IFGH 2012: Addressing Surgical Manpower in Sub Saharan Africa: an Intercollegiate Partnership Between RCSI and COSECSA

January 27, 2012


Posted by Irish Forum for Global Health | Conference Abstracts

Authors:O’Flynn E.1,2, Duggan R.1,2, Tierney S.1, Thompson M.2, Mkandawire N.2, Kakande I.2

Author Affiliations: 1Royal College of Surgeons in Ireland / College of Surgeons of East, Central and Southern Africa Collaboration Programme, 2RCSI Dublin COSECSA Arusha, Tanzania

Option 2– Lessons from the field; project and programme evaluations; and syntheses or analyses

Presented as – Oral Presentation


A recent situational analysis indicates that the COSECSA region* has as few as 1,390 trained surgeons for 273 million inhabitants in 9 of the lowest income countries in the world. Low medical school output, training capacity limited to university hospitals, international “brain drain”, and low remuneration have limited capacity to address this deficit.


In 2007, RCSI entered into an agreement with COSECSA to support the development of their organisationalcapacity, training structures & curriculum, examinations, faculty development and direct budgetary support. This is under the governance of a joint steering committee in a programme funded by Irish Aid. Organisational capacity is supported by 2 programme staff, a volunteer at senior manager level, administrative training and faculty exchange visits to RCSI. COSECSA & RCSI faculty have collaborated to greatly expand the number of clinical skills courses for trainees and local surgical faculty development courses have been developed and delivered. An e-learning platform (www.schoolforsurgeons.net) has been developed and populated with both existing and newly developed, indigenous learning resources. ICT labs have been installed in 18 locations across 7 countries to date with another 9 planned in 2012. Since 2007 the number of trainees taking Membership (after 2 years) and Fellowship (at completion of training after 5 years) examinations has grown from 5 MCS and 13 FCS to 36 and 19 respectively.

Lessons learned:

Working within existing structures is effective in increasing the production of trained surgeons in a way that is further scalable. E-learning is a scalable and cost effective way of delivering standardised training across a wide geographic distance. Institutional relationships are more durable than those between individuals and provide infrastructure to ensure voluntary efforts are effectively utilised. Ensuring that such structures are financially self sustaining is a major challenge.

*Ethiopia, Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia, Zimbabwe




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