An International Fellowship in Trauma Research and the Potential Benefits for Fellows, Sponsoring Institution, and the Global Trauma Community JOSEPH J. DUBOSE, M.D.,PEDRO G.R. TEIXEIRA, M.D., GUSTAVO RECINOS, M.D., GALINOS BARMPARAS, M.D., MARCUS OTTOCHIAN, M.D., KENJI INABA, M.D., PATRIZIO PETRONE, M.D., DEMETRIOS DEMETRIADES, PH.D., M.D. From the Division of Trauma and Critical Care at the Los Angeles County and the University of Southern California Medical Center, Los Angeles, California For over a decade, the Los Angeles County/University of Southern California Hospital has sup- ported an international fellowship in trauma that provides research experience, education, and opportunity for clinical observation at a high-volume American College of Surgeons (ACS) des- ignated Level I trauma center. We performed a descriptive study of the design, implementation, and results of an international fellowship in trauma and critical care. Fellows from 27 countries throughout the world have actively engaged in trauma research at Los Angeles County/University of Southern California Hospital. Our program involves intensive education and clinical obser- vation components designed to facilitate dissemination of evidence-based trauma practices throughout the world by graduates. The majority of alumni responding to a survey returned to their countries of origin, remaining active in trauma care and research. Motivation for partic- ipation varied, but former fellows universally rated their experience highly and stated they would recommend the program to their colleagues. An international research fellowship in trauma and critical care provides foreign medical trainees opportunities for exposure to research and evi- dence-based practices at a high-volume trauma center. The program is designed to be beneficial to both the participating fellow and sponsoring institution; and is constructed to effectively promote improved trauma education and the dissemination of quality trauma practices internationally. G LOBALIZATION AND international integration of economic, technological, sociocultural, and political efforts continue to advance. Similar efforts in medical globalization, and in particular the promotion of a global trauma community, however, have evolved at a comparatively slower pace. Although the diligent efforts of the World Health Organization, The Amer- ican College of Surgeons (ACS), the American Asso- ciation for the Surgery of Trauma, and other groups are making significant improvements in the dissemination of evidence-based trauma practices, significant dis- parities in implementation and quality of trauma care throughout the world persist. International trauma collaboratives and exchange programs may provide a manner by which institutions of advanced trauma systems can support efforts in the global improvement of trauma care. By facilitating exchange with other mature trauma systems or geo- graphical regions of less well developed trauma care initiatives, these efforts promote the exchange of innovation and the dissemination of evidence-based trauma practices. When effectively employed, they nurture the evolution of a global trauma community dedicated to providing the best evidence-based care to the critically injured. At Los Angeles County/University of Southern California Medical Center we have sponsored a 1 to 2-year fellowship in trauma research since 1993. Designed for both medical postgraduates and practic- ing surgeons, we have found the program mutually beneficial to both participating foreign medical grad- uates and our own institution. Our efforts are designed to support those of the World Health Organization and ACS in promoting the dissemination for evidence- based trauma practices throughout the world and foster a global partnership within the trauma community. The development and outcomes of these programs warrants further examination, however, as the role, optimal design, and potential benefits of these programs has not been well defined. Methods After Institutional Review Board (IRB) approval, we conducted a brief review of the development and Address correspondence and reprint requests to Joe DuBose, M.D., 59 MDW/SSS/SGOSQ, 2200 Bergquist Drive, Suite 1, Lackland Air Force Base, Texas 78236-53000. E-mail: jjd3c@yahoo.com. 324