The global burden of surgical disease is immense, far outweighing the surgical services available. Urological disease contributes to a significant portion of this global burden,¹ and urologists in low-middle income countries (LMICs) often report insufficient numbers of trained urologists to treat the local population.² A potential source of optimism is the motivation of surgical trainees in high income countries to participate in global surgical collaboration with LMICs.

As a current resident, the reasons to pursue experiences in global urology are numerous. The opportunity to exchange medical knowledge with providers who practice in different circumstances and with different patient populations is invaluable. This type of work could fast-track clinical exposure to unfamiliar urological problems and to a variety of open surgical approaches. Especially if done in a sustainable way with local partnership, global collaborations could advance patient care in foreign countries. This work is also appealing for the sense of personal achievement and feelings of purposefulness that come with volunteering one’s time for a worthy cause. Taking space from the monotonous grind of residency would no doubt temper the emotional exhaustion and depersonalization that is common among trainees.

For all of the above reasons, our residency group has sought to expand its international outreach, and in the process we searched for other training programs involved in global urology. We were surprised to find that many programs lacked an easily accessible online presence, which is discouraging for future aspiring urology residents. Information on department websites was often inconsistent and outdated. COVID could not explain this trend entirely; many websites had not been updated in several years.

We decided to investigate this problem with systematic search criteria and then with an organized email inquiry. We performed a web search of all 147 urology residency programs recognized by ACGME (Accreditation Council for Graduate Medical Education) to identify those with active international programs in LMICs, then the program coordinators of each urology training program were contacted regarding the presence or absence of academic or clinical opportunities during residency training with LMIC partner institutions. Eleven urology training programs listed ongoing global health opportunities on web search (11/147, 7%) and 136 did not (136/147, 93%). The email correspondences yielded 60 responses (60/147, 41%), with 48 (48/60, 80%) responses accurately reflecting the information we found on their website using our search criteria and 12 (12/60, 20%) not. Through email, we identified a total of 23 programs with active clinical or academic collaborations with LMIC partner institutions, yet less than half of these programs had accurate information about the programs on their residency website.

While the institutional and personal barriers to engaging in these partnerships are many (lack of time, lack of funding, etc), poor communication about availability of existing experiences is a preventable barrier. A study of surgical trainees interested in global work identified: 1) the lack of organized opportunities, and 2) poor understanding of how and where to participate as major barriers to joining global surgery efforts.^3,4 Providing up-to-date information regarding ongoing opportunities can address these barriers.

Finally, it behooves residency programs to share accurate information about global urology work. Surveys of applicants to surgical training programs indicate that an international elective positively influences applicants’ residency selection.³ Operating in resource-poor environments can improve cost-consciousness too, ultimately benefiting the trainee, their home institution, and the overall medical system.⁵

The value of international surgical collaboration to patients, trainees, residency programs, and the medical system is well-supported. It is important for ACGME programs to increase awareness of these international opportunities for medical students interested in urology to both increase enthusiasm for the field and promote cross collaboration between programs.