Canada’s connection to surgical care in Fiji and Guyana
Dr. Brian H. Cameron is the recipient of the 2020 Royal College M. Andrew Padmos International Collaboration Award
Inspired by the teachings of the Baha’i faith, Brian H. Cameron, MD, DipMedEd, FRCSC, made it his mission throughout his career to challenge health care inequities around the world.
Before retiring from McMaster University in June 2021, the professor of Pediatric Surgery and director of the McMaster International Surgery Desk was awarded the 2020 Royal College M. Andrew Padmos International Collaboration Award in recognition of his contributions to global health and surgery.
“Being a recipient of this award really gives me great pride. It shows that Royal College Fellows are seen as valuable partners to where health care is most needed,” he says.
Dr. Cameron’s work has taken him to many countries, including Uganda as part of the St. Joseph’s Health System International Outreach Program; however, it is his early-career years in Fiji and long-term work in Guyana that he considers his most meaningful connections.
Not only did Dr. Cameron help formalize training and improve surgical care in these two countries, but he did so with support from Canadian specialists, building a lasting bond between countries.
Teaching surgery in Fiji while keeping the medical school from closing
Trained in General Surgery at the University of Calgary, Dr. Cameron moved with his family to Suva in 1987 to work at the Fiji School of Medicine. He stayed there for four years working as a senior clinical tutor and full-time surgical teacher.
In fact, he was the only surgical teacher for more than 100 students. He also worked at the local hospital.
“When I arrived, I was one of three consultant surgeons supervising local surgical house officers with more than 20 years’ experience,” he says.
“Although the house officers were able to manage routine surgical care, they never had formal postgraduate medical education [PGME] training in surgery and, instead, were mentored by senior surgeons over the years and relied on consultant surgeons from overseas.”
To address this gap in formal training, Dr. Cameron reached out to the Royal Australasian College of Surgeons. The college subsequently developed rigorous PGME programs in Fiji.
Within a few months of his arrival, Dr. Cameron faced an unexpected challenge.
“Following the events of a military coup, we thought we would need to close the medical school because we did not have enough staff to teach,” he says. “I was one of the remaining faculty and became acting dean as a result.”
In collaboration with Fijian colleagues, Dr. Cameron consulted with the government and made some recommendations. These included funding another half-dozen full-time staff and approaching the Canadian government to send short-term teaching faculty for three-month rotations.
Thanks to his dedication and collaboration, the Fiji School of Medicine remained open. In 1988, they appointed a new dean and celebrated the centenary of the school.
“Looking back at my work and practice in Fiji, keeping the medical school from closing was certainly my proudest moment,” he says.
Developing Guyana’s first postgraduate surgical training program
After Fiji, Dr. Cameron moved to Vancouver to train in Pediatric Surgery. Soon after, his career in global health and surgery steered him in a new direction; this time, to Guyana’s capital city, Georgetown, which he continues to visit to this day.
Dr. Cameron collaborated with Guyanese colleagues and the Canadian Association of General Surgeons (CAGS) to develop the country’s first postgraduate surgical training program at the University of Guyana.
“We pitched the Guyana-CAGS collaboration to the local Canadian consulate [High Commission of Canada to Guyana] to see if they would be interested in supporting the development of the program,” he says. “Thankfully, they had a grant and budget available for travel expenses, which we used for Canadian visiting faculty.”
“Most importantly, half of the budget went to our Guyanese partners so that they could provide stipends for their own teaching faculty and open a postgraduate medical education office affiliated with the university,” he adds.
From 2005 to 2014, 29 Canadian surgeons were recruited through CAGS for more than 75 teaching trips. Held two weeks at a time, the surgeons worked with local Guyanese faculty who taught half of the modules. By 2014, 14 surgeons completed their training. Some have completed fellowships in Canada.
“It has been a wonderfully successful partnership. These surgeons are now consultants running PGME programs and clinical services.”
Two years ago, while attending a Caribbean College of Surgeons (CCOS) meeting, Dr. Cameron saw five of the original graduates of the Guyana-CAGS program gain CCOS Fellowship.
“They were recognized by their peers for being fully qualified and ethical surgeons,” he says. “That was a really exciting moment.”
As a result of the Guyana-CAGS collaboration, several other PGME collaborations have developed with Canadian Royal College Fellows. These include specialists in Anesthesiology, Obstetrics and Gynecology, Pediatrics and Internal Medicine.
A physician’s most important role is to teach
Looking back at his long-term connections in Fiji and Guyana, Dr. Cameron notes the importance of education over all else when building local capacity in low-resource settings.
“The most significant resource for a country is its people and the most important role, as a physician, is to teach others,” he says.