February 9, 2012

Surgical training program takes VU residents to Africa

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Fourth-year Vanderbilt surgical resident Julia Shelton, M.D., was the first to participate in the program’s four-week, elective rotation in Kenya, and said the experience made her a better physician.

Surgical training program takes VU residents to Africa

As the first accredited international general surgery program in the United States, Vanderbilt is working to improve access to surgical care in Kenya, while also providing its surgical residents one-of-a-kind training abroad.

Peter Nthumba, M.D., one of only a handful of plastic surgeons in East Africa and honorary secretary of the Surgical Society of Kenya, has joined the Vanderbilt clinical faculty in Plastic Surgery. In this capacity, he is mentoring Vanderbilt residents on rotation at Kijabe Hospital in Kenya.

Peter Nthumba, M.D., is mentoring Vanderbilt surgical residents at Kijabe Hospital in Kenya.

Peter Nthumba, M.D., is mentoring Vanderbilt surgical residents at Kijabe Hospital in Kenya.

“In his first trip to the U.S., Dr. Nthumba was able to share the remarkable work he is doing in Kenya with minimal resources,” said Bruce Shack, M.D., chair of Plastic Surgery at Vanderbilt.

“I hope his visit and faculty appointment here will be the beginning of long-standing relationship that is mutually beneficial to both Kijabe Hospital and Vanderbilt.”

With a population of 40 million, the people of Kenya struggle to find quality and affordable surgical care among the 300 surgeons in the country.

While most are found in the cities and large towns of the country, 30 percent of all health care in Kenya is provided by mission hospitals, such as Kijabe, as well as other non-governmental health care institutions, many of which are found in rural settings.

Already, Kijabe serves as a teaching and referral hospital. Nthumba says the training program with Vanderbilt will serve as an additional stepping stone in preparing the next generation of surgeons in Kenya.

“With our current numbers and programs, we just can’t treat all the patients,” Nthumba said. “We must teach others how, as well.”

Nthumba specializes in plastic, reconstructive and hand surgery. He trained in Kenya, India and Spain before returning to Kijabe Hospital to address this critical shortage of surgeons.

Each day, Nthumba sees patients who suffer from a host of life-threatening maladies requiring surgery, including massive tumors.

One such patient, a 22-year-old Kenyan man, could not adequately eat, breathe or see because the tumor covered most of his face. And the shocking appearance of the tumor led him to be ostracized and shunned by his family and village.

“As you can imagine, when we remove these tumors, it truly changes their lives,” said Nthumba. “But it’s distressing to know that so many of these tumors could be removed years earlier, as they are in the U.S., if access to surgical care were improved,” he said.

At the annual meeting of the Royal Society of Medicine in London, John Tarpley, M.D., professor of Surgery and Anesthesiology, and program director of the General Surgery Residency Program at Vanderbilt, addressed the issue, saying “It’s time we realized that access to surgery is actually a public health issue. We all must do our part to improve access to quality healthcare across the globe.”

Julia Shelton, M.D., a fourth-year surgical resident at Vanderbilt, was the first to participate in the program’s four-week, elective rotation in Kenya.

“What really struck me is that despite the obvious differences in resources, patients and families are no different in Kenya. On their faces, you see the same concern, compassion and gratitude as you would anywhere.

“This experience has made me a better doctor,” she said.

The program was launched last July under the supervision of pediatric and general surgeon Erik Hansen, M.D., who also serves as associate program director.

Rotations are offered in broad-based General Surgery with experiences in General, Pediatric, Plastic and Urologic Surgery.

Vanderbilt was the first General Surgery Residency program to gain approval for international rotations that count for both time and patient cases, as performed under the new guidelines from the Surgery Residency Review Committee of the Accreditation Council for Graduate Medical Education (ACGME).