Global Health Survey
1) Is your program:
a. Integrated b. Independent c. Both
2) How many residents (integrated +/-‐independent) are taken per year?
a. 1 b. 2 c. 3 d. 4 e. 5 f. 6 g. 7
3) Please choose your program location by region.
a. Northeast (Connecticut, District of Columbia, Maine, Massachusetts, New Hampshire, New Jersey, Maryland, New York, Pennsylvania, Rhode Island, Vermont)
b. Southern (Alabama, Arkansas, Florida, Delaware, Georgia, Mississippi, Kentucky, Louisiana, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, West Virginia)
c. Central (Kansas, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin)
d. Western (Arizona, California, Colorado, Idaho, Montana, Wyoming, Hawaii, Nevada, New Mexico, Oregon, Utah, Washington, Alaska)
4) Is a global health experience recognized as an official part of your curriculum?
a. Yes. (Will be redirected to question 5 and sub questions) b. No. (Will be redirected to question 6 and sub questions)
5) Please answer the following questions
a. How would you best classify this experience (Select all that apply)?
i. Educational ii. Research iii. Clinical Care iv. Charity
b. How have you established this connection (Select all that apply)?
i. Memorandum of Understanding ii. Personal Reference
iii. Regular follow up
c. How long have you had this connection (years)?
i. 1-‐2 ii. 3-‐4 iii. 5-‐6 iv. 7-‐10
v. 11-‐15 vi. >15
d. In the last trip, which of the following conditions/procedures were encountered by residents (select all the apply)
i. Cleft lip/palate
ii. Breast reconstruction
iii. Post-‐traumatic reconstruction
iv. Tumor extirpation and reconstruction v. Ear reconstruction
vi. Thermal injury vii. Carpal Tunnel viii. Congenital Hand
ix. Cosmetic surgery x. Orthognathic Surgery xi. Cranial vault
xii. Vascular malformation
e. Please select your dominant funding sources (select all that apply) i. University
ii. Section/Division/Department iii. Faculty Personal expenditures iv. Non-‐profit/charitable organizations
f. Are you supportive of this experience?
i. Yes ii. No
g. (For No) Why not?
i. Too expensive
ii. Too difficult to coordinate iii. Too little educational value iv. Too many risks
v. Cases do not count towards PSL
h. (For Yes) Why do you encourage this experience? (select all that apply)
i. Key component of surgical education ii. Foster exposure to different health systems iii. Residency recruitment tool
iv. Faculty recruitment tool
v. Fund Raising and Public Relations
vi. Prepare residents for a career in global health
i. Please choose the geographic locations by region to where residents have travelled? (Select all that apply)
i. Asia
ii. Middle East, North Africa, and Greater Arabia iii. Europe
iv. North America
v. Central America and the Caribbean vi. South America
vii. Sub-‐Saharan Africa viii. Australia and Oceania
j. Does your institution provide the following for faculty traveling abroad? (Select all the apply)
i. Malpractice coverage ii. Health coverage iii. Medical Evacuation iv. Disability
v. Salary
vi. None of the above
k. Does your institution provide the following for residents traveling abroad? (Select all that apply)
i. Malpractice coverage ii. Health coverage iii. Medical Evacuation iv. Disability
v. Salary
vi. None of the above
l. Have you applied to have cases performed abroad count towards PSOL?
i. Yes ii. No
1. Are you considering applying?
a. Yes b. No
6) Currently, why is a global health experience unavailable as an official part of your curriculum? (Please all correct answers)
a. At home clinical responsibilities preclude global health (lack of coverage)
b. Lack of salary support (for residents and/or faculty) c. Lack of funding for trip expenses (travel, supplies, etc.) d. Lack of resident interest
e. Risks (malpractice, injury, health, geopolitical, etc.) f. Lack of accreditation for cases performed abroad
g. Global health is inconsistent with our program’s training philosophy for residents
