Avril Hutch1, Abebe Bekele2,3, Eric O'Flynn4, Andrew Ndonga2,5, Sean Tierney6, Jane Fualal2,7, Christopher Samkange2,8, Krikor Erzingatsian2,9. 1. Department of Surgical Affairs, Royal College of Surgeons in Ireland/College of Surgeons of East, Central and Southern Africa Collaboration Programme (RCSI/COSECSA), 121 St Stephen's Green, Dublin 2, Ireland. avrilhutch@rcsi.ie. 2. College of Surgeons of East, Central and Southern Africa (COSECSA), Njiro Road, Arusha, Tanzania. 3. Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. 4. Department of Surgical Affairs, Royal College of Surgeons in Ireland/College of Surgeons of East, Central and Southern Africa Collaboration Programme (RCSI/COSECSA), 121 St Stephen's Green, Dublin 2, Ireland. 5. Department of Surgery, Mater Hospital Kenya, Along Dunga Road, South B, Nairobi, Kenya. 6. Department of Surgical Affairs, Royal College of Surgeons in Ireland (RCSI), 121 St Stephen's Green, Dublin 2, Ireland. 7. Department of Surgery, Mulago Hospital, 256, Kampala, Uganda. 8. College of Health Sciences, University of Zimbabwe, Mazowe Street Campus, Avondale, P.O. Box A178, Harare, Zimbabwe. 9. School of Medicine, University of Zambia, Nationalist Road, University Teaching Hospital, P.O. Box 50110, Lusaka, Zambia.
Abstract
BACKGROUND: This study assesses the retention of specialist surgical graduates from training programmes across eight countries in East, Central and Southern Africa from 1974 to 2013. It addresses the gap in existing data by analysing retention rates of surgical graduates by comparing graduating institution to current location. Data were assessed by country, region, specialty and gender with a view to informing national and regional healthcare and education strategies. METHODS: Twenty-five institutions train surgeons in the ten countries covered by the College of Surgeons of East, Central and Southern Africa (COSECSA)-24 Universities and the College itself. These institutions were requested in November 2014 to supply details of graduates from their postgraduate surgical training programmes. Complete graduate lists were returned by the College and 14 universities by March 2016. These surgical graduates were compared against the database of current practising surgeons in the region held by COSECSA. Data were cross-checked against medical council registers, surgical society records, and with members and fellows of COSECSA. RESULTS: Data were incomplete for 126 surgical graduates. Of the remaining 1038 surgical graduates, 85.1% were retained in the country they trained in, while 88.3% were retained within the COSECSA region. Ninety-three per cent (93.4%) were retained within Africa. Of the eight countries, Malawi had the highest retention rate with 100% of surgical graduates remaining in country, while Zimbabwe had the lowest rate with 65.5% remaining. CONCLUSION: High surgical graduate retention rates across the region indicate that the expansion of national surgical training initiatives is an effective solution to addressing the surgical workforce shortage in East, Central and Southern Africa and counters long-held arguments regarding brain drain in this region.
BACKGROUND: This study assesses the retention of specialist surgical graduates from training programmes across eight countries in East, Central and Southern Africa from 1974 to 2013. It addresses the gap in existing data by analysing retention rates of surgical graduates by comparing graduating institution to current location. Data were assessed by country, region, specialty and gender with a view to informing national and regional healthcare and education strategies. METHODS: Twenty-five institutions train surgeons in the ten countries covered by the College of Surgeons of East, Central and Southern Africa (COSECSA)-24 Universities and the College itself. These institutions were requested in November 2014 to supply details of graduates from their postgraduate surgical training programmes. Complete graduate lists were returned by the College and 14 universities by March 2016. These surgical graduates were compared against the database of current practising surgeons in the region held by COSECSA. Data were cross-checked against medical council registers, surgical society records, and with members and fellows of COSECSA. RESULTS: Data were incomplete for 126 surgical graduates. Of the remaining 1038 surgical graduates, 85.1% were retained in the country they trained in, while 88.3% were retained within the COSECSA region. Ninety-three per cent (93.4%) were retained within Africa. Of the eight countries, Malawi had the highest retention rate with 100% of surgical graduates remaining in country, while Zimbabwe had the lowest rate with 65.5% remaining. CONCLUSION: High surgical graduate retention rates across the region indicate that the expansion of national surgical training initiatives is an effective solution to addressing the surgical workforce shortage in East, Central and Southern Africa and counters long-held arguments regarding brain drain in this region.
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