背景:东方外科医学院,中央,南部非洲(COSECSA)由14个国家组成,其中许多目前正在努力应对心胸外科(CTS)疾病负担的增加。未解决的CTS状况对健康和经济的影响是深远的,需要采取强有力的区域对策。本研究旨在确定该地区CTS专科培训的状况(包括专科人员的密度,设施,和积极的培训岗位),检查含义,和proffer建议。
方法:2022年5月和2023年9月,对COSECSA秘书处文件和项目认证记录进行了案头审查,其中使用了外科学会的信息进行了三角测量,作为教育质量改进的一部分。使用了涉及上下文专家的修改的名义小组程序来制定相关的行动框架。
结果:14个COSECSA国家中只有6个(43%)提供了积极的培训计划,每年仅有18名学员。布隆迪存在重大培训差距,博茨瓦纳,马拉维,卢旺达,南苏丹,赞比亚,津巴布韦。国家专家密度从1/400,000(纳米比亚)到1/800,000,000(埃塞俄比亚)不等。总的来说,该地区每百万人口中有0.2名CTS专家,而高收入国家的每百万人口中有7.15名外科医生。外科教育专家提出了一个行动框架,以解决培训危机,包括增加对CTS教育的投资,建立区域卓越中心,为妇女提供保留奖励和机会,并利用国际伙伴关系。
结论:对基础设施的积极投资,人力资源,培训,以及各国政府的合作努力,区域政府间组织,和国际合作伙伴对于扩大区域CTS培训至关重要。
BACKGROUND: The College of Surgeons of East, Central, and Southern Africa (COSECSA) comprises 14 countries, many of which currently grapple with an increasing burden of cardiothoracic surgical (CTS) diseases. Health and economic implications of unaddressed CTS conditions are profound and require a robust regional response. This study aimed to define the status of CTS specialist training in the region (including the density of specialists, facilities, and active training posts), examine implications, and proffer recommendations.
METHODS: A desk review of COSECSA secretariat documents and program accreditation records triangulated with information from surgical societies was performed in May 2022 and September 2023 as part of education quality improvement. A modified nominal group process involving contextual experts was used to develop a relevant action framework.
RESULTS: Only 6 of 14 (43%) of COSECSA countries offered active training programs with annual intake of only 18 trainees. Significant training gaps existed in Burundi, Botswana, Malawi, Rwanda, South Sudan, Zambia, and Zimbabwe. Country specialist density ranged from 1 per 400,000 (Namibia) to 1 per 8,000,000 (Ethiopia). Overall, the region had 0.2 CTS specialists per million population as compared with 7.15 surgeons per million in High-Income Countries. Surgical education experts proposed an action framework to address the training crisis including increasing investments in CTS education, establishing regional centers of excellence, retention incentives and opportunities for women, and leveraging international partnerships.
CONCLUSIONS: Proactive investments in infrastructure, human resources, training, and collaborative efforts by national governments, regional intergovernmental organizations, and international partners are critical to expanding regional CTS training.