Global Surgery

Overview

This intensive five-day course, in person, in Oxford, is suitable for those in all disciplines interested in global surgery, anaesthesia and obstetrics. The course comprises presentations, discussions and seminars looking at major topics in global surgery such as burden of disease, health workforce capacity, training, partnership, supplies, service management, research needs, advocacy and ethics, and resource allocation.  There will also be a half-day session on practical preparation for going to work in new contexts alongside local surgical teams.

Traditionally surgery has been taught as a technical and practical specialty; however this short course takes a completely different approach and looks at the provision of surgical services at a global level. The term 'Global Surgery' in this course encompasses all related specialities including obstetrics, gynaecology and anaesthesia/critical care.

The course is run by the Oxford University Global Surgery Group which is linked to the four surgically related departments:

 

 

 

The need for global surgery

The publication of the Lancet Commission on Global Surgery in 2015 highlighted the massive disparity in provision of life saving and life changing surgical services around the world. Recent estimates quoted in the commission report suggest that 5 billion of the world’s 7 billion population do not have access to safe timely surgical treatment near to where people live, and that 150 million more surgical procedures are needed per year if even a barely adequate service is to be provided. 

 

Programme details

This 5-day course will run from Monday 18 September to Friday 22 September 2023- the course will run in Oxford in person.

Schedule

Monday 18 September:

  • Beyond the Lancet Commission on Global Surgery: indicators of surgical, anaesthesia and obstetrics need and activity.
  • Equipping the surgical workforce in an age of rapid communication.

Tuesday, 19 September:

  • The journey to safer surgery: the challenges to effective delivery of surgical and anaesthesia and obstetrics care.
  • Research driving change; the opportunities and the questions to ask.

Wednesday 20 September:

  • The right people for the right job; contextually relevant task shifting.
  • Ethics and advocacy

Thursday 21 September:

  • Resource allocation in healthcare systems.
  • Working together developing cooperative partnerships.

Friday, 22 September:

  • Working in new contexts
  • Course summary

Please note this schedule is subject to change.

Course structure

Pre-course preparation - 10 hours

All participants will be given a list of relevant resources (websites, papers, videos etc). This will be accompanied by a series of questions to enable them to critically evaluate these resources systematically.

35 hours in person teaching.

The subjects are outlined in the schedule above and will include presentations from the course tutors and invited international speakers, interactive seminars, small group study and course work undertaken by the participants.

Assessment - up to 50 hours.

The course may be taken for credit (see Certification below). In this case, formative assessment will occur both during the course and in the post-course online discussions. Summative assessment will involve a 4000 written coursework assignment (essay) given at the end of the course, which will give the participant the opportunity to apply the themes presented on the course to their own working environment.  This will need to be returned by five weeks following the course.

Student feedback

  • 'FANTASTIC! So eye opening and thought provoking and genuinely a life/career changing event.' L. Clifton
  • 'I found the mixture of delegates from 23 countries, and both HICs and LMICs, This was something often no seen in other global surgery conferences I have been to, and it is/has been exceptionally valuable.' Melissa Wood, General Surgery Resident, University of Saskatchewan, Canada.
  • 'I have thoroughly enjoyed the course. It has opened my eyes to endless possibilities within global surgery and beyond.' Oreoluwa Bajomo, CTI Surgery
  • 'This course was highly relevant, not only on academic & intellectual levels, but emotional as well. The curiosity, wisdom, and thoughtful critiques in the room will be long felt. Thank you!' Sadie Bazur-Leidy, MPH. Program Administrator, American College of Surgeons.

Certification

You may apply to take the course either for attendance only or for credit. The University of Oxford Department for Continuing Education offers Credit Accumulation and Transfer Scheme (CATS) points for the course.

Participants attending the taught course and successfully completing assessed assignments are eligible to earn 20 CATS-equivalent points which may be counted towards a postgraduate qualification.

