A common feature of low-income regions, such as sub-Saharan Africa is the scarcity or absence of certified surgeons. Non-specialist practitioners must provide surgical service, or the rural population and the urban poor will die of untreated disorders that could easily be avoided. One does not need to be a surgeon to conduct basic surgery. Any clinician, given the opportunity to learn and practice surgical skills under proper supervision, can develop the competence and confidence to save lives in circumstances that are common to these communities.
A three-day ESS instructors course is first taught by volunteer Canadian surgeons to African surgeons. At the end of the course, the African surgeons are certified ESS instructors. They then go on to teach a five-day ESS providers course for medical students and medical practitioners, enabling them to gain experience in surgery, through active learning methods with mannequins, case studies and animal material.
The ESS course has proved an excellent way of advancing learners from the academic to the practical understanding of surgery. Participants are taught how to manage surgical interventions, as well as 40 life-saving surgical techniques.
The concept of structured surgical education was revolutionary when CNIS developed the ESS program at the Jimma Institute of Health Sciences in Ethiopia in 1994. Since 1996, the ESS course has been taught to thousands of clinicians (doctors, medical students, clinical officers) working in low-income countries, proving its practical value. So far, ESS training has been incorporated into the curriculum at 12 medical schools and clinical officer schools in Africa. The ESS course is provided on an annual basis to all the universities with which CNIS works. The course has been taught to over 7,500 primary care practitioners in eight African countries by more than 300 local ESS instructors.
- Proposal to improve the surgical skills of Canadian Medical school graduates: the experiences of a medical student and staff surgeon with the Essential Surgical Skills Course in Kilimanjaro, Tanzania.
Hamadani F., Moroz P.J., and Fairfull Smith R.
Can J Surg, 2010 Feb; 53(1): E5-6. PDF
- Evaluating the impact of the Essential Surgical Skills (ESS) course in Tanzania.
S.S. Fung, A. Scheer, K. Chilonga, T.K. Asano, P. Moroz, and R. Fairfull Smith.
Can J Surg, 2009 Aug; 52(4): 351-352. PDF
- Implementing the Essential Surgical Skills Program at the Kilimanjaro Christian Medical Centre: Challenges and Opportunities.
T.K. Asano, K Chilonga, K.A. Mteta, and R. Fairfull Smith.
Can J Surg, 2008 Aug; 51(4): 315. PDF