Surgery in Nigeria.

Nigeria, like most other developing countries, is today experiencing an increasing incidence of noncommunicable diseases and the unsolved problem of infectious diseases. The role of surgery in the management of these diseases has continued to increase. Surgical training has traditionally been of a high standard, and this has made it possible for surgeons trained in Nigeria to cope with this change in the spectrum of diseases. A low success rate at the diploma examinations and an increasing loss of local talent to foreign countries has increased calls for a modification of the training programs. There is a need to improve the working conditions and environment of surgeons to stem the attrition. Surgery in a poor resource environment demands more, rather than less, skill from the surgeon, and the training programs must ensure that the specialist is adequately equipped to deal with conditions that may not be considered general surgery. While the unavailability of modern technology has limited the scope of research, it is still possible to conduct appropriate, "low-tech," and relevant research that is subject to excellent study design, proper controls, and scientifically valid interpretations.