Short course participants who do not wish to undertake the assessed work required for academic credit but who do satisfy the course attendance requirements will receive a certificate of attendance.

Fees

Description Costs
Course Fee £1517.00

Funding

Bursaries

*Please note bursary applications are now closed*

A limited number of bursaries are available from several funding sources. Any applicant may apply for a bursary. Please state on your application form that you wish to be considered for a bursary. Bursaries may cover the cost of the course fees or may include residential costs as well.

For bursary applications, the admissions panel will consider the following criteria on the standard course application form:

A. Applicant’s credentials in global surgery;

  • Strong interest and involvement in global surgery as evidenced by personal statement and CV relevant to their phase of professional formation
  • Must be eligible for course i.e. meet course admissions criteria of sufficient English language skills, and to be academically able to complete the course

B. Applicant’s potential contribution to the course as a whole (e.g. they have experience which would augment that of the others on the course, their country or region, speciality, phase of career).

C. Applicant’s global surgery leadership potential in their own context

D. Overall view of the candidate based on CV and personal statement

Application deadline for bursaries: 30th April.

Once we have received your completed application it will be considered by the admissions panel.

Bursary applicants will be notified by 26th May on the result of their application.

Payment

The course fee includes:

  • Tuition
  • Course materials
  • Access to the following University of Oxford libraries and services:
    • Bodleian Libraries e-Resources
  • Access to online facilities from the Department for Continuing Education, including:
    • The Graduate School
    • Canvas virtual learning environment

Various payment methods available.

Tutors

Professor Ashok Handa

Course Director and Tutor

Ashok Handa is Professor of Vascular surgery and director of teaching in surgery in the Nuffield Department of Surgical Sciences at Oxford University. He was the inaugural Training Programme Director for Vascular Surgery and National Lead for selection in vascular surgery as well as the Deputy Head of the Oxford Postgraduate School of Surgery for 7 years. He is the Graduate Tutor at St Catherine’s College, where he is also Director of the Collaborating Centre for Values based practice in Health and Social Care. His vast experience in medical education, and international collaborations are a huge asset to the Global Surgery group.

Dr Shobhana Nagraj

Course Director and Tutor

Dr Shobhana (Shobi) Nagraj is a Clinical Researcher, with a professional background in paediatric surgery and primary care, and a research background in Health Services Research and Implementation Science.

During her time as a clinician and medical educator, Shobi has worked closely with rural communities and Community Health Care Workers in low-resource settings globally.  She is passionate about delivering high-quality, universal health services to women and children, that meet the needs of the communities and end-users.  Shobi’s research focuses on the use of theory in the design, development and implementation of complex interventions (including mobile technologies) to support the interprofessional education and training of the healthcare workforce in low-resource settings. 

Shobi co-leads the Oxford University Global Surgery Course and is part of the NIHR Global Health Community of Practice on Community Engagement & Involvement.

View Shobhana Nagraj Global Surgery profile

Dr Hilary Edgcombe

Anaesthetic Lead, Member of the Executive Committee and Tutor

Hilary Edgcombe is a consultant anaesthetist at the Oxford University Hospitals NHS Foundation Trust with expertise in delivering both high quality clinical care and training in low-resource settings. With a Masters in Global Health with Global Surgery, clinical and training experience over the last 15 years in several sub-Saharan African countries, and enthusiasm for locally-led innovation, her current research interests include work on the LIFE project with colleagues from the University of Oxford and KEMRI-Wellcome, Kenya, developing mobile training tools for use in resource-poor settings, and the training of different cadres of anaesthesia provider in sub-Saharan Africa. She also directs the internationally recognised Anaesthesia in Developing Countries course, held in Uganda annually.

> View Hilary Edgcombe's Nuffield Department of Clinical Neurosciences profile

Dr Sarah Davidson

Tutor and Student Lead

Sarah Davidson is an anaesthetist with a specialist interest in equitable global access to safe anaesthesia and surgery.  

