World Journal of Surgery

, Volume 43, Issue 3, pp 723–735 | Cite as

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

  • Adam GyeduEmail author
  • Sam Debrah
  • Kwabena Agbedinu
  • Stephanie K. Goodman
  • Jacob Plange-Rhule
  • Peter Donkor
  • Charles Mock
Original Scientific Report (including Papers Presented at Surgical Conferences)



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.


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.


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.


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.



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.

Authors’ 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.


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.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Adam Gyedu
    • 1
    • 2
    Email author
  • Sam Debrah
    • 3
  • Kwabena Agbedinu
    • 4
  • Stephanie K. Goodman
    • 5
  • Jacob Plange-Rhule
    • 6
  • Peter Donkor
    • 1
  • Charles Mock
    • 7
    • 8
  1. 1.Department of Surgery, School of Medical SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
  2. 2.University HospitalKwame Nkrumah University of Science and TechnologyKumasiGhana
  3. 3.Department of Surgery, School of Medical SciencesUniversity of Cape CoastCape CoastGhana
  4. 4.Komfo Anokye Teaching HospitalKumasiGhana
  5. 5.Standford Children’s HealthPalo AltoUSA
  6. 6.Ghana College of Physicians and SurgeonsAccraGhana
  7. 7.Harborview Injury Prevention and Research CenterSeattleUSA
  8. 8.Department of SurgeryUniversity of WashingtonSeattleUSA

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