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Dr. Stephen Bickler, Associate Clinical Professor of Surgery and Pediatrics at the University of California, San Diego, shares invaluable tips for developing a successful career in global health. With experience in pediatric surgery in The Gambia, he emphasizes the importance of addressing surgical needs in developing countries. He advises aspiring global health professionals to travel widely, seek overseas work experience, learn foreign languages, and publish research. Establishing mentorships and pursuing innovation despite traditional barriers are crucial steps toward making a meaningful impact.
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Tips for developing a successful global health career Stephen Bickler, MD Associate Clinical Professor of Surgery and Pediatrics University of California, San Diego
Pediatric surgery in The Gambia Main government referral hospital • All children aged <15 years treated for surgical problems during 29 months • Inpatient (n=1726) -34,625 total inpatient days -Average census = 40 pts • Outpatient (n=6606) • Operations (n=1347)
Spectrum of surgical conditions Bickler et al, WHO 2000
Estimated Need for Surgical Care Bickler,et al, Trop Doct, 2003
Risk factors for surgical deaths • Analysis of pediatric surgical deaths (n=88) • Univariate and logistic regression • Highest in-hospital mortality • Children aged < 1 year (OR 2.9, p= .0005) • Burn diagnosis (OR 5.2, p <.0001) • Residence outside the Greater Banjul Area (OR 6.6, p =.01) • Female sex was associated with an increased risk of death (P=.065). PAPSA, 2005
Incidence of common conditions Bickler, et al, Ped J Gastro Nutrition 2000
Strategies for improving care …the challenges for pediatric surgery in developing countries are those of definition, policy and delivery. Bickler & Rode, Bull WHO, 2003 • The role of pediatric surgery in developing countries remains poorly defined • Health care policy does not reflect the surgical needs of children • Major problems with delivery of care • Long distances • Limited facilities, equipment, human resources • Shortage of qualified pediatric surgeons
Strategies for improving care • Focusing our efforts • Demonstrate the need for pediatric surgical care • Define a cost-effective package of pediatric surgical care • Improve pediatric surgical care at the community level • Strengthen pediatric surgical education Bickler & Rode, Bull WHO, 2002
Career tips • Travel as much as possible • Always go for the best opportunity, even though it might not be the most direct route to your eventual goal • Get as much overseas work experience as possible
Career tips • Learn a foreign language • Acquire formal training in tropical medicine • Publish, publish, publish! • Create your own foundation
Career tips • Identify mentors • Get yourself into a position where you can influence the bigger picture • Don’t be discouraged by traditional thinkers • Take risks in your career • Have fun!