She was co-founder and past president of GASOC (Global Anaesthetic Surgical and Obstetric Collaboration) and the first and current clinical fellow of the Oxford University Global Surgery Group. Over 10 years her work has included clinical and educational engagements, both short and long term.  These have included working with the Freedom from Fistula Foundation, the Basingstoke Hoima Partnership for Health, SAFE courses, Lifebox teaching and surgical camps for obstetric fistula and for cleft lip. 

Prof Kokila Lakhoo

Surgical Lead and Chair of Executive Committee

Professor Kokila Lakhoo is a paediatric surgeon at the Children’s Hospital in Oxford and the Nuffield Department of Surgical Sciences, University of Oxford, with research interests in global surgery, fetal counselling, neonatal necrotising enterocolitis surgery and paediatric thoracic surgery. She is chair of the international forum for the British Association of Paediatric Surgeons and is personally developing paediatric surgery through a link in Tanzania. She is the director of Global Initiative for Children’s Surgery (GICS) that has followed on from the Lancet Commission on Global Surgery. She is editor of four books, including a recent joint venture with her African colleagues as editor to a text book namely ‘Paediatric Surgery: a comprehensive text for Africa’. She has to date contributed to 70 chapters to paediatric surgical text books and has over 300 peer reviewed publications.

> View Kokila Lakhoo's Nuffield Department of Surgical Sciences profile

Prof Christopher Lavy

Trauma and Orthopaedics Lead and Member of Executive Committee

Chris Lavy is Professor of Orthopaedic and Tropical Surgery and Consultant Orthopaedic and Spine Surgeon at the University of Oxford.

In 1996-2006 he worked in Malawi, where he helped to set up two orthopaedic hospitals, national orthopaedic surgical and clinical officer training, and an international clubfoot programme. He helped set up the College of Surgeons of East Central and Southern Africa (COSECSA), which now has 14 member countries.

He is a commissioner for the milestone report Lancet Commission on Global Surgery 2015, and he has led several DFID-funded health partnership projects linking University of Oxford with COSECSA and other partners in Africa, to develop training and research partnerships in primary trauma care, clubfoot treatment, and orthopaedic surgery. He is a principal investigator for SURG-Africa, an EU Horizon 2020 project, focusing on improving district-level surgical care, and he is currently setting up a children’s orthopaedic unit in Zimbabwe.

Professor Lavy was awarded an OBE in the New Year Honours List 2007 for services to orthopaedics.

> View Professor Lavy's NDORMS profile

Dr Anita Makins

Obstetrics and Gynaecology Lead & Member of Executive Committee

Dr Anita Makins is a fellow of the Royal College of Obstetricians & Gynaecologists and has a Masters in Public Health in Developing Countries.  She is a Consultant at the Oxford University Hospitals Trust and Honorary Senior Lecturer in Global Women’s Health at the Nuffield Department of Women’s and Reproductive Health at Oxford University.

She has extensive experience in Sub-Saharan Africa and is currently Director of the PPIUD Initiative at FIGO (the International Federation of Obstetricians & Gynecologists), a multimillion dollar project running for 6 years across 6 countries in Africa and South East Asia.

Grace Drury

Faculty

Grace Drury is a Programme Manager in the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, where she manages several health partnerships supporting surgical training and research in sub-Saharan Africa. She provided research management support for University of Oxford for SURG-Africa, a EU Horizon 2020 project focusing on strengthening surgical care in district hospitals in Zambia, Malawi and Tanzania.  

She was project manager for a THET Africa Grants Programme 2020 grant to develop training materials for management of delayed presenting clubfoot in Ethiopia. This followed on from the Africa Clubfoot Training project, where Grace co-authored and coordinated the development of standardised clubfoot provider training materials and instructor training materials.

She holds a MA Oxf degree in English Language & Literature from Wadham College, Oxford, and a MA degree in Development and Emergency Practice from Oxford Brookes University.

