“On October 14th, 2025, we had the honor of sitting down with Dr. Miguel Gasakure, a General Surgeon at the University Teaching Hospital of Kigali in Rwanda, who was visiting the University of Michigan’s Department of Surgery. We were deeply inspired by Dr. Gasakure’s genuine and compassionate approach to caring for his patients and are truly grateful for the opportunity to share his insights
Background:
Dr. Miguel Gasakure was born in Burundi and grew up in France before moving to Rwanda in 1996. He completed his primary education in Butare and his secondary education in Kigali, where he remained from 2008 to 2013 for medical school at the National University of Rwanda. After receiving his Bachelor’s of Medecine and Surgery in 2013, he worked as a general practitioner across Rwanda: Rwamagana, Ruli, and finally Kibagabaga. By this time, residency programs were well underway, having started in 2012, and Dr. Gasakure began a neurosurgical residency before changing course to pursue general surgery residency, which he completed in 2021. He started working as a consultant at the University Teaching Hospital of Kigali (CHUK). In February of 2025, Dr. Gasakure was appointed as the Program Director of the University of Rwanda’s General Surgery Residency Program.
Throughout his many roles, Dr. Gasakure has continuously prioritized education and academic collaboration, building strong relationships with various universities and organizations. He serves as the General Secretary for the Rwanda Surgical Society, where he works on outreach programs to support surgeons, trainees, and medical students in Rwanda.
Dr. Gasakure's initial interest in medicine stemmed from an early passion for IT and technology; he was fascinated by the rapidly developing internet and inspired by media works such as the manga Monster: “The manga talks about a neurosurgeon who chose to save a child, but it turns out he saved the wrong person. However, he kept believing in his ethics, despite having saved an assassin—a psychopath—and so he tries his best to stop him himself. It was really interesting, and I really liked the character. At the time, I was introduced to Telemedicine, and it seemed that Medecine could be so much more. I always wanted to help people, and so it made me realize that the best place for me would be as a doctor.”
The intersection of his interests opened up a world of possibilities: “It was not always easy to access medicine throughout the country. So, Telemedicine was really very inspiring at the time.” He has harnessed this potential by turning his IT passion into tangible projects. One of these projects is an “e-logbook”: a logbook that residents can access from anywhere to submit their portfolios, allowing the consultants or the program director to review what the residents are doing. This project will allow Dr. Gasakure and program faculty to use data to better understand which aspects of their teaching and training need improvement. Dr. Gasakure explains, “The resident should not only say: ‘I don't like it here; I don't feel they are helping or supporting me.’ There's actual data that backs it up and helps you make an informed decision to change the pathway of that resident.” A lot changed after COVID because virtual teaching became a more mainstream reality. “We have different virtual professorships throughout the different programs, particularly in Plastic Surgery, for example. We also have a research mentorship program in collaboration with the University of Minnesota.” Dr. Gasakure continues to transform the world of surgery using his passion for technology. One such project: a simulation trial for laparoscopic surgery. “We are looking into the possibility for such simulated exercises, done using a laparoscopic trainer, to be translated into real life or in the OR.” The future of surgery, Dr. Gasakure says, lies in augmented reality.
Dr. Gasakure’s perspectives on the patient-physician relationship:
Dr. Gasakure views the patient-provider relationship as an equal, bidirectional partnership. Providing the best care, from his perspective, is about truly wanting to learn from patients. “We, as doctors, don't live with the disease—we don't understand how long our patients have lived with that disease. So, it's important to be respectful of that and be humble enough to realize that the patient trusted you enough to wait for sometimes years, months, or the whole day just to discuss with you.”
Every moment he spends with patients is deeply valuable: “You're going to discuss with them for about 15 minutes, so it should be a good experience for them. You should learn about them and learn from them.” Dr. Gasakure is deeply committed to building these partnerships with his patients. “It's always about how you make rapport with the patient. You want to make them understand that you're on their side. You want to help as much as possible, even when you can't, and you want to be frank about it. They will feel it, and they will continue discussing it with you, even afterwards, even when you cannot help them.” It can feel challenging to build these relationships, but this comes from misunderstanding the patient’s experience.
“The first thing you have to understand is that all patients come to you in their most vulnerable state, even when they look pissed and want to lash out. It's not really about that; it's mostly that they are angry at themselves. Maybe it took so long to seek care that now they must meet with a surgeon, and meeting with a surgeon is usually for radical things. It's going to be life-changing.” Accordingly, physicians—and surgeons, in particular—should give patients grace.
“Surgeons are drastic, so it’s going to be life-changing for their patients. After meeting a surgeon, you're never the same person. This is important, and I particularly emphasize that to our patients with advanced cancer, because they come in with their families, and they should understand and believe that they’ve done everything in their ability to seek care. They could never have predicted that what happened would happen. Otherwise, when they don’t feel that you are trying to connect with them, they will go look for an alternative treatment, or they will keep on hoping for something else to happen.
You do not want that, because that is a patient who will not heal, and then the burden will also be shared by the family or the caretaker. It's important to try your best to comprehend their understanding and belief about their own disease. There are some good ways to gain someone’s trust, like learning their names. Different cultures have different traditions for greetings and how you discuss specific things. Ask genuine questions such as: ‘I have heard you're Muslim, and I would like to examine you. Should we bring in someone else, or are you comfortable?’ You should always try to truly learn from them.”
