We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

A Pilot Comparison of Standardized Online Surgical Curricula for Use in Low- and Middle-Income Countries

Seth D. Goldstein, MD1; Dominic Papandria, MD2; Allison Linden, MD, MPH3; Georges Azzie, MD4; Eric Borgstein, FRCS5; James Forrest Calland, MD6; Samuel R. G. Finlayson, MD, MPH7; Pankaj Jani, MBChB8; Mary Klingensmith, MD9; Mohamed Labib, MD10; Frank Lewis, MD11; Mark A. Malangoni, MD11; Eric O’Flynn, BS12; Stephen Ogendo, MbChB8; Robert Riviello, MD, MPH7; Fizan Abdullah, MD, PhD1
[+] Author Affiliations
1Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
2Department of Surgery, St Vincent Hospital, Indianapolis, Indiana
3Department of Surgery, Georgetown University Hospital, Washington, DC
4Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
5Department of Surgery, University of Malawi, Blantyre, Malawi
6Department of Surgery, University of Virginia School of Medicine, Charlottesville
7Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
8Department of Surgery, University of Nairobi, Nairobi, Kenya
9Department of Surgery, Washington University, St Louis, Missouri
10Department of Surgery, University of Namibia, Windhoek, Namibia
11American Board of Surgery, Philadelphia, Pennsylvania
12Royal College of Surgeons in Ireland, Dublin, Ireland
JAMA Surg. 2014;149(4):341-346. doi:10.1001/jamasurg.2013.4830.
Text Size: A A A
Published online

Importance  Surgical conditions are an important component of global disease burden, due in part to critical shortages of adequately trained surgical providers in low- and middle-income countries.

Objectives  To assess the use of Internet-based educational platforms as a feasible approach to augmenting the education and training of surgical providers in these settings.

Design, Setting, and Participants  Access to two online curricula was offered to 75 surgical faculty and trainees from 12 low- and middle-income countries for 60 days. The Surgical Council on Resident Education web portal was designed for general surgery trainees in the United States, and the School for Surgeons website was built by the Royal College of Surgeons in Ireland specifically for the College of Surgeons of East, Central and Southern Africa. Participants completed an anonymous online survey detailing their experiences with both platforms. Voluntary respondents were daily Internet users and endorsed frequent use of both print and online textbooks as references.

Main Outcomes and Measures  Likert scale survey questionnaire responses indicating overall and content-specific experiences with the Surgical Council on Resident Education and School for Surgeons curricula.

Results  Survey responses were received from 27 participants. Both online curricula were rated favorably, with no statistically significant differences in stated willingness to use and recommend either platform to colleagues. Despite regional variations in practice context, there were few perceived hurdles to future curriculum adoption.

Conclusions and Relevance  Both the Surgical Council on Resident Education and School for Surgeons educational curricula were well received by respondents in low- and middle-income countries. Although one was designed for US surgical postgraduates and the other for sub-Saharan African surgical providers, there were no significant differences detected in participant responses between the two platforms. Online educational resources have promise as an effective means to enhance the education of surgical providers in low- and middle-income countries.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal


Place holder to copy figure label and caption
Respondent Countries of Residence

Low- and middle-income nations from which surgeons participated are highlighted.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 4

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Does This Patient Have an Instability of the Shoulder or a Labrum Lesion?