CL-12: SCALING-UP SURGICAL TRAINING PROGRAMS ACROSS SUB-SAHARAN AFRICA: AN INTERNATIONAL QUALITATIVE DESCRIPTION OF SURGEON AND TRAINEE PERSPECTIVES
Katherine A. Hill, MD, MS^1,2, Sangki Oak, BS³, Abebe Bekele, MD⁴, Russell E. White, MD, MPH^2,5, Pankaj Jani, MBChB, MMed⁶; ¹University of Pittsburgh Medical Center, USA, ²Tenwek Hospital, Kenya, ³University of Pittsburgh School of Medicine, USA, ⁴University of Global Health Equity, Rwanda, ⁵Brown University, USA, ⁶University of Nairobi, Kenya

Background: The College of Surgeons of East, Central, and Southern Africa (COSECSA) was formed to expand African surgical training. Via a novel regional training structure (a 5-year, clinically-focused surgical education), COSECSA incorporates previously under-utilized trainers and sites. While this college has unprecedented successes, its constituent programs remain extremely diverse. For quality improvement and curriculum development, we produced a qualitative description of COSECSA training experiences from surgeons and surgical trainees.

Methods: COSECSA leadership developed a questionnaire on surgical training experiences, and refined it using feedback from surgeons and trainees. 20 semi-structured interviews and focus groups were conducted, with >60 participants in 5 countries. Recurring content was identified inductively, and themes categorized as strengths or challenges.

Results: Trainer availability emerged as a strength (where present) and a challenge (where absent)—including clinical supervision and mentorship. While trainers cited lack of incentives and time, trainees suggested exchanges to remedy trainer gaps. COSECSA’s strengths included greater numbers of training positions and objective regional exams.

Conclusions: As surgical training scales up worldwide, novel organizations such as COSECSA are essential. Yet as trainee numbers increase, availability of trainers will vary. Our findings may inform strategies to address this—from educational incentives, to technology utilization, to creative curricula.