Dr Fungai Dengu

Tutor

I am a General Surgery Registrar in Oxford currently undertaking a period as a Clinical Research Fellow working towards a DPhil. My undergraduate medical training was at the University of Edinburgh, where I also completed an intercalated BMedSci (Hons) degree (Neurosciences) and my research was focused on the neurocircuitry of learning and memory. After my Foundation training in Edinburgh, I went on to complete my Core Surgical Training in London at Kings College Hospital and the Royal Free Hospital before being appointed as a Specialist Registrar on the Oxford (Thames Valley) Higher Surgical Training (HST) programme. I have a keen clinical interest in multi-organ transplant surgery and complex vascular access surgery as well as applications of novel technology in access and transplant surgery. I am a surgical tutor for undergraduates at the University of Oxford and a member of the Oxford Global Surgery Group with a particular interest in surgical system strengthening and surgical innovation in LMICs. My DPhil research focuses on exploring the use of normothermic machine perfusion (NMP) technology as a platform for organ immunomodulation and reconditioning. With particular emphasis on the potential of delivering novel cell therapies during NMP.

Fungai Dengu — Nuffield Department of Surgical Sciences (ox.ac.uk)

 

Dr Anant Jani

Tutor

Anant is a Research Associate at Somerville College, University of Oxford.  He currently works on understanding how we can improve population health through social prescriptions and by addressing social determinants of health. Prior to his position at the University of Oxford, Anant worked in Europe and the Middle East to help healthcare systems within these countries to focus more on value-based healthcare. Anant has a PhD in immunology from Yale University.

Mr Dennis Mazingi

Tutor

Dennis Mazingi is a clinical researcher and general surgeon from Zimbabwe. He obtained his undergraduate medical degree at the University of Malawi, College of Medicine and an MMed in General Surgery at the University of Zimbabwe, College of Health Sciences  He holds a first-class degree in International Health and Tropical Medicine (IHTM) from Oxford University and is currently a DPhil candidate in the Nuffield department of surgical sciences.

He is passionate about paediatric and adult general surgery, trauma and health systems research and has a keen interest in putting research into practice through engaging policy-makers and public engagement. His current research focuses on developing nascent trauma systems in Africa.

Mr Noel Peter

Tutor

Mr Noel Peter is a Consultant in Trauma and Orthopaedics, and Senior Clinical Lecturer in Global Surgery at the Nuffield Department of Surgical Sciences at the University of Oxford. He is also Associate Director for Medical Education (ADME) at at the Trust. He is also part of the Peer Support Network and an active member of the Diversity Network at his Trust. On completion of his surgical training in Oxford, he went on to pursue a highly acclaimed accredited Australian Orthopaedic Association (AOA) specialist fellowship in minimal access surgery and joint arthroplasty in upper limb, including hand and micro-vascular surgery. Following successful completion of these internationally renowned fellowships, he took on a role as Consultant in Trauma and Upper Limb Surgery at the Princess Alexandra Hospital, Brisbane (Australia) before returning home to the UK.

 

Noel is also the founding president of the Global Anaesthesia, Surgery and Obstetric Collaboration (GASOC) which is the largest postgraduate society for junior doctors involved in global health partnerships and projects in the UK. Noel is currently the Co-Chief Investigator on the COVID Paeds Cancer study involving more than 800 collaborators from a 46 different countries across the world investigating the impact of the COVID-19 pandemic on paediatric cancer outcomes. He is a member of the European Alliance for Artificial Intelligence and regularly lecturers on the role technology plays in bringing equity to surgical care globally.

Noel has been involved in global health projects over the last 11 years, where he has been involved in collaborative partnership to improve surgical training in a number of low-and-middle income countries, particularly in the area of Major Trauma care. His research passion revolves around health care system and policy framework implementation with a focus on non-communicable diseases. He is passionate about medical education, and has previously served as a Clinical Teaching Associate (CTA) at St John’s College, University at Oxford and recipient of numerous Trainer of the Year (TOT) awards by the Medical division. In his role as ADME rowl at GHNHSFT, he now leads on delivering the highest standards of postgraduate medical education and development for trainees at the Trust across all medical and surgical specialties.

