Impact of Acute Care Surgery Service on Acute Cholecystitis Management and Outcomes at a Single Canadian Academic Network

Introduction. Surgery has recently gained a prime position on the global health agenda. However, the global surgery community remains fragmented. We sought to map the Global Surgery Offices (GSOs) in Canada and evaluate the scope of their initiatives.Methods. This is a scoping review of all Canadian GSOs. They were identified through the Canadian Association of General Surgeons and by word of mouth. Surveys were conducted electronically and by phone interviews.Results. A total of seven academic institutions have known GSOs. Six out of seven responded. These GSOs span across five provinces and include six universities: Dalhousie, McGill, McMaster, University of Calgary, University of Alberta and University of British Columbia. Low and middle income countries (LMICs) with involvement included Africa (5/6), Americas (4/6), Eastern Europe (1/6) and Asia (1/6). Most GSOs have multiple partners: governmental organizations (2/6); non-governmental organizations (5/6); private institutions (3/6). Only two have formal partnerships between one another. All offer training in international surgery to Canadian residents and most to Canadian medical students (5/6). Only Half (3/6) offer training to LMIC trainees. Whereas one GSO provides surgical support only, others provide data collection (3/6) and quality improvement initiatives (5/6). All benefit from financial support from their Department of Surgery/Anesthesia, two from private funding and only one from grants and fundraising activities. Conclusion. Despite a unifying commitment to improve surgical care in LMICs, GSO in Canada mostly operate independently of one another. We propose to build an epistemic community of Canadian surgeons involved in global health: the u201cCanadian Global Surgery Initiative.u201d This community could function as a flexible governance structure by providing a platform for networking, sharing of ideas, coordinating initiatives, building research-capacity and obtaining political support and sustainable funding. To ensure a more effective collective action, an additional effort should be made to include all surgical specialties.

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