Addressing Malawi's surgical workforce crisis: a sustainable paradigm for training and collaboration in Africa.
BACKGROUND
The exodus of health professionals including surgeons from sub-Saharan Africa has been well documented, but few effective, long-term solutions have been described. There is an increasing burden of surgical diseases in Africa attributable to trauma (road traffic injuries), burns, and other noncommunicable diseases such as cancer, increasing the need for surgeons.


METHODS
We conducted a Descriptive analysis of surgical academic partnership between Kamuzu Central Hospital (KCH) Malawi, the University of Malawi-College of Medicine, the University of North Carolina in the United States, and Haukeland University Hospital, Norway, to locally train Malawian surgical residents in a College of Surgeons of East, Central and Southern Africa (COSECSA) approved program.


RESULTS
The KCH Surgery Residency program began in 2009 with 3 residents, adding 3 general surgery and 2 orthopedic residents in 2010. The intention is to enroll ≥ 3 residents per year to fill the 5-year program and the training has been fully accredited by COSECSA. International partners have provided near-continuous presence of attending surgeons for direct training and support of the local staff surgeons, while providing monetary support in addition to the Malawi Ministry of Health salary.


CONCLUSIONS
This collaborative, academic model of local surgery training is designed to limit brain drain by keeping future surgeons in their country of origin as they establish themselves professionally and personally, with ongoing collaboration with international colleagues.
Department of Surgery, University of North Carolina, Chapel Hill, NC 27599, USA.
Javeria S
JS
Qureshi
Sven
S
Young
Arturo P
AP
Muyco
Eric
E
Borgstein
Anthony G
AG
Charles
Wakisa
W
Mulwafu
Carol G
CG
Shores
Leonard
L
Banza
Bruce
B
Cairns
Asgaut
A
Viste
Nyengo
N
Mkandawire
D013502:General Surgery / Q000193:education*; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D007391:International Cooperation; D007396:Internship and Residency / Q000639:trends*; D008295:Malawi; D017145:Models, Educational; D009664:Norway; D010820:Physicians / Q000600:supply & distribution; D014481:United States