Post-graduate surgical training in Nigeria: The trainees′ perspective

Abstract

Background:Quality surgical training is crucial to meeting manpower needs and creating a vibrant healthcare delivery. Feedback from trainees provides insight to understanding training challenges and needs to improve the programme. The objective of this study was to determine the challenges faced by surgical trainees and their perception of their training in Nigeria.Materials and Methods:A questionnaire survey of trainees in 16 academic surgical training centres in Nigeria between September and December 2012.Results:Of 235 respondents, 227 were males (96.6%) and 8 females (3.4%) with mean age of 33.9 years. A significant proportion (62.3%) of the respondents believed that the volume and diversities of surgical cases managed during their training were sufficient; however, 53.9% were less satisfied with their operative experience. Majority (71.8%) of the respondents felt “supported” by their trainers but they also believed that the training was skewed towards service provision. They were not actively involved in research due to lack of funds in 77.7%, lack of time/motivation in 15.8%, indifference in 11.8% and poor knowledge of research methods in 9.2%. Inadequate training facilities (50.7%), poor welfare (67.2%), inadequate sponsorship (65.9%) and poor remuneration (88.3%) were identified among their challenges. On the whole, majority (62.3%) believed that their training would adequately prepare them to function independently.Conclusion:Surgical residents in Nigeria face a variety of challenges. Based on our findings, a training that tracks and keeps trend with global changes through a higher investment in surgical training, improved facilities and residents’ well-being from both the teaching authorities and government will more likely improve the quality of training.

An audit of the quality of surgical operation notes in a Nigerian teaching hospital

“…Much of the learning is usually on-the-job training which is usually imperfect and not standardized across board. This also translates to a reduced quality of note writing as these young residents get promoted to more senior levels and have to teach the younger doctors what they themselves did not learn well 11,12 .…”

Evaluating Impact of a Residency Training Program Rural Rotation on Obstetric Care in Rural Southeast Nigeria

“…This might provide a leeway out. As many as 53.9% of residents interviewed in a survey were not satisfied with their surgical exposure in training [13].…”

Ethics, errors and education in surgical operating room

“…The causes behind the never events in OR could be mistakes or human error. (a)Human mistakes in ORis where the plan itself is inadequate to achieve its objective and it could be of two types:'failure of expertise'and 'lack of expertise' (6),(7), (8). (b)Human errors in OR is slips and lapses, where the action does not go according to plan and could have two sources of origin: 'thesurgeon' and'the hospital organization' (6),(7), (8).…”

“…Here the effect is long lasting. Here the corrective measures couldbe:changing the condition under which surgeon's work, through defences, barriers and safe guards which may bring improvement (6),(7), (8).…”

“…Surgical Skill for operative procedures andCommunication Skill for working as a team. A surgical trainees needs the gradually increasing opportunity of doing surgery in operating room to build on his surgical OR skill (8).…”