Global Surgery

Overview

This intensive five-day course 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, manpower issues, 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:

 

 

Apply by 6 May 2021 to be considered for a bursary.

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 online course will run from Monday 13 September to Friday 17 September 2021.

Schedule

Monday 13 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, 14 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 15 September:

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

Thursday 16 September:

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

Friday, 17 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.

Online taught course - 35 hours

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.

Moderated asynchronous online teaching - 20 hours

The topics of the 8 timetabled sessions on the programme will be further explored via an asynchronous online discussion managed through the course VLE (Virtual Learning Environment). These will be moderated by an assigned tutor and will continue to be available after the course.

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
2021 Course Fee £1350.00

Funding

Bursaries

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: 16 May 2021. Once we have received your completed application it will be considered by the admissions panel.

Bursary applicants will be notified by 21 June 2021 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 of Continuing Education, including:
    • The Graduate School
    • Canvas virtual learning environment

Various payment methods available.

Tutors

Sarah Davidson

I am an anaesthetist and the Oxford University Global Surgery Group Clinical Fellow. I have been involved in global health for around 10 years with individual lecture trips, clinical work as part of the Basingstoke Hoima Partnership for Health and clinical teaching and service provision for surgical camps in Uganda, Malawi and Sierra Leone. More recently I spent around 8 months working with the group Freedom from fistula in both Sierra Leone and Malawi working on obstetric fistula and emergency obstetric surgery as well as Lifebox teaching, clinical governance and theatre development projects. In the UK I am immediate past president of GASOC (Global Anaesthetic Surgical and Obstetric Collaboration) a group supporting sub-consultant grade engagement in global surgery.

Mr Fungai Dengu

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.

> View Fungai Dengu's Nuffield Department of Surgical Sciences profile

Dr Hosnieh Djafari-Marbini

Hosnieh is a consultant anaesthetist at the Oxford University Hospitals NHS Foundation Trust with expertise in delivering high quality clinical care and improving healthcare delivery to marginalised groups, in particular asylum seekers.

Hosnieh’s fifteen-year career in the NHS, and low income countries has been heavily focused on communication, partnership-working and education. This has included initiating and organising education series for many institutions including University of Oxford and Malawi School of Anaesthesia, and strategic planning with the Oxford University Global Surgery group and Asylum Welcome.

In her spare time Hosnieh is a City Councillor and campaigns to create a greater platform for addressing inequalities in Oxfordshire.

Dr Hilary Edgcombe

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 Anant Jani

Anant is an honorary research fellow in the Value Based Healthcare Programme in the Department of Primary Health Care Sciences at the University of Oxford. He is interested in understanding how we can improve population health through social prescriptions and by addressing social determinants of health. Given the negative impact of severe heat on morbidity and mortality, he sees access to cooling (both passive and active) as a social determinant of health and cooling as a potential healthcare intervention.

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 Tony Jefferis

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.

Miss Roba Khundkar

Roba Khundkar is a Consultant Plastic and Reconstructive Surgeon and Senior Clinical Lecturer in Global Surgery.  After graduating from Oxford University, she completed her core and higher surgical training in the Southwest and Oxford Deaneries respectively. She has undertaken additional fellowship training in Oxford, India and Japan in Sarcoma, Limb Reconstruction, Microsurgery and Super-microsurgery.  She has a specialist interest in sarcoma epidemiology and management.

Having been actively engaged in medical education all throughout her career Roba is currently an Associate Oxford University Medical Education Fellow and has been involved in setting up regional educational networks and national Medical Education Conferences.

As a founding member of the Global Anaesthesia, Surgical and Obstetric Collaboration (GASOC), she served as Secretary to the committee.  She is a Senior Clinical Lecturer in Global Surgery in the Nuffield Department of Surgical Sciences at the University of Oxford with a special interest in supporting surgical training  programmes in LMICs.  She is involved with research and training collaborations with surgical and academic units in Tanzania, South Sudan, the Middle East, Egypt and Bangladesh.   She is currently involved in surgical care in active conflict zones and displaced populations.

As a core faculty member of the Oxford University Global Surgery Group, she is involved in the group's research, educational and advocacy work. She leads the undergraduate programme for Oxford medical students in Global Surgery and is a research supervisor to both medical students and Academic Foundation Programme Trainees.  

Prof Kokila Lakhoo

Course Director

Kokila Lakhoo is consultant 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

Course Director

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

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.

Dr Shobhana Nagraj

Shobi completed a degree in medical anthropology before training as a surgeon, specialising in paediatric surgery.  After working for a few months in Malawi, she experienced first-hand the importance of the social determinants of health, and the need for robust health systems. Shobi returned to the UK to re-train as an academic primary care physician, conducting health services research at the University of Cambridge, where she completed her MPhil in Primary Care Research Methods. 

During Shobi's time as a clinician and medical educator, she has worked closely with rural communities and community healthcare workers in low resource-settings in India and Malawi, and is passionate about providing high quality, evidence-based care to rural populations.  

Shobi is currently pursuing her DPhil, involving the use of technology in low resource settings, at Oxford University. Her research interests include global maternal child health, innovative technology, community health workers, and medical education. 

Mr Noel Peter

Mr Noel Peter, BMedSci(Hons) BMBS DipSportsMed(UK) FRCS (Tr & Orth)

Consultant in Trauma and Upper Limb Surgery

Noel Peter is a Consultant in Trauma and Upper Limb Surgery and Major Trauma Lead at Gloucestershire Hospitals NHS Foundation Trust. He is a specialist upper limb surgeon who has been trained in internationally renowned surgical centres in the UK and Australia with an exclusive interest in hand, wrist, elbow and shoulder surgery. He is an expert in conservative and surgical management of problems affecting the upper limb. He is the seminar lead for Oxford University Global Surgery Group and one of the core faculty for the Oxford Global Surgery accredited short course. He is an Honorary Research Associate at the Nuffield Department for Orthopaedics, Rheumatology and Musculoskeletal Sciences at University of Oxford, and co-founder and past president of the Global Anaesthesia Surgery and Obstetric Collaborative (GASOC).

Dr Rafael Pinedo-Villanueva

Dr Pinedo-Villanueva is a University Research Lecturer 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

Mr Jim Turner

Jim Turner is a Consultant Paediatric Orthopaedic Surgeon at Bristol Children’s Hospital, and an Honorary Clinical Research Fellow of NDORMS, University of Oxford.

After graduating from University of Edinburgh, Jim was awarded a commission with the British Army and served in the 2003 Iraq war as a Regimental Medical Officer of the Parachute Regiment. This experience was instrumental in him developing a passion for humanitarian healthcare and gaining a post-graduate qualification in medical care for catastrophes. During his orthopaedic training, he spent time working in a rural south African mission hospital, performed free surgery camps in India, and completed paediatric orthopaedic fellowships at Beit CURE International Hospital Malawi and the Hospital for Sick Kids, Toronto. Jim has also worked as a clinical advisor with the World Health Organisation to develop global trauma guidelines. He returned at the end of 2017 from an 18 month stint working as a surgeon in CURE Ethiopia Children’s Hospital, and then worked as a Consultant Paediatric Orthopaedic Surgeon in Oxford University Hospitals NHS Foundation Trust and a Clinical Research Fellow in Global Surgery at NDORMS, University of Oxford from 2017-2018.

> View Jim Turner's NDORMS profile

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

  • 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. Provisional date: Friday 29 October 2021

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 2021 to allow time for this request to be reviewed.)

Applications deadline: 15 August 2021.

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