Dr. Gasakure highlights how frustration and negative emotions expressed by a patient are often not truly about the physician; rather, they reflect a patient’s understanding of their own state. Thus, you should always try your best to acknowledge that to build that inestimable trust. If your patient feels you are being arrogant, paternalistic, or even worse, dismissive, they will not adhere to your treatment plan.
Accordingly, “When the patient feels like they are involved in their own treatment, they will help you treat them.” For example, “How do you know that the patient is taking their treatment? At some point, you must trust them to do the right thing.” Even if you know that when they get home, “there is an aunt who learned about this new medication, or there is an advertisement about a drug or clinic on TV. Therefore, trust in medicine is very much a two-way street.”
A meaningful story Dr. Gasakure shared with us:
“A young man in his thirties was newly diagnosed with Diabetes Mellitus at his district hospital. He had consulted for a wound on his foot that had not healed for over 3 months. The shock was incredible, but he was started on insulin and sent to us at the tertiary hospital.
Here, we had to do a CT-angiography that revealed extensive peripheral artery disease with obstructive thrombosis at mid-tibia level. After discussion with the vascular surgeon, an amputation was recommended. However, when we informed the patient, he immediately fell into depression. We thought that it was because of the sad news we gave him and tried to emphasize that it would help with his ‘healing’; he will ‘heal’ faster like that. He was young and would ‘heal’ easily.
One day, he confided to a resident that he did not think he was going to ‘heal’ because, for the first time in his life, he had saved enough money to buy a brand-new truck. He finally got a driving license, and his business had just started. So, how could we say we were ‘healing’ him when everything else in his life was crumbling down?
The ‘healing’ for us doctors might be different from the ‘healing’ of our patients. It is important to align with what patients actually envision without lying or giving false hope. That balance is crucial but quite difficult to achieve.”
Dr. Gasakure’s current initiatives:
Dr. Gasakure believes that his duty to medicine extends beyond the walls of a hospital. Physicians have a responsibility to reach as many people as they can and help in any way they can. Dr. Gasakure practices these values through several health initiatives. He is currently involved in different clinical trials whose main themes are surgical safety practices and surgical site infections. “One of the earliest trials we worked on showed that the simple change of gloving and gowning during certain steps for abdominal surgeries decreased the rate of surgical site infection by around 13%. So, now we are looking into combining that with the use of single-use material, such as gowns or drapes, versus reusable ones.”
He is also co-leading multiple global initiatives to this end: “We have a couple of worldwide clinical trials around surgical safety and infection prevention that I lead at CHUK under the supervision of and collaboration with the Global Surgery Research Hub of the University of Rwanda, the NIHR Global Health Research Unit on Global Surgery, the University of Edinburgh, and the University of Birmingham. You can look them up on the internet: EMUs, CAMELs, PENGUIN, GECKO, to name a few (Yes, only animal names! Surgeons are facetious like that!).”
Dr. Gasakure also believes in disseminating his knowledge as best he can to inspire an informed future generation of medical professionals: “I am very interested in medical education and simulation, as I was mentioning before, such as trying to translate a laparoscopic or virtual simulation into actual skills within the OR and to see how much it impacts the residents or the medical students.” To this end, he is working on “creating digital tools to help with self-learning for residents: e-logbooks, patient waiting lists, and a skills simulation app. I think the future of surgery resides in being safe while practicing, and what better way to do so but through simulation?”
Among many other initiatives, he is working “to revamp the whole General Surgery Programme by making sure it is truly focused on the residents' needs but also pushing them to academic excellence.” This entails “more mentorship, better clinical rotations, timely feedback, involving them in research projects, and encouraging them to teach undergraduates. Of course, this cannot work without the involvement of the seniors, so I am also trying to find the best ways to incentivize and acknowledge the work of all our esteemed lecturers.”
Further, he is supporting all the new fellowships in Rwanda that are directly affiliated to General Surgery: colorectal, vascular, breast, thoracic, and transplant, so far. “I do so not only by providing the necessary logistics for those teams through the University, but also by working with them in matters such as the review and revision of their curricula, assessment tools, exam materials, etc. I'm an academic advisor in a way.”
While Dr. Gasakure is “still mostly working on system and medical education”, he is slowly working his way “towards community engagement initiatives.” He is ensuring a commitment to cultural humility and sustainable initiatives, “because sometimes we think we know better and are helping people, but we are not even considering their issues or queries. In fact, going to a remote area for only one week and not training the local surgical teams, in the end, only gives poor performance.”
Dr. Gasakure is excited for future global collaborations, including with the University of Michigan. He is currently working to “create bridging programmes for research, but also clinical rotations between our University and the University of Michigan and Virginia so far. This could benefit the trainees and the trainers as well. We are working on the best framework to properly and legally learn from each other.”
Concluding Remarks:
Dr. Miguel Gasakure’s profound respect for his patients and their lived experiences, dedication to medical innovation, and commitment to both intentional leadership and mentorship of future healthcare professionals exemplify ethical engagement in medicine and global health. His wisdom and perspectives have been deeply impactful in our lives, and we are confident that his insights will resonate throughout the global surgery community. We are excited for the future of collaboration between the University of Rwanda and the University of Michigan.
We would like to thank Dr. Miguel Gasakure for the opportunity to learn from him, our mentor Dr. Robin Petroze for her truly invaluable guidance and support, and Michelle Staples and Laura Rivard for their instrumental roles in making this possible. Thank you for your continued support of us and of the University of Michigan’s Global Surgery Student Alliance.
“After meeting a surgeon, you’re never the same person”: A Conversation with Dr. Miguel Gasakure
By: Nathalie Tsimhoni and Anam Noor
