Global Cardiac Surgery in China: 23 Years of Mission Work

The Global Surgery Program at the University of Toronto aims to increase surgical expertise in underserved communities around the world, with a focus in low- and middle-income countries. On the suggestion of our colleagues and in the footsteps of the world-renowned Canadian surgeon Dr. Norman Bethune, we realized that China, with an increasing cardiovascular disease burden and a population exceeding 1.2 billion, offered an opportunity like no other. In this chapter, we reflect on our 23 years of experience in the region, recounting how we began in 1998 as a small initiative to increase access to cardiac surgery in areas that had little of it, but have now evolved into a multidisciplinary effort across 160 medical institutions and 29 subspecialties. In doing so, we have established cardiac surgery training programs at 11 centers, mimicking the “Competency by Design” curriculum implemented here in Canada by the Royal College. We also successfully advocated for health coverage for over 95% of Chinese citizens, while additionally welcoming 142 trainees for observerships to Canada. Not only have these experiences taught us many invaluable lessons, we have also been very fortunate to witness one of the most remarkable socioeconomic developments in recent Chinese history.KeywordsChinaGlobal surgeryCardiacCardiovascularGrowthHealthcare accessSurgical trainingResidencyCompetence by designBMDAC