Spotlight on Dr. Carlie Arbaugh, Zimbabwe

Meet Carlie Arbaugh MD, MS, Chef. Dr. Arbaugh completed a 4-week clinical rotation at Parirenyatwa Group of Hospitals and the University of Zimbabwe in Harare in October-November 2025.

Can you brief us on your current role in Stanford Surgery? How did this rotation develop?  What were dates were you in Zimbabwe?

I am currently a chief resident in Stanford’s General Surgery Residency Program. I recently returned from a four-week clinical rotation at Parirenyatwa Group of Hospitals and the University of Zimbabwe. I spent one month in Harare, from early October to mid-November.

This rotation was made possible through strong ties between Stanford’s Department of Surgery and the University of Zimbabwe. It would not have been possible without the incredible support of our wonderful faculty such as Dr. Sherry Wren, Dr. Cara Liebert, Dr. Tom Weiser, and many other trainees and attendings who have contributed to the partnership over the years. My trip was financially sponsored by the Stanford Center for Innovation and Global Health (CIGH) and the Stanford Department of Surgery.

In 2022, you were one of the first Stanford General Surgery Residents who travelled to assist with surgical education initiatives at the University of Global Health Equity  (UGHE) in Rwanda right after the COVID-19 pandemic. Why do you consider Global Surgery as a crucial part of your surgical education and training?

I have had an interest in how health disparities work both locally and internationally throughout college, medical school, and residency, and these sorts of experiences continue to be a motivating factor and internal compass for me in my daily work. I appreciate the opportunity to learn in resource-limited settings, including being clinically adaptable with a versatile skill set and gaining exposure to diverse environmental, social, and cultural factors that impact health and healthcare.  Humility, vulnerability, and resourcefulness are key.

What were some highlights of your rotation?

Gosh, there were so many! Leading ward rounds with the senior registrar (equivalent to a chief resident or junior faculty member); supporting the interns in consults and bedside procedures, helping with General Surgery and Breast Clinics; leading interns through open hernia repairs and the senior registrar through a laparoscopic cholecystectomy as well as assisting with several bowel perforation, bowel obstruction, and colon cancer cases; assisting the senior consultant (attending) with an open hepatectomy and another senior consultant in a bilateral breast cancer resection and reconstruction (oncoplastics); organizing teaching sessions for the medical students; touring other healthcare settings (Milton Park and The Avenues Clinic) which gave me a sense of the public vs. private healthcare resources in Zimbabwe; meeting with a breast cancer survivor who started a non-profit organization to improve breast cancer screening and access to breast cancer treatment in Zimbabwe. There was so much activity.

What additional benefits do surgical trainees gain from participating in international rotations?

There are countless opportunities for educational, professional, and personal growth from international rotations. Such rotations promote collaboration and bidirectional learning, adaptation to resource-limited settings, and the development of broader clinical knowledge and surgical technical skills among surgical trainees. Visiting Stanford Surgery trainees both teach and learn from Zimbabwean senior consultants (attendings/faculty), registrars (residents), and medical students, exchanging knowledge about surgical pathologies in the U.S. vs. Zimbabwe, clinical decision-making, and surgical techniques based on local practice and available resources.

Exposure to decision-making without the assistance of some of the advanced technologies we are accustomed to having readily available at Stanford, different surgical approaches, and optimizing limited resources are invaluable. For example, in a setting where a CT scanner is not readily available there is a higher reliance on strong history taking and physical exam skills. Since Zimbabwean patients and families (many of whom live on less than $1 per day) pay out of pocket for medications, lab tests, and imaging, more thought and intention need to put into when those resources are truly needed.

My experience in Harare prompted me to again reflect on the tremendous amount of healthcare waste in the United States and the lessons that can be learned from resource-limited settings when it comes to efficient use of limited supplies, cost containment, and environmental sustainability. There is simultaneous gratitude for access to advanced technology and an overabundance of resources practicing at a place like Stanford with humility and respect for the creativity, resourceful, and skill required to practice at a place like Parirenyatwa. There also needs to be an awareness that certain standards of practice at Stanford or in the U.S. may not be appropriate in other contexts which is where situational awareness and adaptability come into play.

What are the impactful aspects of Stanford Surgery’s relationship with Parirenyatwa and the University of Zimbabwe? Tell us about history of this special friendship. Who do you think are the individuals from both institutions who champion this collaboration?

This partnership spans over a decade, surviving challenges like the COVID-19 pandemic and political instability. Champions include Dr. Sherry Wren, Dr. Cara Liebert, Prof. Muguti, Mr. Mbanje, and many others who have participated in this exchange over the years. Their passion and commitment have pathed the way for unique training opportunities like clinical rotations for surgical trainees like me, developed structured local training programs for local Zimbabwean surgeons like the one in laparoscopic surgery, and fostered enduring professional and personal relationships.

