MSKCC has an overarching goal of seeing its trainees practice in their home country, and adjusts the experience of each fellow in the program so that he or she can get the most out of it. By individualizing the education and training they receive, trainees can learn skills for continuous self-improvement along with the technical knowledge they acquire during the program.

The MSKCC fellowship program provides FMGs direct surgical experience in the operating room and perioperative care experience to develop ownership of their patients. The inclusive nature of the program requires trainees to develop communication skills, which can be a challenge for those whose first language is not English.


Study authors said that the MSKCC fellowship gives broad exposure to different areas in surgery and fulfills the recommendations from the Society of Surgical Oncology (SSO) regarding training competences. Additionally, fellows surpass 120 cases per year--the SSO requirement--without interfering with the training of U.S. fellows. Study authors acknowledged that the limitations of the study are "the reporting bias that results from obtaining data from a survey and the inclusion of recently graduated fellows who are just starting their practice. Most of the fellows have come from [high income countries], which limit the generalization of the outcomes to less favored settings."

MSKCC has a long history of training foreign medical graduates--their efforts in this area date back to the early 20th century. The International General Surgical Oncology Fellowship specifically seeks to advance these efforts in surgical oncology. Dr. Brennan said that although MSKCC has seen success in training FMGs, there is still a need for other programs to help assist developing nations. One such program is the American College of Surgeons International Scholarship Program. "During 40 years, 212 surgeons from 62 countries have participated in the program with a positive effect on their practice and opening the possibility of international leadership and remarkable social interactions among surgeons," study authors noted.

"Our hope is to provoke a dialogue to develop other opportunities for international medical graduates at the senior or chief resident level, or even as community assistants," said Dr. Brennan. "We should do more of this training. It's the kind of outreach we have to provide."

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Dr. Brennan's coauthors from Memorial Sloan Kettering Cancer Center were Ismael Dominguez-Rosado, MD; Vitor Moutinho Jr, MD; Ronald P DeMatteo, MD, FACS; T Peter Kingham, MD, FACS; and Michael D'Angelica, MD, FACS.

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