This elective is in Santos, Brazil (about 1 hour away from Sao Paulo) with a general surgeon who specializes in surgical oncology. Four days of the week are spent at a small community hospital, Hospital Sao Jose in Sao Vicente, where there are 2 operating rooms currently in use. There are about 5-7 cases a day, mostly comprising of open general surgery and surgical oncology cases (i.e. hernias, cholecystectomies, various skin tumors, lymphadenectomies, head & neck tumors, vocal cord tumors, colectomies, and amputations). Usually there are 2 rooms running, with the attending in one room and the resident with the PA in the other. A typical day begins around 8am and ends around 7pm after operating and rounding on patients. Clinic is twice a week at both the ER and a government-sponsored clinic. Once a week the attending surgeon covers surgery call in the ER, during which there are occasional traumas, acute abdomens, and airway cases. Fridays are spent in Sao Paulo at Hospital Israelita Albert Einstein, one of the largest major hospitals in Brazil, working with the liver transplant team. Overall, it is an amazing opportunity to learn how to operate independently in a hospital with limited resources.