Demographics |
1. | Age |
2. | Gender |
3. | Marital status |
4. | Are you a Canadian citizen? |
5. | How many languages do you have a working knowledge in? |
Education |
6. | PGY (year of residency training) |
7. | Location of residency training |
8. | Location of medical school studies |
9. | Previous degrees obtained |
10. | Do you plan to complete fellowship training after residency? |
11. | If so, in what specialty? |
Previous International Experience |
12. | Have you ever travelled outside of North America? |
13. | If you have travelled outside of North America, please list the number of times you have done so |
14. | During medical school or residency, have you completed any electives outside of North America? |
Previous International Experience 2 (If answered “Yes” to Q #14) |
15. | Did you complete an elective as a medical student? |
16. | Did you complete an elective as a resident? |
17. | Number of electives completed outside of North America |
18. | Where did you go for your electives? |
19. | Did you get assistance from your medical school to arrange these electives? |
20. | Did you get financial assistance for any of these electives? |
21. | What difficulties, if any, did you encounter while attempting to arrange these electives? |
22. | Would you do another international elective after your previous experience(s)? |
International Opportunities |
23. | Are you interested in doing an international elective during the remainder of your training? |
24. | Please indicate the relative importance of the following factors as impediments to your own involvement in international electives. |
| □ Cost |
| □ Family/other commitments |
| □ Lack of opportunity/information |
| □ Fear of harm or danger to self |
| □ Lack of elective time available |
25. | Are you interested in incorporating international surgery into your future career goals? |
26. | What aspects of international surgery are you interested in? (Click all that apply) |
| □ Travel | □ Teaching | □ Learning | □ Operating | □ None | □ Other |
Canadian Association of General Surgeons (CAGS) |
27. | Prior to this survey, were you aware that CAGS has an International Surgery committee? |
28. | Have you ever heard of the Canadian Network for International Surgery (CNIS)? |
29. | What information and resources would you like the International Committee to make available to residents? |