COSECSA professional development & practice

“developing healthcare leaders who make a difference worldwide.”

COSECSA professional development & practice

Access to surgery

Proportion of Population without access to safe affordable surgery & anaesthesia (5bn)

COSECSA professional development & practice

Access to surgery

Proportion of Population without access to safe affordable surgery & anaesthesia (5bn)

93%

COSECSA professional development & practice

Global disease Burden

• Key message 2:– 143 million additional surgical procedures are

needed each year to save lives and prevent disability

COSECSA professional development & practice

The Surgeons

LCoGS target• 20/100,000 (SAO) by

2030• ↑ 2·28 million by 2030Gap

COSECSA professional development & practice

The Surgeons

• 1,604 surgeons (in COSECSA region)

• 320M population

• 0.5 surgeons /100,000 population

• LCoGS Target 32,000 (2030)– 10/100,000 (surgeons)– 1600 graduates per year

COSECSA professional development & practice

The Surgeons

• Ethiopia• Kenya• Uganda• Rwanda• Burundi

• Malawi• Tanzania• Zambia• Zimbabwe• Mozambique

COSECSA professional development & practice

The Surgeons

COSECSA professional development & practice

2010-2013

Content

Infrastructure

Faculty development

Curriculum

Examinations

COSECSA professional development & practice

Governance

• cross–college collaboration

• funded– Irish Aid €500,000pa– RCSI €630,000 (In

kind) pa

• joint steering committee RCSI (6), COSECSA (6), external (2)

COSECSA professional development & practice

2010-2013

Content

Infrastructure

Faculty development

Curriculum • Basic science course• FCS seminars• Trauma training• Skills training

Examinations

COSECSA professional development & practice

2010-2013

Content

Infrastructure

Faculty development

Curriculum • Basic science course• FCS seminars• Trauma training• Skills training

Examinations

COSECSA professional development & practice

Infrastructure

Faculty development

Curriculum

Content

Examinations

2010-2013

COSECSA professional development & practice

Schoolforsurgeons.net

COSECSA professional development & practice

2010-2013

Content

Infrastructure

Faculty development

Curriculum

Examinations

COSECSA professional development & practice

2010-2013

Content

Infrastructure

Faculty development

Curriculum

Examinations

goo.gl/20JRWY

COSECSA professional development & practice

2010-2013

Content

Infrastructure

Faculty development

Curriculum

Examinations

Examiners exchange

Examiners workshop

External Examiners

COSECSA professional development & practice

Examinations

2 years 3 years

SyllabusGenerality of surgery

Trauma courseBasic skills courseBasic science course

LogbookIn-service assessments

University or district hospitals

MCS(ECSA)

General Surgery

T&O Surgery

Paediatric Surgery

Plastic Surgery

NeuroSurgery

Urology

ENTFCS(ECSA)

Phase 2 2014-2017

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

CEOSenior Programme Officer

Training & Exams Officer

EST co-ordinators

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

COSECSA professional development & practice

Infrastructure

COSECSA professional development & practice

Infrastructure

Pew research centre 2015

20-57% among educated

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

East & Central African Journal of Surgery

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

www.womeninsurgeryafrica.org/

COSECSA professional development & practice

2014-2017

Enhance MCS, FCS training

Exams

↑ COSECSA admin capacity

Professional Hub

COSECSA professional development & practice

Results

Laparotomy/laparoscopy - abdominal abscess/sepsis 359Wound - debridement 316Hernia - inguinal 252Diaphyseal femur fracture intramedullary nailing 194Appendicectomy 167Skin graft 145Biopsy / excision - lipoma 129Other - Upper GI/HpB 118Abscess - drainage (non-breast/anal/abdominal) 97Diaphyseal tibial fracture intramedullary nailing 77Paediatric circumcision / prepuceplasty 68Breast lump - excision 67Supracondylar elbow fracture MUA +/- percutaneous wires 66

57Removal metal 53Insertion of ventriculoperitoneal shunt 53Supracondylar elbow fracture open reduction 49Amputation - BK 49Biliary - cholecystectomy 47Fracture shaft radius ORIF 42Biopsy / excision - lymph node(s) 42Biopsy / excision - skin - simple 41Groin - hydrocele repair 40Biopsy / excision - subcutaneous tumour 40other 3991

• 8 Specialties• 16 Countries• 40 Hospitals• 1000+ per month

N=6559Accessed 8/1/2016

COSECSA professional development & practice

Logbook data

COSECSA professional development & practice

Results

COSECSA professional development & practice

Workforce

Surgical Workforce

COSECSA professional development & practice

Workforce

O Flynn. World J Surg 2016 (in press)

COSECSA professional development & practice

Workforce

O Flynn. World J Surg 2016 (in press)

COSECSA professional development & practice

Workforce

O Flynn. World J Surg 2016 (in press)

COSECSA professional development & practice

Retention

COSECSA professional development & practice

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

2011

0

10

20

30

40

50

60

70

Retention

COSECSA professional development & practice

Retention

93%

N=929

84%

Africa COSECSA

COSECSA professional development & practice

Partnership

Investment in indigenous surgical training initiatives in the COSECSA region

Is likely to be an effective solution in addressing the surgical workforce shortage in East, Central and Southern Africa.

is likely to be the most cost effective way of delivering on WHA Resolution and Lancet Commission objectives.

COSECSA professional development & practice

Partnership

COSECSA professional development & practice

Partnership

goo.gl/5CG4tEOECD 2013

COSECSA professional development & practice

Paris Declaration

OECD

• Ownership• Harmonisation• Alignment• Results• Mutual Accountability

goo.gl/O2vMi9

COSECSA professional development & practice

Accompaniment

@theseant

@theseant

www.surgery.global

COSECSA professional development & practice

COSECSA professional development & practice