Jennifer L Rickard1, Georges Ntakiyiruta2, Kathryn M Chu3. 1. Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: jlr283@mail.harvard.edu. 2. Department of Surgery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda. 3. Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
Abstract
OBJECTIVE: To define the operations performed by surgical residents at a tertiary referral hospital in Rwanda to help guide development of the residency program. DESIGN: Cross-sectional study of all patients operated by surgical residents from October 2012 to September 2013. SETTING: University Teaching Hospital of Kigali (Centre Hospitalier Universitaire de Kigali [CHUK]), a public, tertiary referral hospital in Kigali, Rwanda. PARTICIPANTS: All patient data were entered into the operative database by surgical residents at CHUK. A total of 2833 cases were entered into the surgical database. Of them, 53 cases were excluded from further analysis because no surgical resident was listed as the primary or assistant surgeon, leaving 2780 cases for analysis. RESULTS: There were 2780 operations involving surgical residents. Of them, 51% of procedures were classified under general surgery, 38% orthopedics, 7% neurosurgery, and 4% urology. Emergency operations accounted for 64% of the procedures, with 56% of those being general surgery and 35% orthopedic. Further, 50% of all operations were trauma, with 71% of those orthopedic and 21% general surgery. Surgical faculty were involved in 45% of operations as either the primary or the assistant surgeons, while the remainder of operations did not involve surgical faculty. Residents were primary surgeons in 68% of procedures and assistant surgeons in 84% of procedures. CONCLUSIONS: The operative experience of surgery residents at CHUK primarily involves emergency and trauma procedures. Although this likely reflects the demographics of surgical care within Rwanda, more focus should be placed on elective procedures to ensure that surgical residents are broadly trained.
OBJECTIVE: To define the operations performed by surgical residents at a tertiary referral hospital in Rwanda to help guide development of the residency program. DESIGN: Cross-sectional study of all patients operated by surgical residents from October 2012 to September 2013. SETTING: University Teaching Hospital of Kigali (Centre Hospitalier Universitaire de Kigali [CHUK]), a public, tertiary referral hospital in Kigali, Rwanda. PARTICIPANTS: All patient data were entered into the operative database by surgical residents at CHUK. A total of 2833 cases were entered into the surgical database. Of them, 53 cases were excluded from further analysis because no surgical resident was listed as the primary or assistant surgeon, leaving 2780 cases for analysis. RESULTS: There were 2780 operations involving surgical residents. Of them, 51% of procedures were classified under general surgery, 38% orthopedics, 7% neurosurgery, and 4% urology. Emergency operations accounted for 64% of the procedures, with 56% of those being general surgery and 35% orthopedic. Further, 50% of all operations were trauma, with 71% of those orthopedic and 21% general surgery. Surgical faculty were involved in 45% of operations as either the primary or the assistant surgeons, while the remainder of operations did not involve surgical faculty. Residents were primary surgeons in 68% of procedures and assistant surgeons in 84% of procedures. CONCLUSIONS: The operative experience of surgery residents at CHUK primarily involves emergency and trauma procedures. Although this likely reflects the demographics of surgical care within Rwanda, more focus should be placed on elective procedures to ensure that surgical residents are broadly trained.
Authors: Corrado Cancedda; Phil Cotton; Joseph Shema; Stephen Rulisa; Robert Riviello; Lisa V Adams; Paul E Farmer; Jeanne N Kagwiza; Patrick Kyamanywa; Donatilla Mukamana; Chrispinus Mumena; David K Tumusiime; Lydie Mukashyaka; Esperance Ndenga; Theogene Twagirumugabe; Kaitesi B Mukara; Vincent Dusabejambo; Timothy D Walker; Emmy Nkusi; Lisa Bazzett-Matabele; Alex Butera; Belson Rugwizangoga; Jean Claude Kabayiza; Simon Kanyandekwe; Louise Kalisa; Faustin Ntirenganya; Jeffrey Dixson; Tanya Rogo; Natalie McCall; Mark Corden; Rex Wong; Madeleine Mukeshimana; Agnes Gatarayiha; Egide Kayonga Ntagungira; Attila Yaman; Juliet Musabeyezu; Anne Sliney; Tej Nuthulaganti; Meredith Kernan; Peter Okwi; Joseph Rhatigan; Jane Barrow; Kim Wilson; Adam C Levine; Rebecca Reece; Michael Koster; Rachel T Moresky; Jennifer E O'Flaherty; Paul E Palumbo; Rashna Ginwalla; Cynthia A Binanay; Nathan Thielman; Michael Relf; Rodney Wright; Mary Hill; Deborah Chyun; Robin T Klar; Linda L McCreary; Tonda L Hughes; Marik Moen; Valli Meeks; Beth Barrows; Marcel E Durieux; Craig D McClain; Amy Bunts; Forrest J Calland; Bethany Hedt-Gauthier; Danny Milner; Giuseppe Raviola; Stacy E Smith; Meenu Tuteja; Urania Magriples; Asghar Rastegar; Linda Arnold; Ira Magaziner; Agnes Binagwaho Journal: Int J Health Policy Manag Date: 2018-11-01
Authors: Rebecca G Maine; Allison F Linden; Robert Riviello; Emmanuel Kamanzi; Gita N Mody; Georges Ntakiyiruta; Grace Kansayisa; Edmond Ntaganda; Francine Niyonkuru; Joel M Mubiligi; Tharcisse Mpunga; John G Meara; Bethany L Hedt-Gauthier Journal: JAMA Surg Date: 2017-12-20 Impact factor: 14.766