Noel was part of the team that delivered the COSECSA-Oxford-Orthopaedic Link (COOL) project which was funded by the Department of International Development (DFID) through the Health Partnership Scheme. His work on improving trauma training in low and middle income countries through equitable partnerships has been published in a number of peer-reviewed journals, including the Lancet and BMJ. Over the course of his career, he has held leadership positions in various national and international societies and is involved in research and training partnerships with a number of surgical and academic units in Australia, Rwanda, Uganda and Malaysia. Noel’s involvement in mixed method research in trauma care lead to his appointment as a visiting clinical lecturer at the University of Queensland, Australia, and a Senior Clinical Lecturer at the NDS, Oxford.

Mr Tony Jefferis

Tutor

Tony Jefferis was an ENT Surgeon is East Berkshire between 1985- 2011 after training in Cambridge and London. He was Head of the Oxford School of Surgery 2007-2012 and Deputy PG Dean in Oxford till 2015. Since leaving paid work he teaches on the Education Module for the Oxford MSc in Surgical Science and Practice and works with the Oxford Global Surgery Group. His current overseas involvement is in Sub Saharan Africa and the Middle East.

Dr Faraja Chiwenga

Guest Speaker

Head of Research, Muhimbili University (MUHAS) Tanzania, also working in Endocrinology and Diabetes unit.

Dr Lars Hagander

Guest Speaker

Dr. Hagander is senior consultant paediatric surgeon in Lund, Sweden. He is associate professor in Paediatric surgery and Public health at Lund University and leads the WHO collaborating centre for surgery and public health. Hagander was a global surgery research fellow at Harvard Medical School, and one of the co-chairs of the Lancet commission on global surgery.

Dr Hazel Mumphansha Sonkwe

Guest Speaker

President of Zambia Society of Anaesthesiologists, Trustee of Global Anaesthesia Development Program, Clinical Lecturer and Researcher, University of Zambia

Dr Godfrey Sama Philipo

Guest Speaker

Medical Doctor and Clinical Research Co-ordinator (MUHAS – UCSF Cancer Collaboration), Board of Trustees Member (InciSioN), Tanzania.

Dr Rafael Pinedo-Villanueva

Guest Speaker

Dr Pinedo-Villanueva is Associate Professor and Senior Researcher in Health Economics at the Centre for Statistics in Medicine, University of Oxford. He trained in Economics and Political Science (Michigan), Public Policy (Venezuela), and Health Economics (York, Southampton), and worked for the United Nations Population Fund and United Nations Development Programme before moving full time into academia. He leads the Health Economics and Outcomes Research group, with a portfolio of research projects mainly focused on the use of routinely-collected data for economic analyses of musculoskeletal diseases and interventions in the UK and abroad. His main research interests are understanding the natural history of diseases and assessing healthcare interventions to help healthcare systems make better decisions. Dr Pinedo-Villanueva is a member of the Global Burden of Disease collaborator network.

> View Dr Pinedo-Villanueva's NDORMS profile

> View Dr Pinedo-Villanueva's NDORMS profile

Dr John Sekabira

Guest Speaker

Consultant Paediatric Surgeon and Head of Paediatric Surgery at Mulago Hospital, Uganda. Founding member of COSECSO

Dr Kusum Thapa

Guest Speaker

Kusum Thapa is an Obstetrician and Gynaecologist with a Masters in Public Health. She is a Fellow of the Royal College of Obstetrician and Gynaecologist (UK). At present she is working as a Senior Maternal Health Advisor for MCSP (USAID Flagship Program)/Jhpiego. She has been actively involved in providing leadership and technical guidance in the development and implementation of Maternal Newborn Health interventions both at the global and country level particularly in Asia and Africa. Has been involved in policy decision for task shifting to increase access to MNCH Services including quality surgical care and thus help catalyze change in surgical care through investment in leadership development and capacity enhancement.

