High Disparity Between Orthopedic Resident Interest and Participation in International Health Electives

Interest in global health is growing among residents across several specialties, and efforts to expand these programs abroad have been on the rise. However, whether this interest is shared by orthopedic surgical residents and its demand is met by available international health electives during their orthopedic residency remain unstudied. Expansion of these programs within orthopedic surgery High Disparity Between Orthopedic Resident Interest and Participation in International Health Electives Steven Zhang, Ba; Paul ShultZ, MD; alan DanielS, MD; eDwarD akelMan, MD; roBin n. kaMal, MD Few orthopedic surgical residency programs offer international health electives (IHEs). Efforts to expand these programs have been increasing across medical disciplines. Whether orthopedic residents will participate remains unknown. This study quantified and characterized orthopedic resident interest and barriers to IHEs in US residency programs. A web-based survey was administered to residents from 154 US orthopedic residency programs accredited by the Accreditation Council for Graduate Medical Education 2014 to 2015. Questions assessed demographics and program background, previous medical experience abroad, barriers to participation, and level of interest in participating in an international health elective during their training and beyond. Twenty-seven (17.5%) residency programs responded. Chi-square analysis showed that residents who expressed interest in participating were significantly more likely to have experience abroad compared with those who expressed no interest (P<.004). Analysis using MannWhitney U test suggested that those who expressed interest were more likely to believe IHEs are important to resident training (P<.0011; mean Likert scale score of 3.7 vs 2.6), provide valuable experience (P<.001; mean Likert scale score of 4.2 vs 3.2), and should be required for orthopedic residencies (P<.001; mean Likert scale score of 2.8 vs 1.9). Residents are strongly interested in participating in IHEs during their training, and many may integrate global health into future practices. Residents perceive lack of funding and scheduling flexibility as barriers preventing them from participating. Prior experience abroad influences level of interest, and international clinical experience may enhance future perception of its value. [Orthopedics. 2016; 39(4):e680-e686.] The authors are from Stanford University School of Medicine (SZ), Stanford, California; the Department of Orthopedics (PS), University of Chicago Hospitals, Chicago, Illinois; the Department of Orthopedics (AD, EA), Brown Alpert School of Medicine, Providence, Rhode Island; and the Department of Orthopedics (RNK), Stanford University Hospitals, Redwood City, California. Mr Zhang, Dr Shultz, Dr Akelman, and Dr Kamal have no relevant financial relationships to disclose. Dr Daniels receives personal fees from Stryker, Globus, and DePuy and grants from Orthofix. Correspondence should be addressed to: Robin N. Kamal, MD, Department of Orthopedics, Stanford University Hospitals, 450 Broadway St, MC6342, Redwood City, CA 94603 ([email protected]). Received: December 1, 2015; Accepted: February 8, 2016. doi: 10.3928/01477447-20160419-02