ACS: Global engagement for the care of the surgical patient

The American College of Surgeons (ACS) was founded 105 years ago to provide opportunities for the continuing education of surgeons, rooted in a deep and effective concern for the improvement of surgical patient care and for the ethical practice of medicine in the U.S. and Canada.1 The ACS always has been a global organization, now with more than 80,000 members representing six continents. It is the premier surgical organization in the world—a recognized leader with respect to surgical education, with its mission to ensure access to quality surgical care and to develop trauma systems and educational programming worldwide.

This article outlines some of the College’s global engagement activities and future initiatives.

International Guest Scholarships program

For half a century, the International Guest Scholarships  have provided young surgeons from around the globe with opportunities to visit clinical, teaching, and research facilities in North America with the goal of enhancing the scholars’ patient care and research practices when they return to their respective countries. The scholarships, in the amount of $10,000 each, also provide scholars with the opportunity to participate in the annual ACS Clinical Congress and to observe and participate in clinical, teaching, and research activities in the U.S. and Canada. Over the years, approximately 326 surgeons from 70 countries have received this scholarship and have benefited from this program.2

Other scholarships for international surgeons

The ACS offers a variety of scholarships for surgeons outside of the U.S. and Canada. Examples are as follows:

  • ACS/AAST International Scholarship: This scholarship is awarded to surgeons in acute care surgery, trauma, and emergency general surgery in countries other than the U.S. and Canada to improve the quality of acute care surgical services. Preference is given to applicants from developing nations. The scholarship, in the amount of $5,000, provides scholars with an opportunity to attend the annual meeting of the American Association for the Surgery of Trauma (AAST) and to visit one or two Level I trauma centers and/or the Trauma Quality Improvement Program (TQIP®) at the College’s headquarters in Chicago, IL, to learn about the standards for a trauma program/database and the importance of multidisciplinary acute care surgery.
  • ACS/ASBrS International Scholarship: This scholarship is awarded to breast cancer surgeons in countries other than the U.S. and Canada to improve the quality of breast cancer surgical services. Preference is given to applicants from developing countries. The scholarship, in the amount of $5,000, provides the scholars with an opportunity to attend the annual meeting of the American Society of Breast Surgeons (ASBrS) and to visit the National Accreditation Program for Breast Centers headquarters in Chicago, IL, to learn about the standards for a breast cancer program/database and the importance of multidisciplinary breast cancer care.
  • Community Surgeons Travel Awards: The ACS International Relations Committee provides travel awards for surgeons ages 30 to 50. This award supports community surgeons in countries outside the U.S. and Canada to attend and participate fully in the educational activities at the ACS Clinical Congress.
  • International ACS NSQIP Scholarships: The College’s National Surgical Quality Improvement Program® (ACS NSQIP®) and the International Relations Committee offer International ACS NSQIP Scholarships for two surgeons from countries other than the U.S. or Canada who demonstrate strong interest in surgical quality improvement.

Further educational opportunities for international surgeons

The ACS Division of Education and the International Relations Committee provide two international scholarships focused on surgical education. These awards are for young faculty members from countries other than the U.S. and Canada and provide opportunities for these individuals to participate in a variety of educational opportunities for faculty development and enhancement that will result in the acquisition of new knowledge and skills in surgical education and training.

The Advanced Trauma Life Support® (ATLS®) program is designed to teach a systematic and reliable approach to the care of trauma patients. With leadership from the ACS Committee on Trauma, ATLS was first widely introduced in the U.S. and abroad in 1980. Since its inception, ATLS for health care professionals has spread to more than 60 countries. The MyATLS app, a mobile electronic platform, has been downloaded in more than 170 countries.

Operation Giving Back

Operation Giving Back (OGB) is the volunteer arm of the ACS. OGB grew out of an interest in surgical volunteerism expressed both by the ACS Board of Governors Committee on Socioeconomic Issues and by the membership-at-large as represented in a study spanning from 2001 to 2003. OGB was established in 2004 with the mission to “leverage the passion, skills, and humanitarian ethos of the surgical community to effectively meet the needs of the medically underserved.” The organization’s objective is to serve as a comprehensive resource center for surgeons at any level of training who want to participate in volunteer activities, encouraging the formation of a cohesive community of volunteers.3

The web-based OGB resource center matches fellow surgical volunteers of the ACS with opportunities to provide patient care and teaching in low-resource communities. Over the years, thousands of volunteers have been placed to provide much-needed care to underserved populations. One of the activities of OGB is to support peer-initiated selection of the recipients of the ACS/Pfizer Surgical Humanitarian and Volunteerism Awards each year.4

