{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:38:55Z","timestamp":1792827535804,"version":"4.5.0"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:00:00Z","timestamp":1792800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:00:00Z","timestamp":1792800000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The practice of pediatric surgery, and surgery in general, in low\u2010 and middle\u2010income countries (LMICs) presents multiple challenges. Beyond limitations in physical and human resources, there is a great disparity in the quality and accessibility of training programs in LMICs. In response to input from high\u2010income countries (HICs) and a desire to standardize training, regional associations have formed with the aim of facilitating knowledge sharing and enhancing surgical education around the world. Despite this, no clear guidelines exist regarding the types of initial training programs and Continuing Professional Development (CPD) needed at various levels of health care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a PRISMA literature review to identify the types of training programs needed at the health center, first\u2010level hospital, second\u2010level hospital, third\u2010level hospital, and national children's referral hospital. We then used an iterative Delphi like approach to identify and rank specific educational needs by hospital level. Participation was open to all GICS V conference attendees held in Manila Philippines February 2024. This represents 441 participants from 50 countries (79% low to middle income countries). Final recommendations were made based on greater than 75% agreement by respondents and reviewed by the GICS OReCS 2 core working group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was agreement among respondents that some education program should be offered at every facility level. For health centers and first\u2010level hospitals, programs were limited to initial training and continuing education for community health workers and nurses. General medical provider training should start at the first\u2010level hospital, whereas medical schools should be at the third\u2010level and national children's referral hospital. Specialty training for medical and surgical specialties was recommended only at the third\u2010level and national children's referral hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Providing safe and high\u2010quality surgical care for children requires a standardized approach to training not only for surgeons but also for all members of the care team. While the Optimal Resources for Children's Surgery update does not seek to dictate how the training is administered, it does provide a framework for fostering local training programs and creating a skilled workforce at standards mirroring those in HICs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70628","type":"journal-article","created":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:34:48Z","timestamp":1792827288000},"source":"Crossref","is-referenced-by-count":0,"title":["Optimal Resources for Children's Surgery 2: Updates on Training and Education Recommendations"],"prefix":"10.1002","author":[{"given":"Cathrine","family":"Nixon","sequence":"first","affiliation":[{"name":"Global Initiative for Children's Surgery (GICS)  Sacramento California USA"},{"name":"Department of Pediatrics RAK Medical and Health Sciences University  Ras Al Khaimah UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9060-6900","authenticated-orcid":false,"given":"Sarah B.","family":"Cairo","sequence":"additional","affiliation":[{"name":"Global Initiative for Children's Surgery (GICS)  Sacramento California USA"},{"name":"Department of Paediatric Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2386-3039","authenticated-orcid":false,"given":"Emmanuel A.","family":"Ameh","sequence":"additional","affiliation":[{"name":"Global Initiative for Children's Surgery (GICS)  Sacramento California USA"},{"name":"Division of Paediatric Surgery Department of Surgery National Hospital  Abuja Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1840-708X","authenticated-orcid":false,"given":"Kokila","family":"Lakhoo","sequence":"additional","affiliation":[{"name":"Global Initiative for Children's Surgery (GICS)  Sacramento California USA"},{"name":"Department of Surgical Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6161-5784","authenticated-orcid":false,"given":"Mohamed Sameh","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Global Initiative for Children's Surgery (GICS)  Sacramento California USA"},{"name":"Department of Paediatric Surgery and Urology Bristol Royal Hospital for Children  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"GICS Membership","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,24]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Global Initiative for Children\u2019s Surgery Optimal Resources for Children\u2019s Surgical Care: Executive Summary [PDF] 2018."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo\u20102022\u2010001603"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2015.09.009"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(15)60160\u2010x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103153\u2010y"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010024\u201002336\u20101"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(17)32906\u20109"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010018\u201004887\u20108"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002927"},{"key":"e_1_2_12_11_1","unstructured":"Teaching Modules\u2010Global Initiative for Children\u2019s Surgery \u201cGlobal Initiative for Children\u2019s Surgery \u201d (February 2023) https:\/\/www.globalchildrenssurgery.org\/resources\/teaching\u2010modules\/."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2022.04.021"},{"key":"e_1_2_12_13_1","unstructured":"Association of Pediatric Surgery Training Directors Pediatric Surgery Training Curriculum. (n.d.) Retrieved November 11 2025 from https:\/\/apsapedsurg.org\/wp\u2010content\/uploads\/2020\/10\/APSTPDCURRICULUM.pdf."},{"key":"e_1_2_12_14_1","unstructured":"Pediatric Surgery Board. (n.d.) https:\/\/www.scfhs.org.sa\/sites\/default\/files\/2023\u201003\/pediatric_surgery_curriculum%202023.pdf."},{"key":"e_1_2_12_15_1","unstructured":"APSA Pediatric Surgery Library featuring NaT\u2010App and Website Pedsurglibrary.Com (2025) https:\/\/www.pedsurglibrary.com\/apsa."},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.12.004"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70628","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70628","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70628","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:34:49Z","timestamp":1792827289000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70628"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,24]]},"references-count":15,"alternative-id":["10.1002\/wjs.70628"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70628","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,24]]},"article-number":"wjs.70628"}}