It’s not unusual for students to enter medical school with ideas about paths they’d like to pursue in medicine. Those ideas can evolve over time as they delve into course work and clinical rotations, but the initial interests that guided them to medicine in the first place can be significant.
For Courtney Mangham, who will soon complete her second year in the University of Colorado School of Medicine, her initial interest in global health guided her to a deeper interest in global surgery. This, in turn, led her to the GlobalSurgBox, a portable, economical training tool to help residents and medical students learn surgical skills.
Envisioned by Yihan Lin, MD, MPH, a cardiothoracic surgery fellow in the CU Department of Surgery, the GlobalSurgBox gathers locally available resources in a toolbox-size container to help students and residents practice skills such as knot tying, basic suturing, and aortic valve repair.
Mangham got involved with gathering the materials for, assembling, and distributing the GlobalSurgBox during her first year of medical school. She recently presented research comparing data on GlobalSurgBox use in the United States, Kenya, and Rwanda at the Association of Program Directors in Surgery (APDS) conference in San Antonio, Texas. She was awarded Best Medical Student Paper.
“I didn’t know I was competing for anything while I was presenting, which makes winning all the better,” Mangham says with a laugh. “But I feel very lucky that Dr. Lin, Dr. Michael Kirsch, and my colleagues trusted me to present something I believe in so much.”
An interest in global health
After earning her bachelor’s degree in integrative physiology at the University of Colorado Boulder, Mangham entered medical school with a strong interest in global health. She joined Team Heart and the Global Surgery Student Alliance, for which Lin is a faculty advisor, and soon was helping to assemble GlobalSurgBoxes to distribute to students and residents in the United States, Kenya, and Rwanda.
While Mangham’s plan to intern in-person in Rwanda with TeamHeart was derailed by the COVID-19 pandemic, she says she still learned a lot about how students and residents in Africa were adapting the tool to their needs and with locally available materials.
Along with Lin and Kirsch, Mangham instructed general surgery residents about how to perform two different vascular anastomoses using the GlobalSurgBox and then surveyed participants about the tool’s practicality and helpfulness. The survey data, recently submitted to the Journal of Surgical Education, provided the foundation for Mangham’s presentation at the APDS conference.
The GlobalSurgBox can be used to practice skills such as knot tying, basic suturing, and aortic valve repair.
Planning for a career in global surgery
Mangham was one of just four students to give a podium panel presentation “and I was pretty nervous,” she says. “I’d never presented before – I hadn’t even presented a poster – but I’m really grateful for the experience.”
During the question-and-answer session that followed her 10-minute presentation, she was asked about the study being based on one response from participants “after being given something cool. Their question was how we could know whether they’re using it still,” Mangham says. “And that’s a great question, so there’s definitely room for follow-up research. Just anecdotally, I use it all the time and in Rwanda some medical school faculty are making it part of the curriculum.”
Mangham says the experience of working with and conducting research at GlobalSurgBox has helped cultivate her interest in global surgery. She will be interning with TeamHeart, an organization working to create a cardiac center in Rwanda.
“I’m still trying to figure out what my career looks like in global health,” Mangham says. “I know I need to actually spend time in a hospital in another country to see how I might be able to contribute to an international team. But I do think what I’ve been able to do with GlobalSurgBox has been a good start.”