Patient care and management can be approached in numerous ways across the globe, especially in countries with universal public health care systems. Despite these differences, patients can still receive excellent care and experience comparable health outcomes.
This is what chief residents Rami James Aoun, MD, and Dahlia Kenawy, MD, experienced firsthand during their rotation as part of the Ohio State Department of Surgery Residency’s Global Surgery Program. The one-month international elective took them across the world to Westmead Hospital in Sydney, one of Australia’s biggest hubs for health, education, research and training.
“In Australia, there are differences in patient management due to the constraints of a publicly funded system,” Dr. Kenawy says. “For example, at Ohio State, we typically remove an inflamed gallbladder during the patient’s admission. In Australia, they often treat with antibiotics first and schedule surgery for later. Despite these differences, patients still received excellent care. It was eye-opening to see the various approaches to health care.”
“This experience made me realize that surgical practices and patient care can differ between health systems, all while achieving comparable outcomes. This realization challenged some of my previously held medical beliefs,” Dr. Aoun says. “For instance, during a laparoscopic appendectomy, Australian surgeons typically use a Bovie device for the mesentery and an endoloop for the base of the appendix. In contrast, at Ohio State, we generally prefer staplers for both tasks. This experience has enriched my understanding of new surgical tools and techniques, as well as provided me with a fresh perspective on health care delivery and patient care on the wards.”
During their one-month training, the residents worked on the upper GI service, engaging in foregut (both benign and oncology), HPB and elective/emergent general surgeries. This included performing dozens of procedures such as liver resections, Whipple procedures, and general surgeries like cholecystectomies and hernia repairs.
Both residents are extremely grateful for the opportunity to learn what it’s like to perform surgeries and care for patients on the other side of the world. From meeting and working alongside experienced surgeons to broadening their view on how health care is run in another country, this experience enriched their residency journey and will be invaluable in their careers as surgeons.