Multidisciplinary Assessment of Global and Rural Surgery Initiatives 2019 Northwestern Medicine Feinberg School of Medicine

The purpose of the following survey is to collect information on the interest and experience of individuals involved in the multidisciplinary care of surgical patients at all levels including faculty, fellows, residents, and staff in global and rural surgical care.

This can be interpreted broadly but would include clinical care, education, research, policy, advocacy and/or volunteer work in local, national, or international resource-limited or low-income settings.

The goals are to catalog experiences into an online forum, identify areas of overlap and potentials for collaboration, improve support and funding opportunities, and to strengthen existing partnerships.

Name Name * First Last
Email
Role

Role Faculty/Attending Fellow Resident Staff
Division/Training

Division/Training Advanced Practice Provider Anesthesia Anesthesia – Pediatric Anesthesia – Adult Anesthesia - Pain Bariatric Surgery Burns Business Cardio-thoracic Colorectal Surgery Dentistry Dermatology Emergency Medicine Engineering Engineering – Computer Engineering – Electrical Engineering – Mechanical General Surgery Innovation Interventional Cardiology Interventional Gastroenterology Law Minimally Invasive Surgery Mobile Technology Neurosurgery Nursing Nurse Anesthetist Obstetrics and Gynecology Occupational Therapy Ophthalmology Oral and Maxillofacial Surgery Orthopedics Orthopedics – Hand Orthopedics – Joint and reconstructive surgery Otolaryngology (ENT) Palliative Care Pathology Pediatrics Perioperative Medicine Pharmacy Physical Medicine and Rehabilitation Physical Therapy Physician Assistant Plastics Plastics – Hand Plastics - Facial Podiatry Psychiatry Radiology Radiology – Diagnostic Radiology - Interventional Respiratory Therapy Surgical Oncology Transplant Transplant - Kidney Transplant - Liver Transplant - Lung Transplant - Heart Trauma/Critical Care Urology Vascular
What setting do you typically work in?
Where can someone learn more (e.g., website, link to a publication or your faculty profile)?
Which statement below best describes your interest in Global or Rural Health?Multiple Choice

Which statement below best describes your interest in Global or Rural Health?Multiple Choice I have no interest or available resources to commit. I would like to participate, but don’t know how to get started. I would like to participate, but cannot get the time off. I am currently participating in global or rural health projects. Global Health is/will be a major component of my career.
Have you participated in any global health initiatives in the past 5 years?

Have you participated in any global health initiatives in the past 5 years? Yes No
If you have participated in global health initiatives in the past 5 years, please describe these efforts, your role, and the goals/objectives starting with the most recent.
If you have participated in global health initiatives in the past 5 years, please describe how you became involved.
If you have participated in global health initiatives in the past 5 years, describe why you work in global health and what this brings to you personally, the Department, and/or Northwestern Medicine.
How long have you been involved with global surgery work?
Type of Work (Select all that apply.)

Type of Work (Select all that apply.) Clinical Care Education Research Policy Advocacy Volunteer work Other Other
Local region or city of Global Work (You may list multiple regions and/or cities):
If relevant, please provide the name of the community or clinical organization you partnered with in your work.
If you are not a member of the Center for Global Surgery, would you like to be added to our member list?

If you are not a member of the Center for Global Surgery, would you like to be added to our member list? Yes No
Do you have a funding source for yourself?

Do you have a funding source for yourself? Yes No
At what level? (Select all that apply.)

At what level? (Select all that apply.) Government Private Foundation Your own NGO Institutional Other Other
Do you have a funding source for trainees?

Do you have a funding source for trainees? Yes No
At what level? (Select all that apply.)

At what level? (Select all that apply.) Government Private Foundation Your own NGO Institutional Other Other
What sources of funding do you have now, or have had in the past, that you found to be most helpful for your work?
What groups, societies, organizations, agencies, health care entities, or individuals have you partnered with in order to further your endeavors?
How much time do you currently spend on global health efforts in the US (planning days/year)?
How much time do you currently spend on global health efforts in country of global health work (days/year)?
Is this work done as part of your Northwestern Medicine responsibilities or on your own time?

Is this work done as part of your Northwestern Medicine responsibilities or on your own time? Yes No
How much time would you ideally spend on global health efforts (days/year)?
What is the most limiting factor?

What is the most limiting factor? Time Funding Personal/Family Other Other
Would you be interested in collaborating with other members in the Center for Global Surgery?

Would you be interested in collaborating with other members in the Center for Global Surgery? Yes No
Are you interested in participating in the Center for Global Surgery sponsored programs in global health integrating care for underserved communities in urban/rural/international settings?

Are you interested in participating in the Center for Global Surgery sponsored programs in global health integrating care for underserved communities in urban/rural/international settings? Yes No
As mentioned in the introduction, we are compiling experiences in global and rural surgery experiences with the goal of future collaboration and conversation in mind. Would you consent to have your work shared?

As mentioned in the introduction, we are compiling experiences in global and rural surgery experiences with the goal of future collaboration and conversation in mind. Would you consent to have your work shared? Yes No
Do you have any upcoming local or international trips, events, conferences, or projects that you would like to share?

Do you have any upcoming local or international trips, events, conferences, or projects that you would like to share? Yes No
In addition to global health, we would like to learn what work is being done to promote surgical care and prevent disparities in the Chicago community. Do you have academic or clinical endeavors that serve this population?

In addition to global health, we would like to learn what work is being done to promote surgical care and prevent disparities in the Chicago community. Do you have academic or clinical endeavors that serve this population? Yes No
If so, please describe these efforts, your role, and the goals/objectives.