Motivations and impact of international rotations in low- and middle-income countries for orthopaedic surgery residents: Are we on the same page?

Am J Surg. 2021 Feb;221(2):245-253. doi: 10.1016/j.amjsurg.2020.08.046. Epub 2020 Sep 12.


Background: Despite interest among North American orthopaedic residents to pursue rotations in resource-limited settings, little is known regarding resident motivations and impact on host surgeons.

Methods: Surveys were distributed to North American orthopaedic surgeons and trainees who participated in international rotations during residency to assess motivations for participation and to orthopaedic surgeons at partnering low- and middle-income country (LMIC) institutions to assess impact of visiting trainees.

Results: Responses were received from 136 North American resident rotators and 51 LMIC host surgeons and trainees. North American respondents were motivated by a desire to increase surgical capacity at the LMIC while host surgeons reported a greater impact from learning from residents than on surgical capacity. Negative aspects reported by hosts included selfishness, lack of reciprocity, racial discrimination, competition for surgical experience, and resource burdens.

Conclusions: The motivations and impact of orthopaedic resident rotations in LMICs need to be aligned. Host perceptions and bidirectional educational exchange should be incorporated into partnership guidelines.

Keywords: Education; Global surgery; International rotation; Low- and middle-income country; Orthopaedic residency.

MeSH terms

  • Adult
  • Developing Countries
  • Female
  • Humans
  • International Cooperation*
  • Internship and Residency / organization & administration*
  • Internship and Residency / statistics & numerical data
  • Male
  • Middle Aged
  • Motivation*
  • North America
  • Orthopedic Procedures / education
  • Orthopedics / education*
  • Orthopedics / statistics & numerical data
  • Surgeons / psychology*
  • Surgeons / statistics & numerical data
  • Surveys and Questionnaires