Postgraduate Medical Education in Sub-Saharan Africa: A Scoping Review Spanning 26 Years and Lessons Learned

Abstract

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.

Self-reported confidence and perceived training needs of surgical interns at a regional hospital in Ghana: a questionnaire survey

“…However, the regional hospital had inadequate case volumes for cancer treatment because the majority of cancer patients are referred to teaching hospitals. Therefore, training for cancer treatment should not be overlooked, and solutions such as case-scenario training or rotation in oncology units at teaching hospitals should be considered to improve the quality of surgical training [ 23 ]. In addition, the current state of training at teaching hospitals should be investigated to decide where and how long the rotation should take place.…”

Implementation and evaluation of a specialized diabetes clinic in Guinea Bissau: lessons learnt from the field

“…We have successfully trained a multidisciplinary team of healthcare professionals in the basic management and care of PWD and set up a specialized diabetes clinic in the HNSM. In SSA, it is now well recognized that there is an important need for targeted training of specialists in the management of non-communicable diseases such as diabetes, and to counter the previous predominant focus on infectious diseases [ 14 ]. However, specialist training programs in SSA are lacking, and when available, they are not always well adapted to the local contexts and available resources, described by certain authors as being often Eurocentric [ 15 , 16 ].…”

“…Unfortunately, the nutritionists were quickly unavailable, one due to migration to another country seeking better working opportunities. Indeed, the retention of qualified personnel is another issue that healthcare systems in SSA have to face [ 14 ]. According to a recent review, the retention of HCPs in SSA is influenced by location of training as well as career prospects and employment opportunities after graduation [ 14 ].…”

“…Indeed, the retention of qualified personnel is another issue that healthcare systems in SSA have to face [ 14 ]. According to a recent review, the retention of HCPs in SSA is influenced by location of training as well as career prospects and employment opportunities after graduation [ 14 ]. In GB, a strategy is lacking for attracting professionals and retention of HCPs.…”

The Value of International Research and Learning in Graduate Medical Education

“…Vus and Alekseiev draw attention to the shortage of primary care in Ukraine and efforts to align GME curricula through the development of core competencies based on local needs. 11 Reviews by Miller et al 12 and Talib et al 13 summarize the history and current state of international workforce development, and 3 studies describe novel models to build capacity in key workforce areas important for access to health care in low and lower-middle income countries (Tuyishime et al, 14 Khan et al, 15 Crouch and Williams 16 ).…”