Building Global Capacity in Anesthesia: Department Faculty Help Shape Global Health Education

Faculty from the Department of Anesthesiology & Pain Medicine with colleagues from Department of Surgery have played an important role in shaping global health education at the University of Toronto through their long-standing involvement in the Global Health Education Initiative (GHEI), a program led by Postgraduate Medical Education and one that has become a cornerstone of global health training.

The GHEI was developed after a needs assessment with faculty and trainees to determine how best to support residents and fellows pursuing global health. The result is a practical, accessible certificate program designed to fit demanding postgraduate schedules.

Each year, the GHEI offers 26 modules covering topics including for example ethics, infectious disease, gender health, health systems and law. Participants complete the program in one or two years, selecting modules that match their interests. Faculty and trainees engage in a shared learning environment, bringing together residents and fellows from more than 70 specialties and creating opportunities for anesthesiologists to learn alongside peers in surgery, pediatrics, public health, and more.

The Surgical Skills and Anesthesia in Global Health module has been part of the program since its inception. Dr. Gregory Silverman, anesthesiologist at Mount Sinai Hospital and Assistant Professor in the Department, led the anesthesia component from 2011 to 2020, playing a formative role in shaping the module. He emphasized that “the vast majority of the world doesn’t have access to safe surgery. That’s where we can make the contribution as a university… to make a real difference in safety.” Through his teaching, Dr. Silverman emphasized careful preparation for resource-limited settings, encouraging participants to consider practical challenges such as equipment limitations, medication availability, language barriers, and ethical dilemmas.

From 2021 to 2025, Dr. Beverley Orser, Chair of the Department and anesthesiologist at Sunnybrook Health Sciences Centre, and Dr. Gregory Hare, Professor in the Department anesthesiologist at St. Michael’s Hospital, continued this work, emphasizing safety, equity, and collaboration in the evolving global health landscape.

Reflecting the department’s mission, Dr. Orser noted, “Our department is deeply mindful of our social accountability role. We aim to serve communities beyond the Greater Toronto Area, including rural and remote regions of Ontario and the territories, where medical training opportunities are limited.”

The current iteration of the module, designed for surgeons and non-surgeons, covers major surgical problems in low-resourced regions and teaches basic and improvised surgical techniques, setup of essential infrastructure, and safe anesthesia in constrained environments, making it valuable for any medical professional involved in perioperative care. We all are grateful to our surgery colleagues for their invaluable contribution.

In an upcoming November 2025 session, the Anesthesia in Global Health session will be led by Dr. Henry Cortés Pradilla, a Senior Consultant Anesthesiologist and Interventional Pain Specialist who serves as Coordinator of the Chronic Pain Unit at Don Benito-Villanueva de la Serena Hospital in Spain. His session will highlight recent World Federation of Societies of Anesthesiologists (WFSA) evidence on global anesthesia workforce distribution, translate global inequities into human narratives and emphasize rural innovation, leadership and compassion-based practice as essential components of global health.

Dr. Cortés Pradilla completed a Clinical Fellowship in Pain Medicine at Toronto General Hospital (TGH), holds advanced degrees in palliative medicine, interventional pain medicine, business administration and is a GHEI graduate. Over the past two decades, he has led pain and palliative care programs in Colombia, Brazil and Spain and serves as President of Fundación Más por Hacer, a non-profit supporting patients with chronic pain and expanding access to palliative care in underserved communities.

Reflecting on his GHEI experience, he said, “The GHEI taught me that the greatest role of an anesthesiologist is not only clinical mastery, but system-level leadership.”

During his fellowship at TGH, he observed what the World Health Organization (WHO) and WFSA define as the minimum standards for safe anesthesia practice, including uninterrupted oxygen, continuous monitoring, and trained anesthesia personnel. His later work in low-resource settings showed how the absence of these basic elements can directly affect morbidity and mortality.

According to PGME GHEI leads, Dr. Barry Pakes and Judy Kopelow, the program’s success lies in its accessibility and its ability to bring together diverse disciplines. “Our faculty bring real-world experience to every module,” they explained. “For example, Dr. Orser and Dr. Sliverman have worked extensively in low-resource and northern areas of Canada, while Dr. Cortés Pradilla’s experience reflects the global reach of this work.”

Judy also noted that the program has inspired a new generation of global health leaders from across specialties. Some graduates return as faculty or work from their own settings, continuing a cycle of mentorship and collaboration that sustains the initiative.

Through these efforts, the Department of Anesthesiology & Pain Medicine with Department of Surgery and PGME continue to strengthen global health education and encourage a culture of shared learning beyond the clinical environment.

For those interested in participating, the GHEI program begins every September. Program details, calendar, and the application form are available from the Global Health at PGME site.