A review of the United States global surgery program landscape by website analysis.

Background: Over the past decade, since the 2015 Lancet Commission on Global Surgery (LCoGS) highlighted the global burden of disease attributable to a lack of safe surgical care, medical degree-granting institutions across the United States (US) have worked to increase engagement in global surgery. The research team aimed to analyze the current landscape and provide an overview of all US-based global surgery programs. It was predicted that most medical institutions in the US would not have established programs. For those with global surgery programs, their mission statements and demonstrated output were classified according to a list of five domains, including bidirectionality, education, partnerships, research, and service. These domains were generated from the priorities outlined by the LCoGS 2030 objectives as there is no universally accepted gold standard for quality evaluation in global surgery education. The team hypothesized that mission statements for existing programs would meet a majority, but not all, of the five domains, and that programs would demonstrate less output than their projected goals.

Methods: The team conducted a qualitative analysis of all global surgery programmatic offerings across the US. A list of terms was established to analyze the websites published for each US allopathic (MD) and osteopathic (DO) program. An Excel matrix was produced that outlined all desired information. The domains were used to organize and classify the collected data.

Results: Out of 194 US MD- and DO- granting institutions, 39 had global surgery programs. Twenty-five programs had missions that addressed three to four of the domains and 12 programs projected pursuit of all five domains. Of the 12 programs that projected this mission to meet all five objectives, six demonstrated tangible output in all five areas. Bidirectionality was the most common domain not addressed by programs in either their mission statement or output.

Conclusions: Global surgery is a nascent field, and as predicted, the majority of medical institutions do not have a global surgery program. Furthermore, institutions with programs and well-defined missions did meet a majority of the five domains. Contrary to the team's prediction, most existing programs demonstrated equal or greater output than their expressed goals.