The Gap in Operative Exposure in Trauma Surgery: Quantifying the Benefits of an International Rotation

Background: International rotations with hands-on experience are commonly cited as a potential supplement to the current experience of surgical trainees in trauma, however, quantification of this experience remains unclear. Methods: A link to an online survey was distributed by electronic mail to physicians who rotated for any period of time at the Trauma Unit of the Groote-Shuur Hospital of the University of Cape Town from 1/1/2006 to 12/2016. Results: Of 160 participants, 75 (47%) completed the survey. A high proportion (45%) had performed less than 25 trauma-related surgical procedures during their previous training. The majority (56%) performed ≥10 trauma laparotomies and sternotomies/thoracotomies during their rotation, while 43% performed ≥5 vascular procedures. The level of perceived confidence in managing trauma patients increased significantly from a median of 3/10 to 7/10 (p<0.05). Conclusion: Rotations at large-volume trauma centers abroad offer the opportunity for a hands on operative experience and may enhance the confidence of surgical trainees. Further standardization of these opportunities may result in a larger scale participation of graduate residents and fellows