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The rigor of these programs varies considerably and may not be readily visible to prospective participants prior to engagement. We offer a practical framework to assist prospective volunteers in evaluating cleft surgery programs across domains of patient Safety, Continuity of care, organizational Accountability, Local workforce integration, and Equity and patient rights. The framework is intended for use prior to engagement in overseas clinical work and draws on the authors\u2019 combined experience across multiple international cleft surgical programs.<\/jats:p>","DOI":"10.1177\/10556656261464311","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T12:16:36Z","timestamp":1783340196000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Program Structure and Responsibility in Short-Term Cleft Surgery Programs: The SCALE Framework"],"prefix":"10.1177","author":[{"given":"David","family":"Chong","sequence":"first","affiliation":[{"name":"The Royal Children's Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3828-8089","authenticated-orcid":false,"given":"Janina","family":"Kueper","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000009591"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001009"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2018.05.025"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60160-X"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1597\/06-205.1"},{"issue":"3","key":"e_1_3_2_7_2","first-page":"462e","article-title":"Systematic review of postoperative velopharyngeal insufficiency: Incidence and association with palatoplasty timing and technique","volume":"152","author":"Bregman A","year":"2023","unstructured":"Bregman A, Flores RL, Staffenberg DA, Rodriguez ED, Cutting CB. Systematic review of postoperative velopharyngeal insufficiency: Incidence and association with palatoplasty timing and technique. Plast Reconstr Surg. 2023;152(3):462e\u2013473e.","journal-title":"Plast Reconstr Surg"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003594"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-002319"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-8-121"},{"issue":"5","key":"e_1_3_2_11_2","article-title":"Description of local surgeons\u2019 experience with foreign surgical volunteer missions","volume":"80","author":"Schoenbrunner AR","year":"2018","unstructured":"Schoenbrunner AR, Kelley KD, Buckstaff T, McIntyre JK, Sigler A, Gosman AA. Description of local surgeons\u2019 experience with foreign surgical volunteer missions. 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