Surgical Training Collaborative Updates

Inaugural Surgical Education Course Takes Place in Hawassa, Ethiopia

Kevin Pei, MD, MHSEd, FACS, Beth Hochman, MD, FACS, and Kristin Long, MD, MPH, FACS

To promote excellence and continuous quality improvement in surgical education, ACS Health Outreach Program for Equity in Global Surgery (ACS H.O.P.E.®) and Hawassa University in Ethiopia, partnered to develop an interactive faculty and resident development course in clinical teaching that addressed pressing educational needs. The course took place September 28–29, 2025.

This unique 2-day workshop convened surgical educators and education leaders from multiple disciplines across the university, including orthopaedic surgery, obstetrics and gynecology, general surgery and its subspecialties, and neurosurgery.

Participants demonstrated exceptional engagement throughout the workshop, with robust discussions that stimulated meaningful dialogue around education science, education research, feedback, entrustment, shared challenges, and continuous educational improvement. Through this collaborative exchange, the workshop articulated a shared vision for faculty and resident development in clinical teaching, reinforcing both ACS H.O.P.E.’s and Hawassa University’s commitment to excellence in the education pillar of the tripartite mission, alongside research and clinical care.

Looking ahead, this partnership is positioned to serve as a regional training center for surgical education excellence, extending its impact and strengthening capacity across Eastern Africa.

Building Capacity Through Collaboration: The University of Kentucky’s Third Visit to the University Teaching Hospital in Lusaka, Zambia

Alexis Nickols, MD, FACS

In October 2025, surgeons from the University of Kentucky in Lexington, traveled to University Teaching Hospital (UTH) in Lusaka, Zambia, for their third collaborative visit. The team included Alexis Nickols, MD, FACS, a trauma and acute care surgeon, and Michael Cavnar, MD, FACS,  a surgical oncologist, who were joined by Dr. Nickols’s mother, Connie Nickols, a retired neonatal intensive care nurse with 37 years of clinical experience.

This 2-week visit was structured around the four pillars of the ACS H.O.P.E. collaboration: clinical care, research, quality improvement, and education.

Within the clinical care pillar, the team partnered closely with Wilson Mbewe, MD, and Felix Michelo, MD, to advance laparoscopic surgery capacity through hands-on collaboration across multiple cases, including biopsies, cholecystectomies, and feeding tube placements. In support of research development, the team reviewed seven research proposals submitted by general surgery registrars pursuing their master of medicine degree. Proposed projects included outcomes related to the laparoscopic cholecystectomy experience at UTH and the implementation of early return-to-activity-after-surgery protocols for patients undergoing elective procedures.

Quality improvement efforts focused on addressing critical gaps in perioperative and neonatal outcomes. Connie Nickols worked extensively on a project aimed at improving survival rates for infants born with gastroschisis, a condition associated with a current mortality rate of 100% in Zambia. Dr. Nickols advanced efforts to build a perioperative outcomes database, while Dr. Cavnar evaluated barriers to effective multidisciplinary cancer care delivery at UTH.

Educational engagement was a central component of the visit. Dr. Nickols and Dr. Cavnar delivered a series of lectures spanning topics from point-of-care ultrasound fundamentals for surgeons to radiologic evaluation of liver and pancreatic tumors. Throughout the visit, UTH surgeons and registrars demonstrated strong engagement and commitment to advancing surgical care, research, and education.

Overall, this third visit reinforced the strength of the partnership between the University of Kentucky, ACS H.O.P.E., and UTH, highlighting the power of sustained collaboration to build local capacity, foster trust, and support long-term improvements in surgical care delivery.

Building Lifelines: Advancing Vascular Care in Rwanda

Katherine Kane, MD, FACS

Rwanda, a country in eastern sub-Saharan Africa, has a population of approximately 17 million people. The burden of peripheral artery disease is rising rapidly in Rwanda, with diagnoses occurring at increasingly younger ages due to uncontrolled diabetes, high-cholesterol diets, tobacco use, and hypercoagulable disorders. Recognizing this growing public health challenge, the Rwanda Ministry of Health, King Faisal Hospital, and the ACS partnered in early 2022 to address the need for accessible, high-quality vascular care for all Rwandans.

The partnership was established with a shared vision to strengthen early diagnosis and preventive vascular care while improving outcomes for patients presenting with vascular emergencies. Two Rwandan general surgeons were identified early in the initiative based not only on their interest in vascular surgery, but also on their demonstrated commitment to delivering high-quality vascular care to the people of Rwanda. These surgeons subsequently pursued advanced vascular training through accredited programs in other countries. To support early program development, volunteer vascular surgeons from the US began traveling to Rwanda in 2023.

Monthly vascular surgery camps formed the foundation of the clinical program, focusing on comprehensive patient evaluation, diagnostic review, and preparation for basic and complex surgical procedures. Through these efforts, patients with chronic kidney disease received new hemodialysis access as a bridge to kidney transplantation. More complex cases included lower extremity bypasses for limb salvage, carotid body tumor resections, and open abdominal aortic aneurysm repairs.

The program has now entered its second phase, which includes the establishment of weekly vascular clinics serving patients traveling from the capital city and remote rural regions. Ongoing on-site skills sessions and regularly scheduled webinars support continued clinical education, case discussion, and didactic learning. Looking ahead, the third phase of the initiative will focus on developing a formal vascular training program to ensure sustainable, continuous vascular care delivery for future generations.

US-based surgeons participating in this collaboration consistently return with a sense of humility and deep respect, noting the urgency, dedication, and resilience demonstrated by their Rwandan colleagues. In turn, Rwandan surgeons express gratitude for the partnership and maintain a steadfast commitment to learning, collaboration, and providing the highest standard of care for their fellow citizens.