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Tips for developing a successful global health career. Stephen Bickler, MD Associate Clinical Professor of Surgery and Pediatrics University of California, San Diego. Pediatric surgery in The Gambia. Main government referral hospital
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Tips for developing a successful global health career Stephen Bickler, MD Associate Clinical Professor of Surgery and Pediatrics University of California, San Diego
Pediatric surgery in The Gambia Main government referral hospital • All children aged <15 years treated for surgical problems during 29 months • Inpatient (n=1726) -34,625 total inpatient days -Average census = 40 pts • Outpatient (n=6606) • Operations (n=1347)
Spectrum of surgical conditions Bickler et al, WHO 2000
Estimated Need for Surgical Care Bickler,et al, Trop Doct, 2003
Risk factors for surgical deaths • Analysis of pediatric surgical deaths (n=88) • Univariate and logistic regression • Highest in-hospital mortality • Children aged < 1 year (OR 2.9, p= .0005) • Burn diagnosis (OR 5.2, p <.0001) • Residence outside the Greater Banjul Area (OR 6.6, p =.01) • Female sex was associated with an increased risk of death (P=.065). PAPSA, 2005
Incidence of common conditions Bickler, et al, Ped J Gastro Nutrition 2000
Strategies for improving care …the challenges for pediatric surgery in developing countries are those of definition, policy and delivery. Bickler & Rode, Bull WHO, 2003 • The role of pediatric surgery in developing countries remains poorly defined • Health care policy does not reflect the surgical needs of children • Major problems with delivery of care • Long distances • Limited facilities, equipment, human resources • Shortage of qualified pediatric surgeons
Strategies for improving care • Focusing our efforts • Demonstrate the need for pediatric surgical care • Define a cost-effective package of pediatric surgical care • Improve pediatric surgical care at the community level • Strengthen pediatric surgical education Bickler & Rode, Bull WHO, 2002
Career tips • Travel as much as possible • Always go for the best opportunity, even though it might not be the most direct route to your eventual goal • Get as much overseas work experience as possible
Career tips • Learn a foreign language • Acquire formal training in tropical medicine • Publish, publish, publish! • Create your own foundation
Career tips • Identify mentors • Get yourself into a position where you can influence the bigger picture • Don’t be discouraged by traditional thinkers • Take risks in your career • Have fun!