College of Surgeons for East, Central and Southern Africa Secretariat, Arusha, Tanzania.
Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
World J Surg. 2024 Sep;48(9):2187-2198. doi: 10.1002/wjs.12278. Epub 2024 Jul 7.
The College of Surgeons of East, Central, and Southern Africa (COSECSA) comprises 14 countries, many of which currently grapple with an increasing burden of cardiothoracic surgical (CTS) diseases. Health and economic implications of unaddressed CTS conditions are profound and require a robust regional response. This study aimed to define the status of CTS specialist training in the region (including the density of specialists, facilities, and active training posts), examine implications, and proffer recommendations.
A desk review of COSECSA secretariat documents and program accreditation records triangulated with information from surgical societies was performed in May 2022 and September 2023 as part of education quality improvement. A modified nominal group process involving contextual experts was used to develop a relevant action framework.
Only 6 of 14 (43%) of COSECSA countries offered active training programs with annual intake of only 18 trainees. Significant training gaps existed in Burundi, Botswana, Malawi, Rwanda, South Sudan, Zambia, and Zimbabwe. Country specialist density ranged from 1 per 400,000 (Namibia) to 1 per 8,000,000 (Ethiopia). Overall, the region had 0.2 CTS specialists per million population as compared with 7.15 surgeons per million in High-Income Countries. Surgical education experts proposed an action framework to address the training crisis including increasing investments in CTS education, establishing regional centers of excellence, retention incentives and opportunities for women, and leveraging international partnerships.
Proactive investments in infrastructure, human resources, training, and collaborative efforts by national governments, regional intergovernmental organizations, and international partners are critical to expanding regional CTS training.
东、中、南部非洲外科学院（COSECSA）由 14 个国家组成，其中许多国家目前正面临着不断增加的心胸外科疾病负担。未得到解决的心胸外科疾病对健康和经济的影响是深远的，需要强有力的区域应对。本研究旨在确定该地区心胸外科专家培训的现状（包括专家密度、设施和活跃的培训岗位），并探讨其影响，提出建议。
2022 年 5 月和 2023 年 9 月，作为教育质量改进的一部分，对 COSECSA 秘书处文件和项目认证记录进行了桌面审查，并与外科协会的信息进行了三角剖分。采用涉及情境专家的改良名义群体程序，制定了一个相关的行动框架。
只有 14 个 COSECSA 国家中的 6 个（43%）提供了活跃的培训项目，每年的招生人数仅为 18 人。布隆迪、博茨瓦纳、马拉维、卢旺达、南苏丹、赞比亚和津巴布韦存在明显的培训差距。各国专家密度从每 40 万人 1 人（纳米比亚）到每 800 万人 1 人（埃塞俄比亚）不等。总的来说，该地区每百万人口有 0.2 名心胸外科专家，而高收入国家每百万人口有 7.15 名外科医生。外科教育专家提出了一个行动框架，以解决培训危机，包括增加心胸外科教育投资、建立区域卓越中心、为女性提供留用激励和机会，以及利用国际伙伴关系。
国家政府、区域政府间组织和国际伙伴积极投资于基础设施、人力资源、培训和合作，对于扩大区域心胸外科培训至关重要。