Member of the WHO Technical working group for MPDSR(Maternal and Perinatal Death Surveillance and Response). Led UNFPA’s Nepal Program in the development of Competency based training Manuals for Obstetric Fistula and Pelvic Organ Prolapse and National Guideline and Protocol and training package for Frontline’s Health workers response to Gender Based Violence and training providers in these areas.

Served as a National Coordinator for Figo/NESOG, PPFP/PPIUD Program in Nepal and President of the Society of Obstetrician and Gynecologist Nepal (2017-2019). Current Vice President of SAFOG (South Asian Federation of Obstetrics and Gynecologist).

Passion is to continue to dedicate both personal and professional life to reducing preventable deaths of women and newborns, advancing the cause of women and children globally and finding sustainable and long-term solutions to make a difference in people’s lives.

Teaching methods

The course is run by the Oxford University Global Surgery Group which is linked to the four surgically related departments:

  • Nuffield Department of Surgical Sciences (NDS)
  • Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, (NDORMS)
  • Nuffield Department of Clinical Neurosciences (NDCN)
  • Nuffield Department of Women’s and Reproductive Health (NDWRH)

Joint Course Leads

  • Dr Shobhana Nagraj, Senior Clinical Lecturer in Global Surgery, NDS & Clinical Researcher, Oxford Centre for Global Health Research, NDM
  • Kokila Lakhoo, Associate Professor, NDS
  • Chris Lavy, Professor of Orthopaedic and Tropical Surgery, NDORMS

Learning outcomes

By the end of the course the participant will be expected to:

  • Demonstrate systematic understanding of the factors influencing the availability and practice of surgical care in low and middle income countries (LMICs).
  • Explain the scope and complex interactions of medical and non-medical factors and institutions in supporting surgical services in LMICs.
  • Critically evaluate surgical research in LMICs and suggest new lines of enquiry.
  • Design a contextually relevant approach to improving surgical services in their own LMIC or one where they may have responsibility or interest.

Assessment methods

For those taking the course for credit, formative assessment (non-assessed) will occur both during the course and in the post-course online discussions.

In addition, summative assessment (assessed) will involve a 4000 word written coursework assignment (essay). Only those who are taking the course for credit need to complete the assignment.

The assignment will be set during the course, with a choice of assignment questions which will give the participant the opportunity to apply the themes presented on the course to their own working environment. 

The assignment will need to be submitted online after the course. Submission date: to be confirmed.

Application

This course requires you to complete the online application form (please press the 'Apply' button) and include a copy of your CV as an attachment.

There are two options for this course: you can apply to take this taught course either for attendance only, or for academic credit.

If you are applying to take this course for academic credit, you will also need to complete the reference section of the application form, and input the email address of your referee. Upon successfully submitting the application an email will be sent to your referee asking them to provide a reference in support your application for the course.

Please note that if you are not applying to take the course for academic credit then you do not need to submit a reference.

(N.B if you initially apply to take the course for attendance only, and later wish to request to take the course for academic credit instead, this may be possible, but you will need to contact us with this request and submit the necessary academic references in support of this by 15 August to allow time for this request to be reviewed.)

Applications deadline: 30th May.

There are a limited number of spaces available on this course. Applications will be reviewed by the admissions panel on a rolling basis and spaces filled on a first come first served basis, so we strongly recommend applying early. 

Selection criteria

The course is aimed at medical personnel with an interest in Global Surgery, Anaesthesia and Obstetrics. This includes qualified surgeons anaesthetists and obstetricians/gynaecologists and those in training including senior medical students. The course should also be suitable for allied health care professions linked to Global Surgery. 

The academic level of the course will be set at a Masters equivalent (national level 7).

IT requirements

This course uses an online assignment submission system and online courseware. In order to participate in the course, and to prepare and submit course assignments, participants will need access to the internet and a computer meeting our recommended minimum computer specification