Global Surgery
Exposure in Geneva

Marvin Hsiao

The WHO Trauma Care Checklist project began in 2009, following the successes of the Surgical Checklist project in which the University of Toronto, led by Bryce Taylor and Richard Reznick, played an integral role. The trauma checklist follows the Advanced Trauma Life Support structure. It includes items designated to prevent or to avoid critical mistakes during initial resuscitation of injured patients. Similar to the original Surgical Checklist study design, the Trauma Care Checklist has been piloted in 12 hospitals in diverse settings worldwide, ranging from St. Michael's Hospital in Toronto to Limbe Regional Hospital in Cameroon. Preliminary results show significant improvements in almost all process measures across diverse practice settings.

As an intern with both surgical and research training, Marvin Hsiao was well positioned to immerse himself quickly in the study, which included literature reviews, qualitative, and quantitative data analyses. Marvin said he learned the most from seeing first-hand how the WHO functions and how it conducts research. During the internship, he participated in noon hour seminars, had small group meetings with the WHO Director General Margaret Chan, and attended the 65th World Health Assembly.

This internship helped Marvin plan how he would like to incorporate global surgery work into his career. While he has no immediate plans to work at the WHO, he thinks the Department of Surgery at UofT, with decades of dedication and hard work from the ranks of Georges Azzie, Mark Bernstein, and Andrew Howard, can become a global leader in improving surgical care in low- and middle-income countries. To this end, with support from Avery Nathens and James Rutka, Marvin will be compiling a detailed inventory of global surgery activities within the Department of Surgery. Within the Department's new 5-year strategic plan "Transforming Surgery: Beyond the Cutting Edge", the long-term goals are to (1) develop a concerted University of Toronto strategic plan in global surgery; (2) create a formal academic pathway for surgeons with a focus in global surgery; and (3) improve surgical care in low-resource settings globally through clinical, research, educational, and advocacy activities.

Marvin is a General Surgery resident currently completing his final year of PhD studies in Global Surgery research (Quantification and Characterization of Road Traffic Injury Deaths and Surgical Care Access in India) at the Institute of Medical Science under the supervision of Avery Nathens and Prabhat Jha. Marvin had a unique opportunity to contribute to a World Health Organization (WHO) project to improve trauma care globally through a recent two-month internship in Geneva this past spring.

M.M.