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 ......
Commentary |

Globalization of Surgery Let's Get Serious

Thomas McIntyre, MD; Michael E. Zenilman, MD
Arch Surg. 2010;145(8):715-716. doi:10.1001/archsurg.2010.145.
Text Size: A A A
Published online


The writing of this comment coincided with the tragic earthquake in Haiti, so the focus of it rapidly became a bit more passionate. Chu et al1 summarize the surgical work done by Médecins Sans Frontières–Belgium, analyzing operative mortality as a proxy for the ability to deliver safe surgery. This is about as short-term follow-up as can be measured, since long-term follow-up under the circumstances in which they practice medicine is impossible. Chu et al demonstrate that basic general surgery can be performed in difficult, resource-poor settings with minimal associated mortality. Not surprisingly, areas of conflict, emergency surgery, abdominal surgery, and American Society of Anesthesiologists score were risk factors for death. While the Médecins Sans Frontières mission is to give care in regions of conflict, these data imply that elective surgery and emergency care for trauma, peritonitis, and maternal hemorrhage may be done safely in nonconflict areas and we can expect even better results.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





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.


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

3 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

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

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis