I first traveled to Ethiopia in December, 2012, with Dr. Senait Fisseha, the Director of the Center for Reproductive Medicine at the University of Michigan. I worked with surgeons at the St. Paul's Hospital Millennium Medical College in Addis Ababa. They were planning on starting a surgical residency program in September, 2013, and wanted assistance with developing their training program and planning an educational curriculum.
I spent a week in Addis getting to know the surgeons and the hospital. We discussed the surgical training program at the University of Michigan and I described aspects that are common to most Western residency programs and those that were specific to the University of Michigan. I also shared a number of online resources, including the COACH program from Columbia University and the American Board of Surgery's SCORE curriculum.
I returned to Addis Ababa in December, 2013, with Dr. Fisseha, as well as one of our surgical trainees, Terry Shih, and the OR service leads for Minimally Invasive Surgery and Gynecology Rochelle Crow and Pat Wojno. Terry and I taught a course in laparoscopic surgery that included didactics, as well as technical skills training in the St. Paul's Simulation Center, and operative laparoscopic cases, mostly cholecystectomy. Our service leads did an incredible job of training the OR nurses and technicians on safe use of the laparoscopic equipment. The St. Paul's OR staff went from requiring close supervision for every step of the case on day 1 to independent functioning by day 4. We also shared some OR safety techniques, including the robust timeout and checklists, with the OR staff and surgeons, who initiated these steps independently by the end of our stay. These visits and scholarly exchanges will hopefully open the door to joint research projects between their trainees and ours in the future. - Jonathan F. Finks, M.D., Assistant Professor of Surgery, Division of minimally invasive surgery
I spent two weeks at St. Paul's Hospital Millennial Medical College in Addis Ababa, Ethiopia in December of 2013. The first week, I was part of a larger team that familiarized the St. Paul's surgeons and OR nurses with laparoscopic surgery. The second week, I functioned as a visiting resident on their general surgery and urology services. The exposure to disease processes in Ethiopia was amazing. Patients often delay seeking care until their disease is very advanced. I was exposed to patients with large, invading cancers (breast and gastric) as well as simple goiters for thyroid disease we do not see a lot of in the United States. Even with common problems, the exposure to different methods of treating these patients was very educational. For example, common bile duct stones that are often treated endoscopically with ERCP in our hospital are treated surgically with common bile duct explorations. It was a great experience learning how to operate and treat surgical disease with limited resources. The surgical faculty and residents at St. Paul's were incredibly welcoming. We worked together to help the residents at St. Paul's start tracking outcomes and initiate quality improvement projects. Hopefully, we will continue to work together on this in the future. - Terry Shih, M.D., PGY4 Surgery Resident