Background Investments in training physician specialists through postgraduate medical education (PGME) are critical for Sub-Saharan Africa, given the increasing burden of non-communicable diseases.Objectives The objectives of this scoping review were to (1) understand the breadth of publications on PGME from Sub-Saharan Africa, and (2) conduct a thematic analysis of lessons learned by specific training programs.Methods We conducted a literature search of 7 databases for PGME literature published between January 1991 and December 2016. Two reviewers independently reviewed titles and abstracts for inclusion. Full-text articles were then reviewed, and bibliometric data were extracted to create a profile of PGME-related publications. Two authors coded the manuscripts to identify articles written about specific PGME programs. These were analyzed for lessons learned. ResultsWe identified 813 publications that reported on postgraduate medical education in Sub-Saharan Africa. Most articles were published between 2005 and 2016. Nations leading in publication were South Africa and Nigeria, followed by Ethiopia, Uganda, Kenya, Ghana, and Malawi. The largest number of articles related to general surgery training, followed by family medicine, emergency medicine, and anesthesiology. Thematic analysis revealed advantages of training programs for health facilities, challenges related to teaching, resourcing, and standardizing of training, and lessons learned related to international partnerships, faculty engagement, and research support for trainees.Conclusions PGME in Sub-Saharan Africa has evolved over the past 26 years. Future growth will require strategic support to scale programs, support new specialties, trainees, and teachers, and leverage best practice models to sustain PGME programs.

Frequent turnover of employees began from the last century, increased further with the inception of turnover-prone millennial employees and is likely to continue in the future. This study used expectation–confirmation theory and Herzberg’s two-factor theory as the underpinning theory. Its calibrated factors such as transformational leadership, stress reduction, and compensation and rewards that affect employee retention mediating through job embeddedness. A simple random sampling technique was utilized while selecting the respondents from millennial employees in private sectors. For developing the model, Smart Partial Least Square (PLS) was applied for path modelling, measurement models as well as for bootstrapping while testing the hypotheses. The study found that all these factors have got a significant positive relationship as predicted. This study has got numerous contributions, which are beneficial for all stakeholders of private industries. Although the enormous studies have been carried out in the Western context, the problem of frequent millennial turnover remains unresolved both in the West and in non-Western context. Practically, the study will be helpful for all against the frequent turnover and its losses. The paucity of studies on transformational leadership, stress reduction, compensation and rewards, and the retention of millennial employees in a developing country’s context made this research more significant and relevant. The mediating role of job embeddedness was also found to be significant in this relationship. Finally, the study was found to have implications for all stakeholders and future researchers.

Background Communication in emergency departments (ED) in India is complicated by the country’s immense language diversity. Prior research has revealed challenges in language and communication as barriers to care. Our objective was to quantify language diversity among clinicians in Indian EDs and better understand issues related to clinician-clinician and clinician-patient communication. Methodology A cross-sectional survey of ED clinicians was conducted. Survey participants were recruited in-person and through email at six partner sites in India. ANOVA and binary logistic regression were used for subgroup analysis. Semi-structured interviews were conducted with ED clinicians. Interview data was analyzed using the rapid assessment process to determine predominant themes. Results 106 clinicians completed the survey. On average, clinicians spoke 3.75 languages. Seventy-one percent used a non-English language to speak to fellow clinicians most of the time, and 53% reported at least one critical incident over the last year where poor communication played a part. Interviews revealed challenges including low health literacy, high patient volume, and workplace hierarchy. Conclusions This study is the first to document the impact of language diversity and communication barriers in Indian EDs. The results highlight the need for effective strategies to improve communication between the multiple languages spoken by clinicians and patients.

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