Resident Massachusetts Eye and Ear/Harvard Medical School
Educational Objective: To describe and analyze the development and evolution of an otolaryngology training program in Uganda in order to identify successful strategies, as well as areas for future improvement.
Objectives: Otolaryngologic pathology is a significant component of disease burden in Africa exacerbated by inadequate numbers of otolaryngologists. The otolaryngology department at a university in Uganda is working to evolve to meet this unaddressed disease burden by having created the country's second otolaryngology residency training program in 2010. Surgical training programs rely on surgical volume of varying case complexity to fulfill resident teaching obligations. We investigated surgical case complexity during an early five year period of the program and interpret it with respect to a timeline of key interventions and events.
Study Design: Retrospective review and narrative history.
Methods: Otolaryngology procedures between 2012 and 2016 were collected through retrospective review of surgical logs and coded according to whether they met criteria for classification as a "key indicator procedure" (KIP) per the United States Accreditation Council for Graduate Medical Education (ACGME). This was analyzed and overlayed on a narrative history and timeline of key interventions and educational events constructed through interviews of departmental faculty. Results: During the study period there was not a consistent trend in total procedures per year but the percent of procedures which qualified as KIPs increased from 3% in 2012 (6/175 total procedures) to 29% in 2016 (35/135 total procedures), with otology KIPs increasing the most.
Conclusions: Increasing resources and operating time appear to be the factors important for the continued growth of the program while the effect of educational interventions from outside institutions is unclear.