Abstract:
BACKGROUND : Surgical training varies significantly amongst universities within the same country. This trend is reflected in
South Africa and provides an opportunity for innovation to improve the quality of general surgical training.
OBJECTIVE : To assess the perceptions of South African general surgery registrars regarding surgical training.
METHOD : A prospective descriptive study was performed by means of a confidential questionnaire distributed to general
surgical registrars at all eight training centers in South Africa. Participants were asked to give comments regarding adequacy
of formal academic teaching, level of supervision during surgical procedures, exposure to and training in minimally invasive
surgery (MIS), and preparation for examinations. Descriptive statistics were generated with Microsoft Excel. Ethics
clearance was obtained from the University of the Witwatersrand Human Research Ethics Committee.
RESULTS : Of 200 questionnaires distributed 105 (52.5%) were returned. 44% (105/241) of all registrars from six training
institutions participated. 89.5% (94/105) of respondents reported that they attended less than six hours of formal academic
teaching per week and 71.4% (75/105) indicated that their institution offered less than six hours of formal academic teaching
per week. 76.2% (80/105) of respondents regarded lack of protected academic time as the greatest obstacle to their surgical
training and 95.2% (99/105) reported that clinical responsibilities prevented them from attending formal academic teaching
regularly. Overall, only 31.4% (33/105), 41.9% (44/105) and 37.1% (39/105) were satisfied with the amount of formal
academic teaching, level of supervision during theatre procedures and exposure to minimally invasive surgery respectively.
Lack of resources and lack of appropriate skills were identified as a hindrance to MIS training by 47.6% (50/105) and 28.6%
(30/105) of respondents respectively.
CONCLUSION : Surgical registrars are dissatisfied with the amount of formal academic teaching and protected academic
time, level of supervision in theatre and their exposure to MIS. These challenges compromise trainees’ ability to practice
independently after qualification. Numerous interventions are necessary and possible to address these challenges.
