Worlds apart: training in rural South Africa

Abstract

Reforms in the delivery of surgical and anaesthetic services in the UK have reduced the opportunity for trainees to acquire 'hands-on' training. These problems are seen in other European countries and in North America. Surgical and anaesthetic services within developed health care systems tend to be specialised, and are often consultant led. In rural South Africa there is a shortage of surgeons and anaesthetists to service the population, and the public health care system is vastly over-burdened. Trauma accounts for a large percentage of the surgical and anaesthetic workload. This report compares the anaesthetic and surgical training experience of two first-year registrars during a 6-month training period in rural South Africa and a 6-month training period in the UK. Surgical and anaesthetic trainees from countries such as the UK can spend an out-of-programme training period in rural South Africa, thereby broadening their experience and exposure to trauma. They have the opportunity to take on a higher level of responsibility at an earlier stage of training, gaining 'hands-on' experience. Similarly, South African anaesthetic and surgical trainees can spend an out-of-programme training period in the UK, where they can learn the specialist procedures needed in their home country.