results suggest
that a Spanish-speaking country in either South America
or Central America would best fit the resident desires,
knowledge base and language fluency. Furthermore,
the data suggest that residents would rather participate
in an international mission in the last year of their
residency with mild or limited supervision.
Studies suggest that students would choose residency
programs based on their ability to participate in
overseas missions.1,2
An Australian resident training program has shown
that trainees serving internationally can gain valuable
experiences that could fulfill their training requirements.3
The World Health Organization’s Essential Trauma
Care Project4
demonstrates the need for improved perioperative care
systems worldwide. We surmise that academic anesthesiology
training programs could play an important role in
this effort.
The University of Washington’s mission is to
serve the sparsely populated states of the Alaska,
Idaho, Montana, Washington and Wyoming region. Perhaps
our mission, combined with growing global health programs,
has attracted an unusually large number of internationally
oriented residents, but we do not know if this is
the case.
More research is needed to determine if University
of Washington anesthesiology residents are typical
of their peers in other specialties and other training
programs.
The survey is available on request via e-mail from
rjjense@u.washington.edu.
Other comments, suggestions or questions are welcome.
References:
1. Powell A, et al. Resident interest in international
experience. J Am Coll Surg. 2007; 205(1).
2. Ozgediz D, et al. Surgery in developing countries:
Essential training in residency. Arch Surg.
2005; 140:795-800.
3. Hill A, Woodfield J. Training outside of the
box. ANZ J. Surg. 2003; 73:881-883.
4. Mock C, Joshipura M, Goosen J, Maier R. Overview
of the essen--tial trauma care project. World
J Surg. 2006; 30(6):919-929.
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Ryan
J. Jense, M.D., faculty anesthesiologist, University
of Washington (UW) and Puget Sound Veterans
Administration, Seattle, Washington. He is Chair,
Committee on Communications for the Washington
State Society of Anesthesiologists and serves
on the admissions committee for the UW School
of Medicine. |
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Peter
J. Dunbar, M.B., Ch.B., M.B.A., is Associate
Professor of Anesthesiology and Health Services,
University of Washington, Seattle, Washington.
He is ASA Director for Washington State. |
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