I am in the final year of a seven-year integrated global surgery residency program at Baylor College of Medicine. Our program is designed to train future leaders in global surgery through immersive clinical experience in low-resource settings combined with academic partnership and capacity-building initiatives. The program emphasizes not only individual surgical competence, but also sustainable collaboration with partner institutions abroad through education, program development, and research.
As part of this training, I will spend six weeks at Malamulo Adventist Hospital in Malawi working alongside Dr. Brent Sherwin, program Director of the Pan-African Academy of Christian Surgeons (PAACS) program at Malamulo. Having completed my chief year of general surgery and passed the American Board of Surgery qualifying and certifying examinations, I will function at the level of junior faculty. My role will include direct supervision and instruction of surgical trainees in the operating room, participation in daily ward rounds, and involvement in structured educational activities including daily teaching rounds, weekly didactic lectures, and morbidity and mortality conferences.
This experience will allow me to contribute meaningfully to clinical care and surgical education while further developing skills essential for a career in academic global surgery, including teaching in resource-constrained environments, cross-cultural collaboration, and systems-based problem solving.
Malamulo Adventist Hospital is a 275-bed rural teaching hospital located in Makwasa, in the Southern Thyolo District of Malawi. It serves as a major referral center for a predominantly rural population with limited access to specialty surgical care. Patients commonly present with advanced disease due to geographic, financial, and systemic barriers to timely treatment, making the availability of well-trained surgeons critical to improving outcomes.
Malamulo is a core training site for the Pan-African Academy of Christian Surgeons (PAACS), one of the foremost surgical training programs on the continent of Africa. PAACS focuses on training local African surgeons to provide high-quality surgical care and lead local training programs. The hospital therefore serves not only patients in the region, but also future surgeons who will go on to practice across Malawi and neighboring countries.
The primary goal of this project is to contribute to sustainable surgical capacity building in Malawi through the training and mentorship of local surgeons. By working directly with PAACS faculty and trainees at Malamulo, I will help to strengthen operative skill and educational infrastructure within the program.
This experience builds on my prior work with other PAACS programs in Africa, including Tenwek, Kapsowar, Mbingo, and Bongolo, and represents a continuation of BCM's ongoing relationship with PAACS. Beyond immediate clinical and teaching contributions, I aim to collaborate with Dr. Sherwin to identify context-specific needs within Malamulo’s surgical education and research programs. These may include curriculum development, outcomes tracking, or educational resource gaps that BCM could help address through future partnerships.
During the 6-week rotation, I worked most closely with the nine general surgery residents in the PAACS (Pan-African Academy of Christian Surgeons) training program at Malamulo Hospital. Having recently completed my general surgery training, I was able to teach essential surgical skills, including laparoscopy (pictured), lead didactic sessions, conduct mock oral board examinations for the chief residents, and provide an extra set of hands for the local full-time surgeons who lead the training program.
By working alongside these trainees and surgeons at Malamulo Hospital, we were able to serve the people of southern Malawi (Thyolo district). As a regional referral center, this hospital is the only source of surgical care for many of our patients. As such, we managed the full spectrum of surgical disease: trauma, emergency general surgery, urology, obstetric and gynecologic emergencies, as well as the large burden of oncologic disease including cervical, breast, prostate, esophageal, gastric, and hepatobiliary cancers. In total, the residents and I performed nearly 100 operations or procedures, not including the operative volume of the other two full-time surgeons.
Now working in an attending role, I gained much greater understanding into the real-world systems challenges including limited diagnostic capacity, supply chain and staffing shortages, and the lack of multidisciplinary care available for patients with complex oncologic disease.
The surgical trainees from this program will graduate and continue to impact their local communities in Malawi and beyond. By investing in surgical education and mentorship, programs such as PAACS help build a sustainable surgical workforce, expanding access to high-quality surgical care for thousands of patients over the course of each trainee’s career.
I look forward to continuing my involvement with this training program as a partner in education and research, seeking to improve access to surgical care, particularly in area of surgical oncology, as I start my surgical oncology fellowship this fall.
Many thanks to the Doximity Fund for making this incredible experience possible.
