Starting in 2015, Operation Smile partnered with the University of Rwanda, Partners In Health and the Rwandan Ministry of Health to host twice-annual surgical training rotations. Since then, 17 Rwandan general surgery residents have received hands-on training and education through the rotations. Operation Smile has also worked to improve the skills of local anesthesiologists. Through a grant secured by Operation Smile Sweden through the Swedish Postcode Lottery, Operation Smile will help establish the country’s first-ever postgraduate reconstructive plastic surgery certification program in partnership with the University of Rwanda and Rwanda’s ministries of education and health. The program is scheduled to begin in September 2019 with its first graduates receiving certifications in 2022.