Kayamba Violet, Nzala Selestine, Simuyemba Moses Chikoti, Zyambo Cosmas, Musenge Emmanuel, Wahila Ruth, Kalusopa Victoria Mwiinga, Mwiinga Christabel, Kampata-Olowski Linda, Makukula Marjory Kabinga, Katowa-Mukwato Patricia, Kafumukache Elliot, Goma Fastone
University of Zambia School of Medicine, Nationalist Road, P.O. Box 50110, Lusaka, Zambia.
Eden University, P.O. Box 37727, Barlastone Park, Lusaka, Zambia.
Med J Zambia. 2022 Aug 22;49(1):67-74. doi: 10.55320/mjz.49.1.36. Epub 2022 Aug 5.
There is a significant shortage of medical subspecialists in Zambia. The government of Zambia, through programmes at the Ministry of Health, spends considerable resources to send patients outside the country for subspecialist medical treatment. The objective of this analysis was to evaluate the current situation pertaining to medical subspecialty training at the University of Zambia School of Medicine (UNZASOM) and to illustrate the new programmes that are to be introduced.
We collected data from formal desk reviews on the state of medical specialisation in Zambia, the UNZASOM graduation archives and patient referral records at the Ministry of Health (MoH). In addition, information on planned subspecialist programmes is presented.
From the first graduates in 1986up to 2019,UNZASOM produced 351medical specialists, 63 (18%) in Internal Medicine, 77 (22%) in Obstetrics &Gynaecology, 82 (23%) in Paediatrics&Child Health, 68 (19%) in General Surgery, 17 (5%) in Anaesthesia & Critical Care, 20 (6%) in Orthopaedics &Trauma and 8 (2%) in Urology. The remaining graduates were in Ophthalmology, Psychiatry, Infectious Diseases, Paediatric Surgery and Pathology contributing 1% each. To enhance medical subspecialist training at UNZASOM, new curricula for Breast Surgery, Urology, Glaucoma, Vitreo-retinalSurgery, Adult Gastroenterology, Forensic Pathology, Dermatology & Venereology, Ophthalmology, Gynaecological Oncology and Paediatric anaesthesia, Infectious Diseases, and Gastroenterology were developed. Since 2013, only 44% of patients requiring subspecialist treatment out of Zambia got assisted with the remainder still on the waiting list or having had bad outcomes.
These programmes will provide an opportunity for accessible and affordable medical subspecialization training for Zambia and its neighbouring countries. With enhanced infrastructural support, the subspecialists will contribute toward enhanced healthcare provision and improvement in patient outcomes. They will also form a cohort of trainers to expand the space for quality training and skills building of specialists and subspecialists in the region and beyond.
赞比亚严重缺乏医学专科医生。赞比亚政府通过卫生部的各项计划，花费大量资源将患者送往国外接受专科治疗。本分析的目的是评估赞比亚大学医学院（UNZASOM）目前医学专科培训的情况，并介绍即将推出的新计划。
我们从对赞比亚医学专科状况的正式案头审查、UNZASOM毕业档案以及卫生部（MoH）的患者转诊记录中收集数据。此外，还介绍了计划中的专科培训计划的相关信息。
从1986年的首批毕业生到2019年，UNZASOM共培养了351名医学专科医生，其中内科63名（18%），妇产科77名（22%），儿科与儿童健康82名（23%），普通外科68名（19%），麻醉与重症监护17名（5%），骨科与创伤20名（6%），泌尿外科8名（2%）。其余毕业生分布在眼科、精神病学、传染病学、小儿外科和病理学，各占1%。为加强UNZASOM的医学专科培训，制定了乳腺外科、泌尿外科、青光眼、玻璃体视网膜外科、成人胃肠病学、法医病理学、皮肤病与性病学、眼科、妇科肿瘤学、小儿麻醉、传染病学和胃肠病学的新课程。自2013年以来，赞比亚境外需要专科治疗的患者中只有44%得到了帮助，其余患者仍在等待名单上或治疗效果不佳。
这些计划将为赞比亚及其邻国提供获得可及且负担得起的医学专科培训的机会。随着基础设施支持的加强，专科医生将有助于改善医疗服务提供并提高患者治疗效果。他们还将形成一批培训人员，以扩大该地区及其他地区专科医生和亚专科医生高质量培训和技能培养的空间。
