In pediat
ric su
rge
ry, significant diffe
rences in education and p
ractice exist between developed and developing nations. We compa
red the t
raining of senio
r fellows in a Canadian and a Kenyan pediat
ric su
rge
ry t
raining p
rog
ram, and evaluated a fellow exchange between the p
rog
rams.
Methods
The study was performed six years after creation of the exchange program. Areas studied included case volume and distribution, length of training, curriculum, work hours, and an estimate of service to education ratio. Perceived strengths and challenges of the exchange were investigated using questionnaires.
Results
Fellows at each site performed approximately 450 cases/year. Significant differences in case distribution were noted, with plastic surgery, urology and neurosurgery procedures being significantly more frequent in the Kenyan center, and neonatal, minimally invasive, and vascular access procedures being significantly more frequent in the Canadian center. All participants identified educational value in the exchange, although logistical challenges were significant.
Conclusion
Differences exist in the training experiences of pediatric surgical fellows in Canada and Kenya, reflecting the differences in health care environment, education, and surgical practice in the two countries. The exchange program of pediatric surgical fellows tapped into this rich diversity and may be applicable to other medical and surgical specialty training programs.