Global Surgery Program Aims to Improve Global Surgical Care through Education, Research, and Innovation

The MUSC Department of Surgery recently announced the launch of a new Global Surgery Program led by Mike M. Mallah, M.D., a trauma surgeon with an extensive background in global surgery. Dr. Mallah has operated on five continents, traveled to 45 countries, and was an international healthcare consultant at McKinsey & Company. He worked with the C-suite of multiple institutions and government health ministers to solve complex global healthcare problems. 

According to Dr. Mallah, each country he operated in has provided an opportunity to build on an idea or process that can be incorporated into how things are done in other areas. He explains a benefit of a robust global surgery program is to take a concept that works in one geography, refine that model, and apply it to other geographies to improve patient care or answer an unmet need.

Dr. Mallah says the field of global surgery at academic medical centers is relatively new. Although there are academic medical centers that currently have international surgery programs, their approach tends to skew towards an academic research focus or a service-oriented clinical focus. He hopes to differentiate the MUSC Global Surgery Program by focusing on a truly bidirectional combination of research and clinical work via an exchange program of faculty, trainees, and staff. 

He describes his vision as a beautiful, seemingly free flow of people, ideas, and techniques across geographies, with MUSC serving as the hub, the heartbeat of global surgery. The program’s infrastructure will include a research component, an educational component, and a partnership with international institutions. It builds on a previous MUSC global rotation at Mbingo Baptist Hospital in Cameroon, West Africa, led by James Brown, M.D., a College of Medicine graduate.  

Dr. Mallah was awarded a pilot grant from the MUSC Center for Global Health. The grant funds critical research to study and address the gap between low- and middle-income (LMIC) and high-income countries (HIC) surgical residency training programs through the development of a free, universal but adaptable surgical resident case log system applicable to LMIC. 

The study’s results will be used to identify differences between LMIC and HIC surgical training. Such an understanding would help identify mutually beneficial, bidirectional, and evidence-based educational opportunities for resident exchange programs.

“This will not only help improve healthcare delivery in LMICs, but it will make our surgeons better,” he says. The pilot study also leverages existing data through a partnership with the Pan African Academy of Christian Surgeons, which offers surgical training programs approved and accredited through The College of Surgeons of East, Central, and Southern Africa. 

The first trip will be to Kenya in February, where an international conference is taking place that will host members and trainees from hospitals across Sub-Saharan Africa. He and his team will be able to meet with residents and program directors from various hospitals in Tanzania, Gabon, Ethiopia, Niger, Egypt, Madagascar, Malawi, and Cameroon, conduct interviews and gather data to help demonstrate a gap between LMIC and HIC training programs. His team consists of Dr. Edgar Rodas, Virginia Commonwealth University; Dr. C. Sierra Stingl, a surgical resident at Stanford University; Benjamin Cassidy, a medical student at VCU, who are authors on the grant application; and a cohort from MUSC. 

“Once we demonstrate a gap, then we can use the gap to help each other,” said Dr. Mallah. “Ultimately, creating better care of patients both locally and globally.” 

On the education front, a curriculum is being developed for an international rotation for fourth-year residents. According to Dr. Mallah, data shows that 90% of applicants to residency programs will rank a program higher if they have a global surgery option. To stay competitive and ideally to be considered among the elite surgical programs in the country, having a global residency rotation is paramount. 

“I want this to be a meaningful experience for our residents,” he said. “And, I’d like it to be bi-directional. For instance, if our residents operate in an LMIC, it would be equally advantageous for those residents to observe how we take care of surgical patients here.” He says the upcoming trip to Kenya in February will open doors for possible bi-directional learning and research opportunities as part of the grant received. He also has established an eight-month-long elective global surgery course in the process of approval by the College of Medicine, providing access to global surgery for all students. He hopes to make this course available to students and trainees across the university. 

In addition to the research and educational opportunities, the Global Surgery Program is developing an international lecture series. Initially, the focus will be on MUSC faculty speaking about their work in global surgery, raising awareness of what our experts are doing globally, and inspiring the next generation of global surgeons and health leaders. Eventually, Dr. Mallah aspires to bring international thought leaders in global surgery to MUSC for a more robust lecture series. 

The Global Surgery program kick-off event drew a large crowd of multi-disciplinary clinicians, staff, and students, including non-surgeons. According to Dr. Mallah, the diversity of the group, both in terms of specialties represented and the level of training from students to faculty, demonstrates the profound desire on campus for international engagement. Interest has grown since the initial meeting, and a pipeline to the development of the program is emerging. 

“The vision is to build a program that becomes a center of excellence, with multiple international partners and sites that incorporate all aspects of surgery,” said Mallah. “So, when people think of global surgery, they think of MUSC.”