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[This corrects the article DOI: 10.1371/journal.pgph.0002102.].

Academic 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 this developing field. A consensus-based approach, with input from a diverse group of experts, is needed to identify essential competencies that will lead to standardization in this field. A task force was set up using snowball sampling to recruit a broad group of content and context experts in global surgical and perioperative care. A draft set of competencies was revised through the modified Delphi process with two rounds of anonymous input. A threshold of 80% consensus was used to determine whether a competency or sub-competency learning objective was relevant to the skillset needed within academic global surgery and perioperative care. A diverse task force 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. This Delphi process, with input from experts worldwide, identified 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.

Background: Breast cancer is the most prevalent cancer and the second leading cause of cancer death among women, and understanding how obesity impacts this disease has important public health implications. Materials and Methods: This study was a prospective study that involved 100 participants managed for breast diseases from May 2015 to April 2017 at Nnamdi Azikiwe University Teaching Hospital, Nnewi (NAUTH). All the participants were formally diagnosed using clinical evaluation and core tissue biopsy. Waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), height and weight were measured, subsequently body-mass index was estimated as a ratio of an individual’s weight (kg)/height (m2). Results: The mean age (SD) of the subjects was 41.6 (9.3) years; all the participants were women. The mean (SD) body-mass index, WC and WHR of all the participants were 27.57 (6.85) kg/m2; 87.70 (16.36)cm and 0.87 (0.07) respectively. The mean (SD) body-mass index of pre-menopausal and post-menopausal were 26.52 (6.62) kg/m2 and 30.60 (6.71) kg/m2 respectively. The mean (SD) WHR of pre-menopausal and post-menopausal were 0.87 (0.06) and 0.90 (0.08) respectively, whereas the mean (SD) WC of pre-menopausal and post-menopausal were 85 (15.0) cm and 94.85 (17.97) respectively, thus individuals who were older were more likely to be overweight or obese than younger persons. Conclusion: This study findings emphasize the importance of considering wide WC and high WHR while implementing risk reduction strategies of breast cancer in younger women. Future studies to elucidate the significance of this findings in larger cohorts are needed.

Background: Doctors in training are at high risk for depression, and this could lead to poor-quality of patient care and increased medical errors. Objectives: The study assessed the prevalence of depression among resident doctors in selected institutions in Eastern Nigeria. Materials and Methods: A cross sectional study was conducted at three tertiary hospitals from December 2017 and March 2018. Resident doctors were recruited for self-assessment using Beck Depression Inventory®-II. Data were collated and analysed using SPSS version 21, statistical significance was inferred at P value = 0.05. Results: Among the 170 resident doctors studied, the age range was 26-53 years, and the mean age was 33.89 (SD = 4.71) with 127 (74.7%) males and 43 females (25.3%). Ninety-five (55.9%) were junior residents while 75 were senior residents (44.1%). Eight four (49.4%) residents had attempted the membership certification examination with first attempt success rate of 39(46.4%). The overall prevalence of depression was in the study was 17 (10.0%). The prevalence increased to 17.3% and 17.86% in senior residents and residents who have attempted the first post-graduate membership examinations respectively. Depression was more in residents who attempted the membership exam (p=0.001) and in senior residents (p =0.005) Conclusion: Our study found that trainee doctors who had attempted the membership exam and senior residents were more likely to be diagnosed of depression. Thus, there is a need for relevant stakeholders to review the support network for doctors in training.