Unnoticed to Unforgettable: How Global Surgery Professionals Develop Relational Awareness around their Expertise

Scholars of professions have increasingly highlighted that professional expertise is shaped by multiple relational factors – including social relationships, institutional affiliations, technological affordances, and regulations – that enable professionals’ core skills and know-how. However, it is unclear how professionals themselves may become aware of the broader relational structure surrounding their expertise (i.e., develop relational awareness) and the consequences of this. This study of global surgeons and anesthesiologists – doctors who work in high-income countries (e.g., US, Canada) that do volunteer surgical work in low-income countries (mostly in Africa) – aims to better understand this little-explored phenomenon. Drawing on interviews and observations, findings reveal that as these doctors moved across contexts, while their own competencies and the skills of their hands remained constant, their sense of expertise – how they gauged their ability to have an effect – varied. By unpacking the various features in low-income countries that shifted these doctors’ sense of expertise, I show how they developed relational awareness of their expertise and how such awareness led them to profoundly reconfigure their work abroad. Overall, findings contribute to the professions literature by showing how developing relational awareness of one’s expertise can deeply change how professionals work.