Abstract
Background
The common goal of surgical training is to provide effective, well-rounded surgeons who are capable of providing a safe and competent service that is relevant to the society within which they work. In recent years, the surgical workforce crisis has gained greater attention as a component of the global human resources in health problems in low- and middle-income countries. The purpose of this study was to: (1) describe the models for specialist surgical training in Uganda; (2) evaluate the pretraining experience of surgical trainees; (3) explore training models in the United States and Canada and areas of possible further inquiry and intervention for capacity-building efforts in surgery and perioperative care.
Methods
This was a cross-sectional descriptive study conducted at Makerere University, College of Health Sciences during 2011–2012. Participants were current and recently graduated surgical residents. Data were collected using a pretested structured questionnaire and were entered and analyzed using an excel Microsoft spread sheet. The Makerere University, College of Health Sciences Institutional Review Board approved the study.
Results
Of the 35 potential participants, 23 returned the questionnaires (65 %). Mean age of participants was 29 years with a male/female ratio of 3:1. All worked predominantly in general district hospitals. Pretraining procedures performed numbered 2,125 per participant, which is twice that done by their US and Canadian counterparts during their entire 5-year training period.
Conclusions
A rich pretraining experience exists in East Africa. This should be taken advantage of to enhance surgical specialist training at the institution and regional level.
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References
Peters MJ, Pappalardo J, Cresswell Ab (2009) Surgical Education. ANZ J Surg 79(3):192–197
Ozgediz D, Galukande M, Mabweijano J, Kijjambu S, Mijumbi C, Dubowitz G, Kaggwa S, Luboga S (2008) The neglect of global workforce: experience and evidence from Uganda. World J Surg 32(6):1208–1215. doi:10.1007/s00268-008-9473-4
Galukande M, Luboga S, Kijjambu SC (2006) Improving recruitment of surgical trainees and training of surgeons in Uganda. East Cent Afr J Surg 11(1):17–24
Linden AF, Sekidde FS, Galukande M, Knowlton LM, Chackungal S, McQueen KAK (2012) Challenges of surgery in developing Countries: a survey of surgical and anesthesia capacity in Uganda’s public hospitals. World J Surg 36(5):1056–1065. doi:10.1007/s00268-012-1482-7
Galukande M, von Schreeb J, Wladis A, Mbembati N, de Miranda H et al (2010) Essential surgery at the district hospital: a retrospective descriptive analysis in three African Countries. PLoS Med 7(3):e1000243. doi:10.1371/journal.pmed.1000243
Kruk ME, Wladis A, Mbembati N, Ndao-Brumblay SK, Hsia RY, Galukande M et al (2010) Human resource and funding constraints for essential surgery in district hospitals in Africa: a retrospective cross-sectional survey. PLoS Med 7(3):e1000242. doi:10.1371/journal.pmed.1000242
Memon B, Memon MA (2009) Mentoring and Surgical training: a time for reflection. Adv Health Sci Educ. doi:10.1007/S10459-009-9157-3
Kakande I, Mkandawire N, Thompson MIW (2011) A review of surgical capacity and surgical education programmes in the COSECSA region. East Cent Afr J Surg 16(3):6–34
American College of Surgeons division of Education. http://www.facs.org/medicalstudents/answer3.html. Accessed 1 Nov 2012
Geoffrion R, Jae Won C, Gretchen ML (2011) Training surgical residents: the current Canadian perspective. J Surg Educ 68(6):547–559
http://www.facs.org/medicalstudents/answer2.html. Accessed 1 Nov 2012
Accreditation Council for graduate medical education: 1999. Outcome project: General competencies. http://www.acgme.org/outcome/comp/compfull.asp. Accessed 3 Nov 2012
Swing SR (2007) The ACGME outcome project: retrospective and prospective. Med Teach 29:648–654
The American Board of Surgery Booklet of Information (2011–2012). www.absurgery.org. Accessed 3 Nov 2012
Postgraduate courses at Makerere College of Health Sciences (2012/3). http://chs.mak.ac.ug/content/academics. Accessed 4 Nov 2012
Bell RH, Biester TW, Tabuenca A, Rhodes RS, Cofer JB, Britt LD, Lewis FR (2009) Operative experience of residents in US general surgery programs. A gap between expectation and experience. Ann Surg 249(5):719–724
Mutabdiz D, Bedada AG, Bakanisi B, Motsumi J, Azzie G (2012) Designing a contextually appropriate surgical training program, in low-resource settings: the Bostwana experience. World J Surg. http://www.ncbi.nlm.nih.gov/pubmed/22851149. Accessed 1 Aug 2012
SCORE General Surgery Residency Curriculum outline patient care and Medical Knowledge (2012–2013). www.surgicalcore.org. Accessed 1 Nov 2012
Thomas WEG (2008) The changing face of surgical training (Oxford). Surgery 26(10):399. doi:10.1016/j.mpsur.2008.08.003 ISSN: 0263-9319
Jamsheer JT, Nadir AS (2008) Surgical Training Programs in Pakistan. World J Surg 32(10):2156–2161. doi:10.1007/s00268-008-9639-0
Acknowledgment
We thank all the graduate students who participated in this study.
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The authors declare no competing interests.
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Galukande, M., Ozgediz, D., Elobu, E. et al. Pretraining Experience and Structure of Surgical Training at a Sub-Saharan African University. World J Surg 37, 1836–1840 (2013). https://doi.org/10.1007/s00268-013-2053-2
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DOI: https://doi.org/10.1007/s00268-013-2053-2