title: Is it possible to train surgeons for rural Africa? A report of a successful international program.
abstract: BACKGROUND
  The critical shortage of surgeons and access to surgical care in Africa is increasingly being recognized as a global health crisis. Across Africa, there is only one surgeon for every 250,000 people and only one for every 2.5 million of those living in rural areas. Surgical diseases are responsible for approximately 11.2% of the total global burden of disease. Even as the importance of treating surgical disease is being recognized, surgeons in sub-Saharan Africa are leaving rural areas and their countries altogether to practice in more desirable locations.
  
  
  METHODS
  The Pan-African Academy of Christian Surgeons (PAACS) was formed in 1997 as a strategic response to this profound need for surgical manpower. It is training surgical residents through a 5-year American competency-based model. Trainees are required to be of African origin and a graduate of a recognized medical school.
  
  
  RESULTS
  To date, PAACS has established six training programs in four countries. During the 2009-2010 academic year, there were 35 residents in training. A total of 18 general surgeons and one pediatric surgeon have been trained. Two more general surgeons are scheduled to finish training in 2011. Four graduates have gone on to subspecialty training, and the remaining graduates are practicing general surgery in rural and underserved urban centers in Angola, Guinea-Conakry, Ghana, Cameroon, Republic of Congo, Kenya, Ethiopia, and Madagascar.
  
  
  CONCLUSIONS
  The PAACS has provided rigorous training for 18 African general surgeons, one of whom has also completed pediatric surgery training. To our knowledge, this is the only international rural-based surgical training program in Africa.
authors.affiliation: Department of Surgery, Emory Global Surgery Program, Emory University, 1365 Clifton Road, NE, Atlanta, GA 30322, USA. jdpollo@emory.edu
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Pollock
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Love
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Steffes
authors.forename: David C
authors.initials: DC
authors.lastname: Thompson
authors.forename: John
authors.initials: J
authors.lastname: Mellinger
authors.forename: Carl
authors.initials: C
authors.lastname: Haisch
mesh_terms: D000328:Adult; D000349:Africa; D017954:Africa South of the Sahara; D003906:Developing Countries; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D005260:Female; D014943:Global Health; D006301:Health Services Needs and Demand; D006801:Humans; D007391:International Cooperation; D007396:Internship and Residency / Q000458:organization & administration; D008297:Male; D008507:Medically Underserved Area; D016730:Program Development; D015397:Program Evaluation; D019035:Rural Health Services / Q000458:organization & administration*; D013043:Specialties, Surgical / Q000193:education*; D000078329:Workforce