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In-Country Training by the Ghana College of Physicians and Surgeons: An Initiative that has Aided Surgeon Retention and Distribution in Ghana

  • Original Scientific Report (including Papers Presented at Surgical Conferences)
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Abstract

Background

Prior to 2003, production of new surgeons in Ghana was limited. In 2003, the Ghana College of Physicians and Surgeons (GCPS) initiated the first wholly in-country training and credentialing of surgeons. The purpose of this study was to assess the impact of in-country training of surgeons in Ghana.

Methods

We interviewed 117 (80%) of the 146 surgeons trained through the GCPS from inception through 2016. We gathered data on type of training, practice location, clinical workload, and administrative and teaching roles. Operations were categorized into those deemed essential (most cost-effective, highest population impact) by the World Bank’s Disease Control Priorities project versus other.

Results

In-country retention was 87–97%. A little more than half (56%) were working in the two largest cities and 44% were working in higher need areas. Twenty-two (19%) were the first surgeon to have worked at their current hospital. The surgeons performed a mean of 13 operations per week (seven electives, six emergencies). 35% of elective and 77% of emergency operations were in the essential category. Most (79%) surgeons were engaged in training/teaching; 46% were engaged in research; and 33% held an administrative office.

Conclusions

In-country surgical training has led to high retention and wide geographic distribution, including high need areas. The in-country trained surgeons are playing key roles in clinical practice, training, and administration. These data provide support for investments in similar efforts in other low- and middle-income countries.

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Acknowledgements

The authors wish to thank all the surgeons who participated in the study. Because of the sensitive nature of the data collected for this study, requests to access the data set from qualified researchers trained in human subject confidentiality protocols may be sent to the corresponding author.

Funding

This study was funded in part by Grant D43TW007267 from the Fogarty International Center, US National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

    Adam Gyedu & Peter Donkor

  2. University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

    Adam Gyedu

  3. Department of Surgery, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana

    Sam Debrah

  4. Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Kwabena Agbedinu

  5. Standford Children’s Health, Palo Alto, CA, USA

    Stephanie K. Goodman

  6. Ghana College of Physicians and Surgeons, Accra, Ghana

    Jacob Plange-Rhule

  7. Harborview Injury Prevention and Research Center, Seattle, WA, USA

    Charles Mock

  8. Department of Surgery, University of Washington, Seattle, WA, USA

    Charles Mock

Authors
  1. Adam Gyedu
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  2. Sam Debrah
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  3. Kwabena Agbedinu
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  4. Stephanie K. Goodman
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  5. Jacob Plange-Rhule
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  6. Peter Donkor
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  7. Charles Mock
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Contributions

AG, SD, JP, CM was involved in study concept and design. AG, KA, SKG, PD was involved in acquisition, analysis, or interpretation of data. AG, SD. KA, SKG, JP, PD, CM drafted the manuscript. AG, SD. KA, SKG, JP, PD, CM critically revised the manuscript for important intellectual content. AG, SD. KA, SKG, JP, PD, CM was involved in administrative, technical, or material support.

Corresponding author

Correspondence to Adam Gyedu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Appendix: Survey tool

Appendix: Survey tool

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Gyedu, A., Debrah, S., Agbedinu, K. et al. In-Country Training by the Ghana College of Physicians and Surgeons: An Initiative that has Aided Surgeon Retention and Distribution in Ghana. World J Surg 43, 723–735 (2019). https://doi.org/10.1007/s00268-018-4840-2

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  • DOI: https://doi.org/10.1007/s00268-018-4840-2

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