rcsi global surgery (final)

COSECSA professional development & practice

“developing healthcare leaders who make a difference worldwide.”


Access to surgery

Proportion of Population without access to safe affordable surgery & anaesthesia (5bn)


Access to surgery

Proportion of Population without access to safe affordable surgery & anaesthesia (5bn)

93%


Global disease Burden

• Key message 2:– 143 million additional surgical procedures are

needed each year to save lives and prevent disability


The Surgeons

LCoGS target• 20/100,000 (SAO) by

2030• ↑ 2·28 million by 2030Gap


The Surgeons

• 1,604 surgeons (in COSECSA region)

• 320M population

• 0.5 surgeons /100,000 population

• LCoGS Target 32,000 (2030)– 10/100,000 (surgeons)– 1600 graduates per year


The Surgeons

• Ethiopia• Kenya• Uganda• Rwanda• Burundi

• Malawi• Tanzania• Zambia• Zimbabwe• Mozambique


The Surgeons


2010-2013

Content

Infrastructure

Faculty development

Curriculum

Examinations


Governance

• cross–college collaboration

• funded– Irish Aid €500,000pa– RCSI €630,000 (In

kind) pa

• joint steering committee RCSI (6), COSECSA (6), external (2)


2010-2013

Content

Infrastructure

Faculty development

Curriculum • Basic science course• FCS seminars• Trauma training• Skills training

Examinations


Infrastructure

Faculty development

Curriculum

Content

Examinations

2010-2013


Schoolforsurgeons.net


2010-2013

Content

Infrastructure

Faculty development

Curriculum

Examinations


2010-2013

Content

Infrastructure

Faculty development

Curriculum

Examinations

goo.gl/20JRWY


2010-2013

Content

Infrastructure

Faculty development

Curriculum

Examinations

Examiners exchange

Examiners workshop

External Examiners


Examinations

2 years 3 years

SyllabusGenerality of surgery

Trauma courseBasic skills courseBasic science course

LogbookIn-service assessments

University or district hospitals

MCS(ECSA)

General Surgery

T&O Surgery

Paediatric Surgery

Plastic Surgery

NeuroSurgery

Urology

ENTFCS(ECSA)

Phase 2 2014-2017


2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub


2014-2017


Exams


Professional Hub

CEOSenior Programme Officer

Training & Exams Officer

EST co-ordinators


2014-2017


Exams


Professional Hub


Infrastructure


Infrastructure

Pew research centre 2015

20-57% among educated

http://www.pewglobal.org/2015/04/15/cell-phones-in-africa-communication-lifeline/


2014-2017


Exams


Professional Hub

https://www.youtube.com/watch?v=PEeFNTcDjww


2014-2017


Exams


Professional Hub


2014-2017


Exams


Professional Hub

East & Central African Journal of Surgery


2014-2017


Exams


Professional Hub

www.womeninsurgeryafrica.org/


2014-2017


Exams


Professional Hub


Results

Laparotomy/laparoscopy - abdominal abscess/sepsis 359Wound - debridement 316Hernia - inguinal 252Diaphyseal femur fracture intramedullary nailing 194Appendicectomy 167Skin graft 145Biopsy / excision - lipoma 129Other - Upper GI/HpB 118Abscess - drainage (non-breast/anal/abdominal) 97Diaphyseal tibial fracture intramedullary nailing 77Paediatric circumcision / prepuceplasty 68Breast lump - excision 67Supracondylar elbow fracture MUA +/- percutaneous wires 66

57Removal metal 53Insertion of ventriculoperitoneal shunt 53Supracondylar elbow fracture open reduction 49Amputation - BK 49Biliary - cholecystectomy 47Fracture shaft radius ORIF 42Biopsy / excision - lymph node(s) 42Biopsy / excision - skin - simple 41Groin - hydrocele repair 40Biopsy / excision - subcutaneous tumour 40other 3991

• 8 Specialties• 16 Countries• 40 Hospitals• 1000+ per month

N=6559Accessed 8/1/2016


Logbook data


Results


Workforce

Surgical Workforce


Workforce

O Flynn. World J Surg 2016 (in press)


Retention


1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

2011

0

10

20

30

40

50

60

70

Retention


Retention

93%

N=929

84%

Africa COSECSA


Partnership

Investment in indigenous surgical training initiatives in the COSECSA region

Is likely to be an effective solution in addressing the surgical workforce shortage in East, Central and Southern Africa.

is likely to be the most cost effective way of delivering on WHA Resolution and Lancet Commission objectives.


Partnership


Partnership

goo.gl/5CG4tEOECD 2013

http://goo.gl/5CG4tE


Paris Declaration

OECD

• Ownership• Harmonisation• Alignment• Results• Mutual Accountability

goo.gl/O2vMi9

http://goo.gl/O2vMi9


Accompaniment

@theseant

@theseant

www.surgery.global

rcsi global surgery (final)

Healthcare