A TEMPLATE FOR SURGICAL RESIDENCY TRAINING PROGRAM (SURGICAL POSTGRADUATE TRAINING) IN DEVELOPING COUNTRIES.
Authors: Gbolagunte Ajao Oluwole 
Published: November 2019

Background: Many doctors who trained in developing countries always travelled to developed countries for specialization. After specialization,
many of them do not return to their countries of origin but stay put in the host countries, and get absorbed into the health delivery system of the host
countries. To stop this exodus of much needed man-power in the developing countries, many of these developing countries devised their own
postgraduate programs so that there will be no need for doctors that aspire to specialize to leave the country any more. This review article is to
assess the quality of the various postgraduate programs in the Third World countries.
Study design: The postgraduate programs in some developing countries like Nigeria, Ghana and some countries in the South Pacific were studied
and compared with some programs in the developed countries like the United States of America and Canada. There are differences in these
programs. We therefore attempt to identify the weaknesses of the programs in the developing countries and make suggestions in some aspects of
the programs so as to produce Residency training programs that will satisfy the needs and the peculiarities of the developing countries, and yet
measure up to international standards.
Results and findings: Many of the postgraduate programs in the developing countries, as they are now, fall far short of international acceptable
standard. There are essentially two main reasons for this: some of the programs are directly under the control of the Governments in those countries,
where the priorities are more economic than quality. Also, there is this notion among the doctors in the developing countries that surgical
postgraduate training must be treated like preparation for a university PhD degree, even though university Senate has no in-put in awarding
fellowship certificate. In the Third World countries, it is felt that “special breed” of surgeons must work in the university environment because it is
considered “prestigious” to work in the universities.
Conclusion:Even though the aim to retain doctors in their countries can be said to have been achieved, it came at a great price because the programs
are very different from the well established residency training program as introduced by William Halsted and Churchill. This gives rise to a
program comparative to residency training in the specialty of General Medical Practice, which is very different and of lower standard than
internationally accepted surgical residency training program. It also equates the training, in some aspects, to that of a university Master's and PhD
degrees.
Abbreviations: RTP, Residency Training Program; LSP, Local Specialist Program; GCPS, Ghana College of Physician and Surgeons; NPGMC,
National Post Graduate Medical College; WACS, West African College of Surgeons; LST, Local Surgical Training; MCQ, Multiple Choice
Questions; OSCE, Objective Structured Clinical Examination; SRTP, Surgical Residency Training Program; MMed, Master's degree in Medicine.