Improving Surgical Skills of OBGYN Residents through Partnership with Rural Hospitals: Experience from Southeast Nigeria

Background: surgical burden of disease is enormous in sub-Saharan Africa where conditions amenable to surgery also contribute to high maternal mortality ratio in the region. Training of specialists in Obstetrics and Gynaecology must include acquisition of requisite surgical skills. Aim: To evaluate the impact of clinical rotations at rural hospitals on the clinical knowledge, and surgical and administrative skills of residents in Obstetrics and Gynaecology. Subjects and Methods: This was a cross-sectional study using mixed methods involving resident doctors in Obstetrics and Gynaecology at the Federal Teaching Hospital, Abakaliki, Nigeria who had undergone rural postings. Information was obtained from consented residents (June 2013 to February 2015) using a questionnaire and focused group discussion. Data was analyzed using Epi info (CDC, Atlanta USA). Results: Thirty-four questionnaires (89.5%) were analyzed; 70.6% were junior residents. Junior residents had a 900% and 460% rise in the rates of emergency and elective caesarean sections they performed, and had similar increases with regard to gynaecological procedures. Senior residents had a 100% and 80% rise in performance of total abdominal hysterectomy and myomectomy respectively. Seventy-five percent of all the residents believed that their surgical skills improved tremendously while 87.5% of the senior residents believed their administrative skills greatly improved also. Conclusion: Residents in Obstertics and Gynaecology at the Federal Teaching Hospital Abakaliki believed that supervised clinical rotations in rural hospitals offered them an opportunity to improve on their clinical knowledge and surgical skills. We advocate an objective assessment of the skills and knowledge of the residents against the claimed subjective improvement.Keywords: Clinical and surgical skills, Rural posting, Resident

Knowledge, attitude and practice of Nigerian specialist doctors in training of cervical cancer and its screening

Introduction: Cancer of the cervix is the second commonest cancer among women worldwide, the commonest female genital‑tract malignancy in Nigeria, and one of the leading causes of morbidity and mortality among women in Nigeria. Health workers are the trusted source of medical information and their attitude and practice toward diseases of public health importance like cervical cancer are very critical if the country must make progress toward the prevention of such diseases. This work assesses the knowledge, attitude, and practice of Nigeria’s specialist doctors in training toward cervical cancer and its methods of screening because this is critical to its prevention in the country.Materials and Methods: This is a cross‑sectional study involving the administration of pretested structured questionnaire to fifty specialist Nigerian doctors in training in various disciplines from different parts of the country.Results: The knowledge of the participants regarding cervical cancer and its screening is very good, with an average of 98%, but their attitude toward cervical cancer screening is poor as only 7 (14%) had ever recommended a woman for cervical cancer screening. The practice of cervical cancer screening among the participants is poor as only 5 (22.7%) of the 22 female doctors in training had ever screened for cervical cancer and only one male specialist doctor in training out of the 28 of them had the partner screened for cervical cancer before this study. Only 4 (9%) of the 28 males had ever recommended cervical cancer screening to their female partner and 44 (88%) of the specialist doctors in training had never spoken to any organization about cervical cancer screening.Conclusion: Though the knowledge of Nigerian specialist doctors in training on cancer of the cervix and its screening is very good, their attitude to it and practice are very poor.Keywords: Attitude; cervical cancer screening; knowledge; Nigerian specialist doctors; practic

Knowledge, attitude and practice of Nigerian specialist doctors in training of cervical cancer and its screening

Introduction: Cancer of the cervix is the second commonest cancer among women worldwide, the commonest female genital-tract malignancy in Nigeria, and one of the leading causes of morbidity and mortality among women in Nigeria. Health workers are the trusted source of medical information and their attitude and practice toward diseases of public health importance like cervical cancer are very critical if the country must make progress toward the prevention of such diseases. This work assesses the knowledge, attitude, and practice of Nigeria's specialist doctors in training toward cervical cancer and its methods of screening because this is critical to its prevention in the country. Materials and Methods: This is a cross-sectional study involving the administration of pretested structured questionnaire to fifty specialist Nigerian doctors in training in various disciplines from different parts of the country. Results: The knowledge of the participants regarding cervical cancer and its screening is very good, with an average of 98%, but their attitude toward cervical cancer screening is poor as only 7 (14%) had ever recommended a woman for cervical cancer screening. The practice of cervical cancer screening among the participants is poor as only 5 (22.7%) of the 22 female doctors in training had ever screened for cervical cancer and only one male specialist doctor in training out of the 28 of them had the partner screened for cervical cancer before this study. Only 4 (9%) of the 28 males had ever recommended cervical cancer screening to their female partner and 44 (88%) of the specialist doctors in training had never spoken to any organization about cervical cancer screening. Conclusion: Though the knowledge of Nigerian specialist doctors in training on cancer of the cervix and its screening is very good, their attitude to it and practice are very poor