The first six years of the APSA Travel Fellowship Program: Impact and lessons learned

Introduction: The American Pediatric Surgical Association (APSA) travel fellowship was established in 2013 to allow pediatric surgeons from low-and middle-income countries to attend the APSA annual meeting. Travel fellows also participated in various clinical and didactic learning experiences during their stay in North America. Methods: Previous travel fellows completed a survey regarding their motivations for participation in the program, its impact on their practice in their home countries, and suggestions for improvement of the fellowship. Results: Eleven surgeons participated in the travel fellowship and attended the annual APSA meetings in 2013-2018. The response rate for survey completion was 100%. Fellows originated from 9 countries and 3 continents and most fellows worked in government practice (n = 8, 73%). Nine fellows (82%) spent N3 weeks participating in additional learning activities such as courses and clinical observerships. The most common reasons for participation were networking (n =11, 100%), learning different ways of providing care (n =10, 90.9%), new procedural techniques (n = 9, 81.8%), exposure to a different medical culture (n =10, 90.9%), and engaging in research (n = 8, 72.7%). Most of the fellows participated in a structured course: colorectal (n = 6, 55%), laparoscopy (n = 2, 18%), oncology (n = 2, 18%), leadership skills (n =1, 9%), and safety and quality initiatives (n =1, 9%). Many fellows participated in focused clinical mentorships: general pediatric surgery (n = 9, 82%), oncology (n = 5, 45%), colorectal (n = 3, 27%), neonatal care (n = 2, 18%) and laparoscopy (n = 2, 18%). Upon return to their countries, fellows reported that they were able to improve a system within their hospital (n = 7, 63%), expand their research efforts (n = 6, 54%), or implement a quality improvement initiative (n = 6, 54%). Conclusions: The APSA travel fellowship is a valuable resource for pediatric surgeons in low-and middle-income countries. After completion of these travel fellowships, the majority of these fellows have implemented important changes in their hospital's health systems, including research and quality initiatives, to improve pediatric surgical care in their home countries. Level of evidence: This is not a clinical study. Therefore, the table that lists levels of evidence for "treatment study", "prognosis study", "study of diagnostic test" and "cost effectiveness study" does not apply to this paper.(c) 2020 Elsevier Inc. All rights reserved.