Dalhousie – Rwanda Partnership
Rwanda has a severe shortage of surgeons with only 0.49 surgeons per 100,000 people. Compare this to Canada where 21 surgeons per 100,000 people serve the population. In an attempt to quickly correct this deficiency the Rwandan government has prioritized health human resources in their national budget and policies, rapidly increasing the number of surgical residents over a short period. In a system with few staff, a large number of trainees and heavy clinical demands, hands-on practice of surgical skills is placed at a premium.
In North America, the response to decreased clinical time and operative exposure has been to increase simulation and skills training to augment the first part of the learning curve. In an effort to do the same in Rwanda, the Dalhousie Global Surgery Office and the Dalhousie Department of Anesthesia Global Health Office partnered with the University of Rwanda to develop a simulation and skills centre. The Faculty of Medicine Simulation and Skills Centre (FOMSSC) officially opened on 30 July 2013, but had already been enthusiastically adopted for several preceding months. From February to September, 26 distinct courses were conducted at the FOMSSC involving 476 trainees.
The Dalhousie Global Surgery Office has maintained its involvement with the FOMSSC through several activities. Our group created a surgical skill session template to be used by local surgeons when developing skills sessions. To evaluate the efficacy of this 3 hour surgical skills session format, we will be conducting a study in conjunction with local surgeons to measure knowledge and skills retention among surgical residents in Rwanda and Canada. Pending the results of this study, we will continue to develop further skills sessions. Michelle Murray (operating room nurse, skills centre coordinator and board member of the Dalhousie Global Surgery Office) is increasing local capacity for simulation and skills training by mentoring the FOMSSC project coordinator, Angelique Mugirente.
We are working with our Rwanda colleagues to find new ways to increase surgical capacity and resident education in Rwanda. This partnership is rapidly growing strong roots. We look forward to an ongoing relationship where mutual learning contributes to better surgical education, both here and in Rwanda.