Getting This to Work

What is involved?
 

What Surgeons for Cambodia, Inc. has to do:

Residency Review Committee requirements specifically state that the resident's experience must be fully funded.  That includes international airfare, accommodation, local transportation, health insurance, and evacuation insurance.

International Rotation Application Process

Review Committee for Surgery
The following are required to accompany an application for an international rotation. When applying for an international rotation, a letter of request must be sent to both the American Board of Surgery (ABS) and the Executive Director of the Review Committee for Surgery at the following addresses:

American Board of Surgery
1617 John F. Kennedy Boulevard, Suite 860
Philadelphia, Pennsylvania 19103

Review Committee for Surgery
Accreditation Council for Graduate Medical Education
515 North State Street, Suite 2000
Chicago, Illinois 60654

The letter must be co-signed by both the program director and the designated institutional official (DIO) providing the following:

 Name and location of site
        Khmer Soviet Friendship Hospital, Phnom Penh, Cambodia
            If additional hospitals are used, an MOU will be worked out with each separate location.
Documentation that the resident has the appropriate license to practice in the country where the rotation will occur
        Cambodian Licensing.  As of Dec 2016 a license is required to practice medicine in Cambodia.  We qualify for a Type D license which is for non-Khmer Interns, residents, doctors or medical assistants who practice clinical medicine, public health, medical training etc. in the not-for-profit (public) sector in Cambodia.  http://www.mcc.org.kh/publications/14_fs_en.pdf.  The form needs to be completed along with appropriate documentation as required.  On arrival at customs, the forms are filed for approval.
     PGY level of the resident for whom the rotation is requested (international rotations cannot occur during the R1 or R5 years)
        PGY3 or PGY4
 Dates of the rotation
        Anticipated to begin Dec. 1st, 2017.  The planned rotation will be for one month.
 Verification that the rotation is an elective
        Rotation is specified as an elective.
 Program’s accreditation is “Continued Accreditation”
        All residents with be from a "Continued Accreditation" program.
 A list of ABMS-certified faculty members (or faculty members with qualifications deemed acceptable in advance by the Review Committee) who will supervise the resident
        A list of volunteer senior supervisors, all FACS, will be provided.
 A statement of the competency-based goals and objectives of the assignment
        The goal is to provide the senior resident with a significant case load that he/she will be fully responsible for.  We are aiming for 60 cases/month.  The resident will run a surgical clinic, operate on those surgical cases deemed appropriate, follow and manage hospitalized patients, share trauma/ER call with fellow Cambodian Surgeons.  The resident will also play a teaching role with fellow Cambodian surgeons and medical students.
 Educational Rationale - A statement describing what educational experience the international rotation provides for the resident that the primary institution or affiliates do not
          Cambodia is a poor country that has been decimated by the Khmer Rouge who killed over 1.7 million people in a 4 years period.  All the educated we killed; only farmers were spared.  Since 1979 Cambodia started over.  Hospitals are gradually coming into the 21 century but a lot of help is needed.  Patients are very poor.  Workups are often inadequate due to a lack of funding.  You learn to work with what you have.  Your learn the art of surgical diagnosis.  For example there are no staplers; all GI anastamoses are hand sewn.  Senior surgeons will find this is much like when they first started in surgery 50 years ago. 
 Verification that that there will be an evaluation of the resident’s performance based on the stated goals and objectives
        The senior attending will be required to evaluate the residents performance.  Both the attending and the senior resident will be required to provide an evaluation of the overall program.
 A description of the clinical experience:
        The resident will arrive in Phnom Penh and will be met by our Cambodian Sponsor, Dr. Theavy Mok.  He will get the resident thru customs and brought to his hotel.  The resident will then be brought to KSFH where he/she will meet the staff, meet the senior supervising surgeon, and tour the hospital.  Clinic will be held with sufficient frequency to general a steady stream of patients.  Surgeries will be scheduled at the discretion of the resident (with attending supervision).  The resident is responsible for the total care of the patient.  The resident will also be integrated into the trauma/ER call schedule to both assist and provide care as appropriate.  There will also be a teaching responsibility as there will be Cambodian surgeons, Cambodian surgical residents, and Cambodian medical students.        
 Type of center (governmental, non-governmental, private
        Khmer Soviet Friendship Hospital is Phnom Penh's largest public hospital providing service to the poor.
 Scope of practice of the host center
        This is a full service hospital.  It had internal medicine, surgery, ENT, ob-gyn, oncology, pediatrics.
 A statement of the center’s operative volume and type
        KSFH have 500 beds but in reality has nearly 550 patient admissions with extra beds.  There are 3 different floors for ORs, depending on the type of surgery, general, orthopedic, ob-gyn.  Each floor has 5 Operating room. The emergency  trauma admitted to Hospital 1616 patients.  8064 performed surgery in 2013.
 Verification that the experience will include an outpatient experience
        The resident will be responsible for his own outpatient clinic.  The clinic is one of several locations where the resident will obtain patients.  The hospital will provide advertising on the newspaper, on TV, that American surgeons will be available at KSFH and will provide all care for FREE.
 Verification that the resident will enter operative experiences in the ACGME Case Log System for credit
        This will be completed by the resident and verified by the supervising attending.
 Verification that salary, travel expenses, health insurance and evacuation insurance is provided by the sponsoring institution
        Salary will be provided by the sponsoring institution i.e., the residency program.  International travel expenses, local travel expenses, hotel, breakfast, health insurance, & evacuation insurance will be provided by Surgeons for Cambodia, Inc. All hotel accommodations are air-conditioned, have Wi-Fi, breakfast, and a swimming pool. 
 A description of the educational resources, including access to a library with reasonably current resources and/or reliable access to web-based educational materials
        We have access to the HCVI Medical Library at the National Pediatric Hospital.  Permission has been given by its founder Dr. Frank Duggan for our unlimited use at any time.
 A statement addressing physical environmental issues, including housing, transportation, communication, safety, and language
        Handling Language Barriers.  The number one question.  3 languages are spoken.  Khmer.  Cambodians speak Khmer.  English.  Most of the younger population speak some English.  International University Medical School is taught in English.  I usually use medical students to act as my guides and translators.  French.  Unfortunately French is left over from when this was French Indochina so the older physicians speak French and not much English.  I have hired Ratana Ban, as my project coordinator.  She and her team are all fluent in English and will help to translate when necessary.
        Housing.  Surgeons for Cambodia, Inc. will arrange appropriate housing.  Hotels will be in a safe neighborhood, air-conditioned, free wi-fi, swimming pool, & provides a free breakfast.  Loal transportation will be provided.  Both the resident & attending surgeons will be provied with local cellphones for communication and summoning a dedicated driver available to them 24/7.
         A copy of the Program Letter of Agreement

The program will receive separate approval letters from the ABS and the Review Committee. Both approval letters must be received prior to implementation of international rotations.

What I need from you:

MONEY.  Costs are as follows:

Resident -  $1000 - International Airfare
                  $1500 - Accommodation, breakfast, local transportation, documentation
                  $  250 - Health insurance, evacuation insurance
Supervising Attending - 
                  $1000 - International Airfare ($3500 business class)
                  $1500 - Accommodation, breakfast, local transportation
                  $  250 - Health insurance, evacuation insurance
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                  $5500  will get the project started.  PLEASE GIVE GENEROUSLY.



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