Department of Surgery, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Faculty of Health Sciences, University of Buea, Buea, Cameroon.
World J Surg. 2019 Dec;43(12):2973-2978. doi: 10.1007/s00268-019-05163-z.
World Health Organization recommends that basic surgical care be administered at the district level. In the absence of qualified surgeons, general practitioners are sometimes proposed to bridge the gap. Medical curricula in low- and middle-income countries must be designed accordingly. The aim of this study was to assess the achievements of training of undergraduate medical students in Cameroon towards meeting this objective.
A descriptive cross-sectional study was carried out in the four state-owned medical schools in Cameroon. All students who had completed all clinical rotations were assessed with a self-administered questionnaire for their exposure and self-perceived comfort in conducting some selected basic surgical skills and procedures.
A total of 304 (87.6%) students returned filled questionnaires. Their self-perceived comfort in surgical skills ranged from 25% (manual node tying) to 86% (surgical scrubbing). Adequate exposure to selected surgical procedures was 87% for repair of perineal tear complicating vaginal delivery, above 80% for caesarean section and incision and drainage of abscess, 73% for cast immobilization of extremity fracture and just above 50% for hernia repair and appendectomy. It was as low as 3% for bowel resection and anastomosis. The choice to perform extra-curricular activity for skills improvement was significantly associated with adequate exposure (p < 0.05).
Overall, the mastery of practical surgical skills and basic surgical interventions by final-year medical students in Cameroon is insufficient. There is need to reinforce the training and assessment by creating the conditions for an appropriate exposure of medical students during surgical rotations.
世界卫生组织建议在地区一级提供基本外科护理。在缺乏合格外科医生的情况下，有时会提议由全科医生来填补这一空白。低中等收入国家的医学课程必须据此进行设计。本研究旨在评估喀麦隆医学生的培训成果，以实现这一目标。
在喀麦隆的四所国立医学院进行了一项描述性的横断面研究。所有完成所有临床轮转的学生都通过自我管理的问卷评估了他们在进行一些选定的基本外科技能和手术方面的暴露程度和自我感觉舒适程度。
共有 304 名（87.6%）学生返回了填写完整的问卷。他们对手术技能的自我感觉舒适程度从 25%（手动节点结扎）到 86%（手术刷洗）不等。对某些手术程序的充分暴露率为：会阴撕裂修补术（87%）、剖宫产术和脓肿切开引流术（80%以上）、四肢骨折石膏固定术（73%）、疝修补术和阑尾切除术（50%以上）。肠切除术和吻合术的暴露率仅略高于 3%。选择进行课外活动以提高技能水平与充分暴露显著相关（p<0.05）。
总体而言，喀麦隆最后一年医学生掌握实用外科技能和基本外科干预的能力不足。需要通过为医学生在外科轮转期间提供适当暴露的条件来加强培训和评估。
