The effect of a new surgery residency program on case volume and case complexity in a sub-Saharan African hospital.
BACKGROUND
Improved access to surgical care could prevent a significant burden of disease and disability-adjusted life years, and workforce shortages are the biggest obstacle to surgical care. To address this shortage, a 5-year surgical residency program was established at Kamuzu Central Hospital (KCH) in July 2009. As the residency enters its fourth year, we hypothesized that the initiation of a general surgical residency program would result in an increase in the overall case volume and complexity at KCH.


METHODS
We conducted a retrospective analysis of operated cases at KCH during the 3 years before and the third year after the implementation of the KCH surgical residency program, from July 2006 to July 2009 and the calendar year 2012, respectively.


RESULTS
During the 3 years before the initiation of the surgical residency, an average of 2317 operations were performed per year, whereas in 2012, 2773 operations were performed, representing a 20% increase. Before residency, an average of 1191 major operations per year were performed, and in 2012, 1501 major operations were performed, representing a 26% increase.


CONCLUSION
Our study demonstrates that operative case volume and complexity increase following the initiation of a surgical residency program in a sub-Saharan tertiary hospital. We believe that by building on established partnerships and emphasizing education, research, and clinical care, we can start to tackle the issues of surgical access and care.
['Kendig|Claire|C|', 'Tyson|Anna|A|', 'Young|Sven|S|', 'Mabedi|Charles|C|', 'Cairns|Bruce|B|', 'Charles|Anthony|A|']
D017954:Africa South of the Sahara D013502:General Surgery D007396:Internship and Residency D012189:Retrospective Studies D013514:Surgical Procedures, Operative D016526:Workload
Global Health Global Surgery Medical Knowledge Patient Care Practice-Based Learning and Improvement Surgical Education in Sub Saharan Africa Surgical Workforce Systems-Based Practice and Professionalism