title: Surgical training and experience of medical officers in Ghana's district hospitals.
abstract: OBJECTIVE
  To document the quality of training and experience of those who care for patients undergoing surgery and emergency obstetrical procedures at 10 government district hospitals in Ghana.
  
  
  METHODS
  A study team composed of Ghanaian and U.S. surgeons visited 10 district hospitals in 10 different regions of Ghana in August 2009. On-site interviews were conducted documenting the formal and informal training and the experience of the medical officers (MOs) performing in surgical facilities in these hospitals.
  
  
  RESULTS
  Fourteen of the 17 MOs working at these facilities were available for interviews. All 14 had completed two years of housemanship, which is similar to a rotating internship. Only one had obtained any formal surgical training beyond the housemanship, although all were responsible for performing major surgical procedures. The formal training under qualified supervision during the housemanship was limited; the mean number of the most common major surgical procedures performed during training ranged from four to eight, depending on the procedure.
  
  
  CONCLUSIONS
  Even though formal general surgical residency training in Ghana is well developed, graduates of these programs are not working in the district hospitals surveyed. The majority of surgical services provided at the district hospital are provided by MOs, who would benefit from more comprehensive training and ongoing supervision. To help meet the challenge of a shortage of physicians working at district hospitals, the authors present alternative approaches to care described in the literature that involve nonphysician midlevel health providers.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
authors.forename: Shelly
authors.initials: S
authors.lastname: Choo
authors.forename: Henry
authors.initials: H
authors.lastname: Perry
authors.forename: Afua A J
authors.initials: AA
authors.lastname: Hesse
authors.forename: Francis
authors.initials: F
authors.lastname: Abantanga
authors.forename: Elias
authors.initials: E
authors.lastname: Sory
authors.forename: Hayley
authors.initials: H
authors.lastname: Osen
authors.forename: Colin W
authors.initials: CW
authors.lastname: McCord
authors.forename: Fizan
authors.initials: F
authors.lastname: Abdullah
mesh_terms: D005260:Female; D013502:General Surgery / Q000193:education*; D005869:Ghana; D006767:Hospitals, District / Q000458:organization & administration*; D006801:Humans; D007393:International Educational Exchange; D008297:Male; D013513:Obstetric Surgical Procedures / Q000193:education; D011787:Quality of Health Care; D011795:Surveys and Questionnaires