Current Models of Plastic Surgery Training in Sub-Saharan Africa: A Review From 2018 to 2022

Background: In sub-Saharan Africa (SSA), there is a significant burden of surgical disease that necessitates expanded plastic surgery (PS) training and infrastructure. There has been no recent comprehensive comparison of the available training programs and regional disparities in training opportunities. Methods: The websites of PS training paradigms were reviewed, and information regarding program requirements and structure was obtained. Data were supplemented by contributions from current and past PS trainees. Results: Surgical care within SSA is organized through (1) the College of Surgeons of East, Central, and Southern Africa (COSECSA), through which 14 accredited PS programs in 19 countries serve 38.8% of the SSA population; (2) the West African College of Surgeons, through which 32 accredited PS programs in 15 countries serve 41.2% of the population; (3) the Colleges of Medicine of South Africa, through which 9 accredited PS programs serve 4.9% of the population. The Master of Medicine PS training program in Kenya serves 4.5% of the population. Examinations taken for certification include a preresidency, a general surgery assessment, and a final examination at the end of residency. In 2022, 14 PS trainees were certified through COSECSA, and 5 were certified through the West African College of Surgeons. Both Master of Medicine and COSECSA trainees can sit for the certifying examination administered by COSECSA. Conclusions: PS training prerequisites, curriculum, and examination structure are comparable across SSA, although regional disparities exist. This suggests the strong possibility of success for initiatives that would be directed toward standardizing the qualifications to practice PS in SSA and increasing opportunities for intraregional training.