Analysing the Operative Experience of Paediatric Surgical Trainees in Sub-Saharan Africa Using a Web-Based Logbook
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SURGERY IN LOW AND MIDDLE INCOME COUNTRIES
Analysing the Operative Experience of Paediatric Surgical Trainees in Sub-Saharan Africa Using a Web-Based Logbook Ciaran Mooney1
•
Sean Tierney2 • Eric O’Flynn3 • Miliard Derbew4 • Eric Borgstein5
Accepted: 16 November 2020 Ó The Author(s) 2020
Abstract Background The expansion of local training programmes is crucial to address the shortages of specialist paediatric surgeons across Sub-Saharan Africa. This study assesses whether the current training programme for paediatric surgery at the College of Surgeons of East, Central and Southern Africa (COSECSA) is exposing trainees to adequate numbers and types of surgical procedures, as defined by local and international guidelines. Methods Using data from the COSECSA web-based logbook, we retrospectively analysed numbers and types of operations carried out by paediatric surgical trainees at each stage of training between 2015 and 2019, comparing results with indicative case numbers from regional (COSECSA) and international (Joint Commission on Surgical Training) guidelines. Results A total of 7,616 paediatric surgical operations were recorded by 15 trainees, at different stages of training, working across five countries in Sub-Saharan Africa. Each trainee recorded a median number of 456 operations (range 56–1111), with operative experience increasing between the first and final year of training. The most commonly recorded operation was inguinal hernia (n = 1051, 13.8%). Trainees performed the majority (n = 5607, 73.6%) of operations recorded in the eLogbook themselves, assisting in the remainder. Trainees exceeded both local and international recommended case numbers for general surgical procedures, with little exposure to sub-specialities. Conclusions Trainees obtain a wide experience in common and general paediatric surgical procedures, the number of which increases during training. Post-certification may be required for those who wish to sub-specialise. The data from the logbook are useful in identifying individuals who may require additional experience and centres which should be offering increased levels of supervised surgical exposure.
& Ciaran Mooney [email protected]
2
Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
Sean Tierney [email protected]
3
Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
Eric O’Flynn [email protected]
4
School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
Miliard Derbew [email protected]
5
Department of Surgery, University of Malawi, Blantyre, Malawi
Eric Borgstein [email protected] 1
Faculty of Medicine, Health and Life Sciences, Queen’s University Belfast, Belfast, United Kingdom
123
World J Surg
Introduction Children make up half of the population of Sub-Saharan Africa [1]. It has been estimated that as many as 85% of them will develop a surgically treatable condition by the time they turn fifteen [2]. Despite this, paediatric surgical services across much of the continent remain
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