Participants pointed out that sometimes surgical healthcare providers take an individualistic approach to ISTCs that may make it difficult to consolidate efforts. They expressed that surgical healthcare providers are driven people and want to be involved in ISTCs on their own without needing to get approval from others. An unfortunate side effect of this is that those involved in ISTCs do not disclose with each other, as they should, what they have done and what they know regarding global surgery work. “I think the thing is as surgeons and physicians in general, we are driven people, so we think whatever we decide to do is the best way to do it, and whatever other people are doing is a waste of resources.” –Neurosurgery Resident, Canada