Addressing the shortage of pathologists in Africa: Creation of a MMed Programme in Pathology in Zambia

Abstract

Background: With approximately one pathologist for one million people compared to ratios of approximately 1 to 25 000 in the United States and United Kingdom, there is a severe shortage of pathologists in much of Africa. The situation is particularly severe in Zambia, where, in 2009, the ratio was 1 to 1.4 million.Objective: To address this, a postgraduate Master of Medicine (MMed) training programme was launched in Lusaka in 2011.Methods: The process and most significant challenges and lessons learned were documented, as they may be of value to other countries facing similar challenges.Results: Since 2011, four Zambian pathologists have graduated, doubling the number of indigenous pathologists in the country. Currently 10 students are in training. The most significant problem was issues arising from the split responsibilities of the Ministries of Health and of Education and the most important lesson learned was the crucial need for broad local ownership and commitment.Conclusion: Successfully addressing the shortage of local pathologists by creating country-specific, postgraduate MMed training programmes, even in situations of restricted resources, is feasible. However, having access to and support from the shared resources, expertise and knowledge of a regional College of Pathologists would be a major advantage.

Post-mortem examination of Hospital Inpatient COVID-19 Deaths in Lusaka, Zambia - A Descriptive Whole-body Autopsy Series

“…However, our study illustrates that autopsies during the COVID-19 era are possible to conduct on SARS-CoV-2 infected subjects in Zambia. There is a need to revive clinical and research autopsies througout sub-Saharan African countries ( Mawalla, 2020 , Mucheleng’anga and Himwaze, 2020 , Bruce-Brand et al, 2020 , Mudenda et al, 2020 , Rampatige and Gilks, 2015 , Barth et al, 2020 , Yi et al, 2020 ) to add to the provisional information provided by our study. Further autopsies with accurate data are required to conjure a more comprehensive picture of the pathogenesis and impact of COVID-19 in SSA.…”

“…There are only two individual case reports of whole body autopsies and lung biopsy studies of four South African ICU patients obtained after death ( Mulale et al, 2021 , Khaba et al, 2020 , Bruce-Brand et al, 2020 ). Several reports have emphasized the need for rekindling and revamping autopsy and post-mortem studies in SSA ( Mawalla, 2020 , Mucheleng’anga and Himwaze, 2020 , Maiese et al, 2020 , Mulale et al, 2021 , Khaba et al, 2020 , Bruce-Brand et al, 2020 , Mudenda et al, 2020 ), to determine the underlying pathology and causes of COVID-19 deaths occurring in hospital inpatients.…”

3D-Printed Portable Robotic Mobile Microscope for Remote Diagnosis of Global Health Diseases

“…In 2018, The Royal College of Pathologists reported that only 3% of anatomical pathology departments in the UK had enough pathologists to meet clinical demand [29]. China, US, Africa as a continent, and many other countries have also reported a significant shortage of pathologists [30][31][32]. Cost-effective devices that process and digitize histopathological samples in an automatic manner, and which are connected to a telemedicine platform, may alleviate these limitations, particularly if they can be linked to automated interpretation software.…”

Establishing the College of Pathologists of East, Central and Southern Africa – The Regional East Central and Southern Africa College of Pathology

“…In an accompanying article 9 , we articulate the need for a harmonised curriculum that can serve the region, as has been demonstrated by the lessons learned from the Zambia MMed programme in cellular pathology. It is notable that COPECSA's Anatomical Pathology Curriculum has recently been adopted in full by the Ministry of Health and Ministry of Education in Zambia.…”