Emergency medicine doctoral education in Africa: a scoping review of the published literature

Abstract

Background While Africa accounts for a significant proportion of world population, and disease and injury burden, it produces less than 1% of the total research output within emergency care. Emergency care research capacity in Africa may be expanded through the development of doctoral programmes that aim to upskill the PhD student into an independent scholar, through dedicated support and structured learning. This study therefore aims to identify the nature of the problem of doctoral education in Africa, thereby informing a general needs assessment within the context of academic emergency medicine. Methods A scoping review, utilising an a priori, piloted search strategy was conducted (Medline via PubMed and Scopus) to identify literature published between 2011 and 2021 related to African emergency medicine doctoral education. Failing that, an expanded search was planned that focused on doctoral education within health sciences more broadly. Titles, abstracts, and full texts were screened for inclusion in duplicate, and extracted by the principal author. The search was rerun in September 2022. Results No articles that focused on emergency medicine/care were found. Following the expanded search, a total of 235 articles were identified, and 27 articles were included. Major domains identified in the literature included specific barriers to PhD success, supervision practices, transformation, collaborative learning, and research capacity improvement. Conclusions African doctoral students are hindered by internal academic factors such as limited supervision and external factors such as poor infrastructure e.g. internet connectivity. While not always feasible, institutions should offer environments that are conducive to meaningful learning. In addition, doctoral programmes should adopt and enforce gender policies to help alleviate the gender differences noted in PhD completion rates and research publication outputs. Interdisciplinary collaborations are potential mechanisms to develop well-rounded and independent graduates. Post-graduate and doctoral supervision experience should be a recognised promotion criterion to assist with clinician researcher career opportunities and motivation. There may be little value in attempting to replicate the programmatic and supervision practices of high-income countries. African doctoral programmes should rather focus on creating contextual and sustainable ways of delivering excellent doctoral education.

Methodological stance

“…Even though there have been some initiatives on the African continent to boost research training, such as the Consortium for Advanced Research Training in Africa (CARTA) (Jørgensen 2012) to support doctoral candidates and universities' supervisory capacity, African nations continue to face similar difficulties in achieving their objective of increased PhD graduates (Molla & Cuthbert 2016). In most African nations, there is a lack of money, poor institutional capability that may be related to infrastructure for both students and institutions of higher learning and a lack of qualified supervisors, as well as faculty members who are approaching retirement age (Breetzke & Hedding 2018;Craig et al 2023). The majority of students in Africa also support themselves during their PhD studies and pay for their own tuition, which frequently results in the risk that their studies will be interrupted and postponed any time they face financial difficulties (Cross & Backhouse 2014;Louw & Godsell 2016).…”

“…The lack of female supervisors has a negative effect on the doctorate trajectories of female PhD students. Attesting to the important role that women supervisors play in women doctoral students' doctoral paths, Craig et al (2023) mention that when women are supervised by a woman, they succeed at higher levels. Because of their perception that a supervisor of the same gender has greater compassion because they are also a woman, women emphasise the value of same-gender supervision (Ramohai 2013;Tsephe 2014).…”

Lessons learned from individual stories narrated by women in Africa

“…The lack of female supervisors has a negative effect on the doctorate trajectories of female PhD students. Attesting to the important role that women supervisors play in women doctoral students' doctoral paths, Craig et al (2023) mention that when women are supervised by a woman, they succeed at higher levels. Because of their perception that a supervisor of the same gender has greater compassion because they are also a woman, women emphasise the value of same-gender supervision (Ramohai 2013;Tsephe 2014).…”

Neglect of women in Africa within higher education

“…Even though there have been some initiatives on the African continent to boost research training, such as the Consortium for Advanced Research Training in Africa (CARTA) (Jørgensen 2012) to support doctoral candidates and universities' supervisory capacity, African nations continue to face similar difficulties in achieving their objective of increased PhD graduates (Molla & Cuthbert 2016). In most African nations, there is a lack of money, poor institutional capability that may be related to infrastructure for both students and institutions of higher learning and a lack of qualified supervisors, as well as faculty members who are approaching retirement age (Breetzke & Hedding 2018;Craig et al 2023). The majority of students in Africa also support themselves during their PhD studies and pay for their own tuition, which frequently results in the risk that their studies will be interrupted and postponed any time they face financial difficulties (Cross & Backhouse 2014;Louw & Godsell 2016).…”

“…The lack of female supervisors has a negative effect on the doctorate trajectories of female PhD students. Attesting to the important role that women supervisors play in women doctoral students' doctoral paths, Craig et al (2023) mention that when women are supervised by a woman, they succeed at higher levels. Because of their perception that a supervisor of the same gender has greater compassion because they are also a woman, women emphasise the value of same-gender supervision (Ramohai 2013;Tsephe 2014).…”