According to the Lancet, surgical conditions alone account for approximately one third of the global burden of disease. Doruk Ozgediz, MD, directs the UCSF Center for Health Equity in Surgery and Anesthesia (CHESA), part of the Institute for Global Health Sciences, where he works with partners to reduce disparities in access to surgical and anesthesia care and improve outcomes for vulnerable populations worldwide. Ozgediz was recently honored with an UCSF Exceptional Physician Award. He spoke with Steven Birenbaum about his work in global surgery, the skills early career surgeons need, and what the award means to him. This interview has been edited for length and clarity.
IGHS: You’ve worked in global surgery for more than two decades. What drew you to the work?
Ozgediz: The opportunity for impact. There’s just a tremendous need in this space. Although global health had been evolving as a field, there hadn’t been much work in the surgical space. More traditional global health efforts focused on communicable diseases. Surgery felt like an area with a lot of unmet need, and I had a passion for the clinical work and for partnerships. Some people advised me that it wasn’t really feasible, as a clinical surgeon, to build a career tackling these questions in the same way people had in more traditional global health fields. It’s been a continuous learning process to figure out how to do this work, and pass those lessons on to early-career colleagues and students.
IGHS: Why was surgery previously not seen as a natural fit for developing countries?
Ozgediz: There were a lot of myths, including that surgery was just too expensive, the training took too long, and it dealt with rare diseases. The thinking was that public health interventions should focus on more cost-effective treatments, like vaccinations, or treating TB, pneumonia, and diarrhea in children. There was also a lack of appreciation for the true burden: major issues like road traffic injuries cause more deaths than HIV, TB, and malaria combined.
During my residency in the early 2000s, when Dr. Haile Debas was starting IGHS, he led research looking at the economics of surgery, especially emergency and essential surgical care. We found that surgical interventions are very cost-effective, and it became clearer that surgery should be something governments and agencies invest in to prevent death and disability. There are also areas like safe childbirth and maternal mortality, and for me, pediatric surgery, that were underappreciated. During the last few decades, we’ve been generating evidence and making a strong advocacy case for investing in surgical care worldwide. We’ve done this by implementing programs, evaluating them, and sharing that information with partners and funders globally.
IGHS: You mentioned the need to demonstrate cost-effectiveness of surgical interventions. Was that true of communicable diseases too?
Ozgediz: Cost-effectiveness is one of many factors that drive investment. But from a human rights perspective, if you break your leg, it’s common sense that you deserve care, regardless of cost. Cost-effectiveness is one piece, but over time we’ve been working to debunk many misconceptions about surgery as a population-based intervention: that surgical conditions are rare, too expensive, or too complex to scale.
There are very cost-effective training programs that build surgical capacity. Many have been led by surgeons in low-income countries. We have a lot to learn, especially how they deliver care with far fewer resources. That’s been one of the most sustaining parts of my work, learning from international partners about resilience, efficiency, and how not to burn out. I’ve tried to bring those lessons back to our programs here.
IGHS: What lessons stand out from working with partners in low-income settings?
Ozgediz: One is their close relationship with patients, and how much they rely on listening rather than advanced technology. Another is their persistence and advocacy, even in very challenging environments. Because the burden of disease is so high, they develop practical solutions. These might seem like “workarounds”, but they’re actually proven approaches. They also rely heavily on community health workers and first-level hospitals, extending care into communities. That’s something we don’t do as well in the U.S.
IGHS: It sounds like there’s a stronger public health infrastructure in other countries.
Ozgediz: Yes, those systems were part of why some low-income countries initially responded well to COVID. They could mobilize community-level workers quickly. We can learn from that. Global engagement isn’t just about helping others; it helps improve our own systems. Many innovations from low-income countries inspired by resource scarcity have informed care in the U.S. It’s important that science is inclusive and global. These include basic things, like skin-to-skin contact for newborns, surgical outreach programs, the effective use of community health workers, and advances in cancer care.”
IGHS: What skills do young surgeons need to work in global surgery?
Ozgediz: Humility. The ability to listen. You have to enter different systems with an open mind and learn from local providers. Second, you need a broad clinical skill set. In many settings, providers handle a wide range of conditions. Third, strong bedside skills – being able to make decisions without relying heavily on tests or advanced technology. In some settings, ordering unnecessary tests can financially devastate a family. And finally, understanding how to build trusted partnerships and collaborations.
IGHS: Can humility and listening be taught?
Ozgediz: I think they can be taught and modeled. We emphasize them in our training programs, and we’re fortunate to have strong role models who demonstrate these values in practice.
IGHS: Why was CHESA created?
Ozgediz: CHESA’s fundamental mission is to give everyone who needs surgery a fair chance at a healthy life, regardless of where they live or their life circumstances. We grew out of more than 20 years of collaboration, particularly with colleagues in Uganda. Those partnerships focused on capacity building and workforce development. We took lessons from that work and built the CHESA fellowship to expand opportunities and bring in more disciplines. We also intentionally focused on health equity, not just global health, because these lessons apply abroad and at home.
IGHS: Surgery and anesthesia both are in CHESA’s name. Why is collaboration with anesthesia critical?
Ozgediz: Surgery is entirely team-based. Surgeons and anesthesiologists depend on each other for patient outcomes. Anesthesia also includes critical care, pain management, and post-operative care, essential areas with global disparities. Collaboration is necessary at every level: clinical, systems, and policy.
IGHS: Describe your early experience as a surgeon in Uganda.
Ozgediz: It was incredibly humbling. I was struck by the expertise of local surgeons, the resilience of families, and the innovative strategies already in place. It became clear that solutions already existed, they just needed support and resources. That experience shaped my career and reinforced the importance of long-term partnerships.
IGHS: It sounds like relationships are central.
Ozgediz: Absolutely. Global health is fundamentally about relationships and trust, which take time to build. You need to be patient and committed for the long term.
IGHS: If you were making the case to philanthropy to fund global surgery, what would you say?
Ozgediz: This work allows you to save lives and prevent disability immediately, while building systems that sustain impact for decades. You get short-term and long-term impact.
IGHS: How has the work shaped your view of human nature?
Ozgediz: It’s shown me the universality of humanity. I feel fortunate to have learned from so many people across different environments.
IGHS: What does the Exceptional Physician Award mean to you?
Ozgediz: It’s a recognition of collective effort. It reflects the incredible teams and people I work with – in CHESA and our clinical teams at our children’s hospital. I feel fortunate to work globally and as a clinician caring for children and families.