The African experience: a proposal to address the lack of access to neurosurgery in rural sub-Saharan Africa.
Restricted access to neurosurgical care in rural sub-Saharan Africa remains an unaddressed and formidable challenge. Despite the implementation of a rigorous 5-year curriculum to train and certify indigenous neurosurgeons "in continent" as Fellows of the College of Surgeons in Neurosurgery for East, Central, and Southern Africa (FCS-ecsa-NS), provincial and rural hospitals are likely to see no change in this woeful status quo for the foreseeable future. Modifying that curriculum with a two-tiered training experience that includes fast-track certification of general surgeons to perform basic neurosurgical procedures in their own hospitals is a viable alternative to redress this problem in a timely fashion. Founded on a competence-based as opposed to a time-served assessment of clinical/surgical skills along the lines of a 2002 landmark study in the United Kingdom, such an approach (in tandem with retaining separate FCS certification for prospective faculty in the NSTP-ECSA program) deserves urgent reconsideration.
Park
Bert Edward
BE
Midwest Brain and Spine, Centerpoint Medical Center, Department of Neurosurgery, Independence, Missouri, USA. Bertandvickipark@sbcglobal.net
D017954:Africa South of the Sahara; D002568:Certification / Q000379:methods / Q000592:standards; D002983:Clinical Competence / Q000592:standards; D003906:Developing Countries / Q000191:economics; D004503:Education, Medical, Graduate / Q000458:organization & administration / Q000592:standards* / Q000639:trends*; D006297:Health Services Accessibility / Q000592:standards / Q000639:trends*; D006801:Humans; D007391:International Cooperation; D007393:International Educational Exchange; D008507:Medically Underserved Area; D009493:Neurosurgery / Q000193:education* / Q000592:standards; D012423:Rural Health / Q000592:standards / Q000639:trends*; D000078329:Workforce