Enhancing Neurosurgical Education in Low- and Middle-income Countries: Current Methods and New Advances

OBJECTIVEAfrica still significantly lags in the development of neurosurgery. Egypt, located in North Africa, is well-developed in this specialty, with the largest number of neurosurgeons among all African countries. This article provides insight into neurosurgical training in Egypt, the challenges African neurosurgeons are facing, and the requirements needed to enhance neurosurgical education and build up the required neurosurgical capacity in Africa.METHODSThe information presented in the current work was collected from databases of the Egyptian Society of Neurological Surgeons and the World Federation of Neurosurgical Societies.RESULTSThere are two types of neurosurgical certification in Egypt. The first type is granted by the universities (MD), and the second is awarded by the Ministry of Health (Fellow of Neurosurgery). The program in both types ranges from 6 to 9 years. The number of qualified neurosurgeons in Egypt constitutes one-third of the total number of African neurosurgeons. There is a significant shortage of neurological surgeons in Africa, and the distribution is entirely unbalanced, with the majority of neurosurgeons concentrated in the North and South regions. The most important challenge facing neurosurgery in Africa is lack of resources, which is considered to be the main obstacle to the development of neurosurgery. Other challenges include the limited number of neurosurgeons, lack of training programs, and lack of collaboration among the different regions.CONCLUSIONSProper collaboration among the different regions within the African continent regarding neurosurgical education will enhance African neurosurgical capacity and make neurosurgery an independent specialty. The definite functional polarity among different regions, regarding both the number of qualified neurosurgeons and the neurosurgical capacity, is an important factor that could help in the development of neurosurgery in this continent.

Section: Postgraduate Educationmentioning

confidence: 99%

Section: Postgraduate Educationmentioning

confidence: 99%

Neurosurgical education in Egypt and Africa

El-Ghandour¹

2020

“…Distance electronic learning (eLearning) has become an accepted teaching tool, widely used in the field of medicine. 25 Different organizations such as the Ptolemy Project (Canada) have developed eLearning platforms with the goal of supplementing the surgical training of physicians from LMICs. One of the major advantages of online models is their low cost and good educational results.…”

Section: Online Surgical Curriculummentioning

confidence: 99%

“…An online model is a potential substitute to the surgical mission model in selected cases, which is also highly effective but significantly more expensive. While it is estimated that more than $250 million is spent each year for surgical trips alone, 25,31,32 eLearning projects would demand a fraction of this cost. Additionally, this model allows the students/trainees to have access to the learning material on demand, so review of different topics can be conducted at virtually any time and at any location.…”

Section: Online Surgical Curriculummentioning

confidence: 99%

Global neurosurgery: models for international surgical education and collaboration at one university

Almeida

Velásquez

Karekezi

et al. 2018

Self Cite

OBJECTIVEInternational collaborations between high-income (HICs) and low- and middle-income countries (LMICs) have been developed as an attempt to reduce the inequalities in surgical care around the world. In this paper the authors review different models for international surgical education and describe projects developed by the Division of Neurosurgery at the University of Toronto in this field.METHODSThe authors conducted a review of models of international surgical education reported in the literature in the last 15 years. Previous publications on global neurosurgery reported by the Division of Neurosurgery at the University of Toronto were reviewed to exemplify the applications and challenges of international surgical collaborations.RESULTSThe most common models for international surgical education and collaboration include international surgical missions, long-term international partnerships, fellowship training models, and online surgical education. Development of such collaborations involves different challenges, including limited time availability, scarce funding/resources, sociocultural barriers, ethical challenges, and lack of organizational support. Of note, evaluation of outcomes of international surgical projects remains limited, and the development and application of assessment tools, such as the recently proposed Framework for the Assessment of International Surgical Success (FAIRNeSS), is encouraged.CONCLUSIONSActions to reduce inequality in surgical care should be implemented around the world. Different models can be used for bilateral exchange of knowledge and improvement of surgical care delivery in regions where there is poor access to surgical care. Implementation of global neurosurgery initiatives faces multiple limitations that can be ameliorated if systematic changes occur, such as the development of academic positions in global surgery, careful selection of participant centers, governmental and nongovernmental financial support, and routine application of outcome evaluation for international surgical collaborations.

“…surgical scenarios can provide an accessible way to reduce the gap in neurosurgical education between surgeons from countries of differing wealth and to create a structured online curriculum. 10 Education tools to be adopted in countries with limited facilities should be not only easily accessible and low cost, but also regularly updated, oriented to surgical practice, and of scientific validity (supported by international neurosurgical societies and/or journals with high impact factors).…”

mentioning

confidence: 99%

Neurosurgical digital teaching in low-middle income countries: beyond the frontiers of traditional education

Nicolosi¹,

Rossini²,

Zaed

et al. 2018

OBJECTIVENeurosurgical training is usually based on traditional sources of education, such as papers, books, direct surgical experience, and cadaveric hands-on courses. In low-middle income countries, standard education programs are often unavailable, mainly owing to the lack of human and economic resources. Introducing digital platforms in these settings could be an alternative solution for bridging the gap between Western and poor countries in neurosurgical knowledge.METHODSThe authors identified from the Internet the main digital platforms that could easily be adopted in low-middle income countries. They selected free/low-cost mobile content with high educational impact.RESULTSThe platforms that were identified as fulfilling the characteristics described above are WFNS Young Neurosurgeons Forum Stream, Brainbook, NeuroMind, UpSurgeOn, The Neurosurgical Atlas, Touch surgery, The 100 UCLA Subjects in Neurosurgery, Neurosurgery Survival Guide, EANS (European Association of Neurosurgical Societies) Academy, Neurosurgical.TV, 3D Neuroanatomy, The Rhoton Collection, and Hinari. These platforms consist of webinars, 3D interactive neuroanatomy and neurosurgery content, videos, and e-learning programs supported by neurosurgical associations or journals.CONCLUSIONSDigital education is an emerging tool for contributing to the spread of information in the neurosurgical community. The continuous improvement in the quality of content will rapidly increase the scientific validity of digital programs. In conclusion, the fast and easy access to digital resources could contribute to promote neurosurgical education in countries with limited facilities.