Surgical education in and for low- and middle-income countries is expanding in recent years. An increase in training programs corresponds to an increase in graduates and the stakes are high for these graduates to be successful.

Specialty pediatric surgical training on the continent of Africa has expanded significantly in the last 5 years. The authors work or were trained in a Kenyan pediatric surgery training program founded in 2007. Literature is sparse on best practices in candidate selection, and we seek to share lessons learned from the success of our graduates.

We propose geography be a significant factor not only in development of new training programs but also in trainee selection to ensure success of the graduate surgeon and that their efforts can reach the underserved.