Featured Article| Volume 221, ISSUE 2, P245-253, February 2021

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Motivations and impact of international rotations in low- and middle-income countries for orthopaedic surgery residents: Are we on the same page?

Published:September 12, 2020DOI:


      • Resident rotations in low-income countries must consider needs of host surgeons.
      • Successful academic partnerships foster reciprocity and bidirectional exchange.
      • Resident motivations are not aligned with perceived impact on host surgeons.



      Despite interest among North American orthopaedic residents to pursue rotations in resource-limited settings, little is known regarding resident motivations and impact on host surgeons.


      Surveys were distributed to North American orthopaedic surgeons and trainees who participated in international rotations during residency to assess motivations for participation and to orthopaedic surgeons at partnering low- and middle-income country (LMIC) institutions to assess impact of visiting trainees.


      Responses were received from 136 North American resident rotators and 51 LMIC host surgeons and trainees. North American respondents were motivated by a desire to increase surgical capacity at the LMIC while host surgeons reported a greater impact from learning from residents than on surgical capacity. Negative aspects reported by hosts included selfishness, lack of reciprocity, racial discrimination, competition for surgical experience, and resource burdens.


      The motivations and impact of orthopaedic resident rotations in LMICs need to be aligned. Host perceptions and bidirectional educational exchange should be incorporated into partnership guidelines.


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