ArticleResearch square2025
Ugandan Physician Attitudes towards a Potential, Local Trauma Fellowship Program.
Article in Research square, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background: In low-income countries, clinicians trained through a context-specific trauma surgery fellowship program (TFP) can help reduce injury-related mortality to levels closer to those observed in higher-resource settings. Successful implementation, however, hinges on buy-in from local clinicians. We therefore assessed clinician support for a potential TFP in Uganda, considering perceived need, curricular recommendations, barriers, and motivating factors. Methods: After cognitive interviews with experts and questionnaire pilot testing, we cross-sectionally surveyed Ugandan consultants (general surgeons and procedural specialists involved in trauma care) and surgical residents at a tertiary, national referral hospital. Respondent percentages were calculated for multiple-choice answers, and we performed thematic analysis of free-text responses using a primarily inductive approach. Results: Among 46 faculty (from 13 specialties) and 42 resident respondents, 86% supported a Ugandan TFP. Respondents recommended incorporating emergency general surgery (66%), critical care (84%), and international rotations (76%) into the curriculum. Severe resource and structural deficiencies (82%) and concern about governmental support for post-training employment and compensation (66%) were leading perceived barriers to TFP implementation. Most faculty felt a TFP would improve patient outcomes (93%), overall trainee education (77%), and clinical efficiency (68%). Free-text responses were consistent with survey themes, indicating acute awareness of current trauma system inadequacies and conviction that a TFP would reduce injury-related mortality. Conclusions: Ugandan clinicians who care for injured patients view a TFP as crucial to improving injury-related outcomes, despite known barriers. TFP implementation should incorporate curricular recommendations from this survey and address widespread concerns about financial and infrastructural support from the national government and local institutions.
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