For cancer patients requiring surgery, the outcome of their treatment depends on more than a surgeon’s skill. Coordinated referrals, multidisciplinary planning and strong clinical training all shape the care they receive long before they enter an operating room.
As part of a new global surgery fellowship at the uOttawa Faculty of Medicine, Dr. Kennedy Misso from the East African nation of Tanzania saw how all those pieces fit together within Canada's healthcare system—and how many of the same principles could be adapted to strengthen cancer care in his homeland.
"My time in the fellowship program has significantly improved how I approach clinical cases—from diagnosis and imaging to pre-case planning discussions and laying out all possible options with colleagues and patients," says Dr. Misso, a general surgeon at Kilimanjaro Christian Medical Centre (KCMC) who recently completed a six-month fellowship in advanced surgical care.
The international fellowship was created by the University of Ottawa's Global Surgery, Obstetrics & Gynecology, and Anesthesia Committee (GSOGAC) in partnership with the Kilimanjaro Christian Medical University College (KCMCU). The uOttawa Faculty of Medicine and KCMCU boast a longstanding partnership.
“I am certain that the training I have received in this fellowship will have a lasting impact on the community I serve.”
Dr. Kennedy Misso
For Dr. Misso, the fellowship experience in Canada was about much more than observing new surgical procedures. It offered a new perspective on building systems that improve patient outcomes and can create enduring change for the next generation of surgeons in Tanzania’s Kilimanjaro region.
"I am certain that the training I have received in this fellowship will have a lasting impact on the community I serve. It provided valuable exposure to a range of cases, systems, and resources that I will pass on to the next generation and the wider community."
Building Capacity Through Collaboration
That ripple effect is exactly what the global surgery fellowship is designed to achieve.
Unlike many traditional fellowships, the uOttawa program begins with needs identified by partner institutions.
"This is a new form of fellowship that is specifically tailored to the needs of our partners in developing countries," says Dr. Gilgamesh Eamer, who helped establish the program in his capacity as Director of Global Surgery in the uOttawa Department of Surgery.
"They identify a clinical gap and a physician who wants to fill it. We provide the training so they can return home, fill that gap and train future physicians—including some of our own who do electives there,” says Dr. Eamer, who is a pediatric surgeon at CHEO and the CHEO Trauma Medical Director.
Across rotations at The Ottawa Hospital and Kingston Health Sciences Centre, Dr. Misso gained new perspectives on multidisciplinary cancer care and clinical decision-making. One of the fellowship's most valuable lessons came from watching healthcare teams work together across disciplines.
"I have learned that team building is the most important factor: regardless of seniority, team members contribute equally to planning and execution," he says.
That culture of collaboration is something he’s confident he can nurture back home.
Closing the Global Gap in Cancer Care
Education emerged as another defining feature of the fellowship. Rather than treating teaching as a separate responsibility, Dr. Misso observed how his surgical colleagues in Canada integrated learning into every stage of patient care.
"Teaching is woven into daily practice—pre-op planning, intra-operative coaching, and structured case discussions," Dr. Misso says.
“The goal is not to replicate or copy-paste what I have seen; it is to achieve similar or better outcomes for our patients with the resources we have.”
Dr. Kennedy Misso
He says that while his experience in Canada broadened his perspective, his long-term ambition remains constant.
"My horizon has not changed," he says. "The ambition is to close the gap in cancer care between high-income countries and low- and middle-income countries."
That ambition, he explains, is rooted in adapting proven approaches to local realities rather than attempting to recreate another country's healthcare system.
"The goal is not to replicate or copy-paste what I have seen; it is to achieve similar or better outcomes for our patients with the resources we have," he says.
Partnerships Across Borders
For Dr. Misso, international partnerships like the global surgery fellowship are essential to making that vision possible.
While many low- and middle-income countries continue to confront infectious diseases alongside maternal and child health challenges, the growing burden of cancer demands new approaches and stronger global collaboration.
"Through this collaboration, I can see, analyze, and act on what is needed so that underserved populations can access equitable healthcare."
The fellowship's success will ultimately be measured by its sustainability, according to Dr. Eamer.
"Our main goal right now is to ensure this isn't a one-off and that the program gets established as an annual fellowship with stable funding, a transparent selection process, and a model that is sustainable,” Dr. Eamer says.
Faculty mobility is a cornerstone of global engagement, and the International and Global Health Office (IGHO) is committed to provide financial and logistical support for initiatives like the GSOGAC global surgery fellowship that create lasting partnerships, inspire innovation, and strengthen health education and research across borders.
Enduring Lessons that Travel Home
When Dr. Misso first arrived in Ottawa in November, Dr. Eamer and his family hosted him for a week while he settled into life in Canada. "The warmth and hospitality of the Tanzanian people was personified by Kennedy,” Dr. Eamer says.
Like many newcomers, Dr. Misso had to quickly adapt to his first Canadian winter.
“The weather in Canada is something else, though not as harsh as I had expected. There were some rough days, such as the last week of January, but in general it was not as bad as I had imagined,” he recalls.
Dr. Misso soon came to appreciate much more than Canada's winter preparedness. "People here are kind, welcoming, and friendly," he says.
Now back in Tanzania, Dr. Misso is starting to focus on bringing new ideas about teamwork, teaching, screening and system design that will advance surgery care in his homeland and influence colleagues, residents and patients alike.