To underscore the need for global surgical system improvement, the World Health Organization (WHO) passed the World Health Assembly Resolution 68.15 in May 2015. The resolution, which includes surgery as an essential component of universal health care, was accepted and signed by all participating countries with the understanding that more than 5 billion people lack access to basic surgical care and that the major deficit is a shortage of surgical workforce. Following a retreat on global engagement in 2016, the ACS Board of Regents (the highest governing body of the College) provided strategic direction for the ACS leadership to engage directly in the training of surgical workforce in low- and middle-income countries (LMICs). ACS OGB, in addition to improving existing services, is actively working to develop programs to implement this strategic direction. Developing partnerships with surgical colleges and societies in LMICs based on mutual benefits and shared goals is our guiding principle.

ACS Fellows have been engaged in volunteerism across sub-Saharan Africa. OGB and the College of Surgeons of East, Central and Southern Africa (COSECSA) have developed working relationships based on local priorities, including the following:

  • The ACS-COSECSA Women Scholars program promotes and encourages women to join the surgical workforce (see photos below).
  • The ACS Surgeons as Leaders: From Operating Room to Boardroom Course is a recognized national program. COSECSA leaders have attended this training program with the intention of recreating a contextually relevant leadership course for COSECSA.
  • The OGB has supported the COSECSA fellowship examination process by recruiting ACS Fellows to serve as external examiners (see photo below).
  • The East and Central African Journal of Surgery is developing a twinning partnership with the Journal of the American College of Surgeons to improve its standing in quality as reflected in impact factor and PubMed indexing.
  • A proposed partnership between COSECSA; the ACS; U.S. Consortium of Academic Global Surgery Programs, in development at present; and a COSECSA-accredited training program in Hawassa, Ethiopia, would develop a surgical training center of excellence. The goal is for this site to serve as a training hub with local and regional impact that will encourage improved innovation, clinical research, and patient care. The pilot project for this initiative will be implemented by fall 2018.

As we celebrate the passage of the third anniversary of the WHA Resolution 68.15, the ACS will continue to engage in the implementation of the global surgery agenda. To this end, the College looks forward to working closely with WHO and the office of the Global Initiative for Emergency and Essential Surgical Care.

ACS Global - ACS-COSECA Women Scholars

First cohort of ACS-COSECSA Women Scholars, from left: Barbara Lee Bass, MD, FACS, FRCS(Hon), ACS President; Mahder Eshete Yilma, MD; Woubedel Kiflu Aklilu, MD; Wambui Njoroge, MB, BCh, FCS; Nardos Worku Ketema, MD; Mukagaju Francoise, MD; Ananya Kassahun, MD; Florence Umurangwa, MD; and Dr. Tefera

 

ACS-COSECA Women Scholars

First cohort of ACS-COSECSA Women Scholars, from left: Gita Mody, MD, ACS Associate Fellow; Sherry M. Wren, MD, FACS, FCS(ECSA), 2017 International Surgical Volunteerism Awardee; Dr. Yilma; Dr. Ketema; Hilary A. Sanfey, MB, BCh, MHPE, FACS, FRCSI, Immediate Past-First Vice-President of the ACS; Dr. Bass; Drs. Njoroge, Kassahun, and Aklilu; Kathleen Casey, MD, FACS, Past-Director, OGB; and Ann O’Rourke, MD, FACS

 

ACS Fellow participating as external examiners

ACS Fellows participating as external examiners, December 2017. Front row, from left (all ACS Fellows pictured are MD, FACS): Bruce Steffes, Dr. Helder de Miranda (COSECSA member), Keir Thelander, Stephen Bickler, Dr. O’Rourke, Neil Wetzig (Australia), and Andrew Chew (PAACS Australia). Middle row: Timothy Berg, Jim Brown, John Tarpley, Adrian Park, Dr. Sanfey, Dr. Wren, Ohwofiemu Nwariaku, Dr. Tefera, and Benedict Nwomeh. Back row: Three unidentified COSECSA fellows, Marilyn W. Butler, Erik Hansen, Doruk Ozgediz, and Russ White.


References

  1. American College of Surgeons. History of the American College of Surgeons. Available at: facs.org/about-acs/archives/acshistory. Accessed on March 25, 2018.
  2. American College of Surgeons. Scholarships for international surgeons. Available at: facs.org/member-services/scholarships/international. Accessed March 26, 2018.
  3. American College of Surgeons. Operation Giving Back. Available at: facs.org/ogb. Accessed March 26, 2018.
  4. American College of Surgeons. ACS/Pfizer Surgical Volunteerism and Humanitarianism Awards. Available at: facs.org/ogb/award-winners. Accessed March 27, 2018.

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