Editorial: New horizons in postgraduate medical training
Postgraduate medical training has barely existed in South Sudan, causing a stultifying effect on medical services and a lack of opportunity for a generation of doctors. Training in nearby countries or overseas has been the only option, with a patchy uptake and inevitably leading to a substantial brain drain. The problem is compounded by a lack of career structure, properly paid posts and longer term vocational opportunities. This unhappy situation may continue with a demoralised and often inadequately trained workforce, and a service which would collapse entirely if not propped up by NGOs and other bodies. Alternatively, new systems can be devised and emplaced to radically redeem this unacceptable position.
How then to introduce a new structure to embed postgraduate training and continuing professional development? Early progress has stemmed from the St Mary's-Juba Hospitals link, the work of the Harvard group and other international links, and with the strong support of the Ministry of Health. Building on these initiatives is a coordinated drive from within and without the country to establish a training structure for current and future doctors. A Business Case has been drawn up encompassing the many threads which will be woven into the overall strategy. Funding is being sought.
In this postgraduate training:
- All trainees will have a structured training curriculum comprising a modular system enabling the acquisition of basic skills and knowledge. When satisfactorily completed this will allow for safe practice in a district or community setting. For others it will lead to specialty training.
- A specialty training programme will be delivered by local and visiting trainers. This will be recognised at an equivalent level to the Master of Medicine (MMed) and successful completion will allow appointment as a specialist. Until this programme is established, MMed scholarships abroad will continue and a few trainees will be selected for a two year training period in the UK.
- Leadership, teaching skills, managerial and organisational techniques will be formally addressed.
- A College of Physicians and Surgeons of South Sudan will be established to coordinate postgraduate training, set and maintain standards, and oversee postgraduate activity.
With good will and adequate funding, these aims will be achieved. A more detailed account and timetable of these developments will be published in this Journal in due course.