Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
Rutgers New Jersey Medical School, Newark, NJ.
Surgery. 2021 Aug;170(2):478-484. doi: 10.1016/j.surg.2021.04.018. Epub 2021 May 18.
The global burden of disease treatable by surgical subspecialists remains an outstanding area of need, and yet little is known about the subspecialist workforce worldwide, especially in sub-Saharan Africa. This study aims to quantify the subspecialty surgical workforce and number of subspecialty training programs in West Africa and to identify socioeconomic factors predicting the number of subspecialists in West African countries.
West African subspecialists and accredited fellowship training programs in 17 West African countries were quantified using membership data from the West African College of Surgeons and compared with publicly available workforce data from the United States, the United Kingdom, and East, Central, and Southern Africa. Spearman's coefficients were calculated to identify socioeconomic predictors of subspecialist surgical workforce.
Of 2,181 surgeons, 712 (32.6%) were surgical subspecialists. Three (18%) of 17 West African countries had greater than 11 subspecialists. There were 174 subspecialty training programs in the region, though 13 countries (76%) had no programs. The number of subspecialists correlated most strongly with the number of subspecialty training programs (r = 0.68, P = .003) but also correlated significantly with gross population and number of medical schools (r = 0.50-0.52, P ≤ .05).
Subspecialist surgeons represent one third of surgeons in West Africa, though most countries have fewer than 12 providers. The number of subspecialists is significantly correlated with the number of subspecialty training programs, and yet many West African countries lack accredited programs. These results suggest that investing in training programs is the most valuable potential strategy to address the shortage of surgical subspecialists in West Africa.
可由外科专科医生治疗的全球疾病负担仍然是一个急需解决的领域，但全球范围内的专科医生劳动力，特别是撒哈拉以南非洲地区的专科医生劳动力情况，人们知之甚少。本研究旨在量化西非的专科外科医生人数和专科培训计划数量，并确定预测西非国家专科医生人数的社会经济因素。
使用西非外科医师学院的会员数据量化了 17 个西非国家的专科医生和认证的专科医师培训计划，并将其与来自美国、英国以及东非、中非和南非的公开可用劳动力数据进行了比较。使用 Spearman 系数来确定专科外科医生劳动力的社会经济预测因素。
在 2181 名外科医生中，712 名（32.6%）是外科专科医生。17 个西非国家中有 3 个（18%）的专科医生人数超过 11 人。该地区有 174 个专科培训计划，但 13 个国家（76%）没有培训计划。专科医生人数与专科培训计划数量相关性最强（r=0.68，P=0.003），但与人口总数和医学院数量也显著相关（r=0.50-0.52，P≤0.05）。
在西非，专科外科医生占外科医生的三分之一，但大多数国家的专科医生人数都少于 12 人。专科医生人数与专科培训计划数量显著相关，但许多西非国家缺乏认证的培训计划。这些结果表明，投资培训计划是解决西非外科专科医生短缺问题最有价值的潜在策略。