The strong professional partnership and deep friendships between Stanford and Parirenyatwa/University of Zimbabwe were apparent in the warm welcome I received when I arrived in Harare and throughout my stay. I developed wonderful relationships with Prof. Muguti, Mr. Mbanje, Mr. Mungazi, the registrars (residents), medical students, and Jaldin, Wilbert, and their family. I hope to be able to continue to support this relationship by sending educational resources/opportunities to the registrars and medical students there, supporting future resident rotations (in both directions), and hopefully returning to Zimbabwe in the future in a different role.

Over the past three years, Stanford surgeons have played a significant role in advancing laparoscopic surgical training at the International Centre for Surgical Simulation (UZiCSS) in Zimbabwe. There appears to be a discernible trend toward increased adoption of minimally invasive, robotic, and laparoscopic procedures within Zimbabwean operating theaters, gradually replacing a proportion of traditional open operations. Is that something you sensed in your recent visit?

Yes, there is definitely curiosity and enthusiasm around laparoscopic surgery and other minimally invasive approaches at Parirenyatwa/University of Zimbabwe and throughout Harare and Zimbabwe.

The University of Zimbabwe established a simulation center, where trainers and faculty conduct laparoscopic training and certification for general surgeons, similar to the American Board of Surgeons Fundamentals of Laparoscopic Surgery which all general surgery residents in the U.S. complete prior to graduation.

The first cohort of Zimbabwean surgeons have completed laparoscopic surgery certification and there are plans to start the training for the next cohort of Zimbabwean surgeons in late November or early December.

During my rotation, I performed a laparoscopic cholecystectomy with Dr. Machiri, a senior registrar, facilitating exchange of training experiences and intraoperative collaborative decision-making and operating. I also suggested several times that we implement diagnostic laparoscopy for cancer cases to assess disease extent before major operations, a practice not previously routine, but which proved valuable in several cases especially when preoperative imaging like CT scans are not as detailed or up to date when entering an operation.

While you were in Harare, you were invited to give a guest lecture at the Inaugural CME Program for the Zimbabwe Society of General Surgeons (a professional society which just formed this past year - 2025) including General Surgeons and Surgical Subspecialists from Harare and across Zimbabwe. You mentioned that they asked you to speak about Artificial Intelligence (AI) Applications in General Surgery and were very interested to learn about Fundamentals of Laparoscopic Surgery (FLS) which they have recently launched at Parirenyatwa, Fundamentals of Endoscopic Surgery (FES), robotic surgery training, advances in medical documentation automation, etc. Can you elaborate on the outcome of that session?

It was serendipitous that the Zimbabwe Society of General Surgeons had its first continuing medical education (CME) conference while I was there.

When initially asked to present on artificial intelligence applications I felt ill-equipped not being a researcher or entrepreneur in this area. However, I prepared a talk based on a literature review and my lived experiences over the past 10-11 years at Stanford as a medical student and surgery resident. What I had learned was routinely available but not used in the current Zimbabwe healthcare setting. My talk generated excitement and discussion around the adoption of more of these technologies in Zimbabwe. Several senior consultants and senior registrars expressed interest in visiting Stanford for exposure and training, with enthusiasm around resuming reciprocal surgery exchange programs. It was a true honor to be invited to participate in this historic inaugural CME event with this esteemed professional group of Zimbabwean surgeon leaders.

You are a trained chef, and it’s no secret that you genuinely consider community health, education, healthy diet and nutrition as important pillars in promoting sustainable healthcare. Did you have any observations in these areas during your time in Zimbabwe?

Zimbabwe’s traditional diet is generally balanced, featuring staple ingredients like sadza (cornmeal), leafy greens, peanut butter, and usually some meat, but there is an increasing prevalence of processed foods and fast-food chains such as Pizza Inn, Chicken Inn, and Dairy Inn, widely available throughout Harare. Zimbabwe faces simultaneous challenges of food insecurity, malnutrition, overweight/obesity, and related comorbidities, mirroring trends seen in the United States and other developed countries.

Preventive care and screening services such as mammograms and colonoscopies are not routinely covered by government funding. Most healthcare services require out-of-pocket payment by patients and families, which severely limits their access and leads to late-stage presentation of diseases like breast, colon, and other cancers. As mentioned before, diagnostic imaging such as ultrasounds, x-rays, and especially CT scans and MRIs are prohibitively expensive for the majority of Zimbabwean families, with costs representing months or sometimes years of living expenses, contributing to delayed care, disease progression, and financial ruin.

HIV screening is widely promoted and free, with visible campaigns throughout hospitals and communities. Nutritional education particularly related to prevalent disease like diabetes is less prominent including among physicians and other healthcare providers. However, there is pride in traditional foods and some awareness of healthy choices such as home cooked vs. fast food.

Closing thoughts: Dr Arbaugh’s reflections underscore the importance of global partnerships in advancing surgical education and training and working together in the pursuit of health equity and healthcare sustainability. Her experiences remind us that collaboration, adaptability, creativity, respect, and humility are essential for shaping the future of healthcare worldwide. She is grateful to the Stanford Department of Surgery, Stanford Center for Innovation in Global Health, and Parirenyatwa/University of Zimbabwe for supporting the invaluable learning and relationships that came from this experience.