Surgical Training in South Africa: An Overview and Attempt to Assess the Training System from the Perspective of Foreign Trainees

• Published in: World journal of surgery 2019-09, Vol.43 (9), p.2137-2142
• Main Authors: Mantica, Guglielmo, Fransvea, Pietro, Virdis, Francesco, Hardcastle, Timothy C., Ackermann, Hilgard, Terrone, Carlo, Costa, Gianluca, Van der Merwe, André, Balducci, Genoveffa, Steyn, Elmin
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Attitude of Health Personnel; Cardiac Surgery; Clinical Competence; Digital media; Education, Medical, Graduate - organization & administration; Education, Medical, Graduate - standards; Emergency response; Exposure; Female; Foreign Medical Graduates - psychology; General Surgery; Humans; Male; Medicine; Medicine & Public Health; Minimally Invasive Surgical Procedures - education; Original Scientific Report; Research projects; South Africa; Supernumerary; Surgery; Surgical Procedures, Operative - education; Surveys and Questionnaires; Thoracic Surgery; Training; Trauma; Trauma Centers - statistics & numerical data; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-019-05034-7

Background Currently, there are no objective reports evaluating the quality of the South African surgical training. The aim of this study is to evaluate the current state of surgical training in South Africa from an external impartial point of view and to rate the experience of short-term supernumerary registrars and fellows (STSRF) within the South African training system. Methods A 29-item survey was distributed via e-mail and social media to non-South African trainees who worked in South Africa as STSRF for a period of at least 1 month during the past 5 years. The survey evaluated the surgical, clinical and academic training received during their elective period in a South African department. Results Sixty-four STSRF replied to the survey. Sixty-two percent of STSRF attended a trauma unit during their experience. For the majority of respondents, open and emergency surgical exposure, as well as experience as first surgeon, is significantly higher in the South African system, while minimally invasive and endoscopic surgery exposure is significantly less. Research project involvement is significantly less, for the STSRF, as opposed to lectures and teaching that constitute a higher percentage. No significant difference was found regarding exposure to hands-on activities. Conclusions The South African system still provides excellent surgical and clinical exposure as well as teaching. However, minimally invasive surgery training and research are generally lacking for the STSRF. Exchange programs between South African and developed country institutes should be improved and encouraged in order to gain mutual benefits.