Academic Global Surgical Competencies: A Modified Delphi Consensus Study

<b>Background</b>: Global surgery is a rapidly growing field that aims to improve access to safe surgical care worldwide. However, no universally accepted competencies exist to inform in this developing field. A consensus-based approach, with input from a diverse group of experts, is needed to develop competencies that will lead to a standardization in this field. <b>Methods:</b> A taskforce was set up to recruit a broad group of content and context experts in global surgical and perioperative care. A draft set of competencies was modified through the Delphi process in two rounds of anonymous input. A threshold of 80% consensus was used to determine whether a competency or sub-competency objective was relevant to the skillset needed within academic global surgery and perioperative care. <b>Results:</b> A diverse taskforce recruited experts from 22 countries to participate in both rounds of the Delphi process. Of the n=59 respondents completing both rounds of iterative polling, 63% were from low- or middle-income countries. After two rounds of anonymous feedback, participants reached consensus on nine core competencies and 31 sub-competency objectives. The greatest consensus pertained to competency in ethics and professionalism in global surgery (100%) with emphasis on justice, equity, and decolonization across multiple competencies. <b>Conclusions:</b> This Delphi process, with input from experts worldwide, led to nine competencies which can be used to develop standardized academic global surgery and perioperative care curricula worldwide. Further work needs to be done to validate these competencies and establish assessments to ensure that they are taught effectively.