ArticleBMC medical education2026
The impact of the Sudan conflict on urological surgical training: a national study of challenges, adaptations, and trainee-led pathways to resilience.
Article in BMC medical education, 2026. 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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Abstract
backgroundArmed conflicts pose severe challenges to healthcare workforce pipelines, with specialized surgical training being particularly vulnerable. The war in Sudan, which began in April 2023, has led to a complex humanitarian crisis, damaging health infrastructure and displacing medical professionals. The impact on postgraduate urological surgical training requires detailed assessment.
methodsA national, descriptive quantitative cross-sectional study was conducted from September to December 2024. A structured online questionnaire was distributed to the complete national cohort of urology specialty trainees (n = 40, 100% census) and to surgical trainees in general and pediatric surgery programs who undertake mandatory urology rotations (high-response sub-cohorts, n = 60). Data on demographics, displacement, mental health, training quality, resource access, and adaptations were collected. Descriptive statistics were analyzed using SPSS v26.0.
resultsAmong 100 trainees in the urological training pipeline-representing all current urology specialists-in-training in Sudan and a majority of surgical trainees with urology exposure-the majority (68%) were displaced to Port Sudan. A profound psychological burden was evident: 57% reported significant war-related mental health impacts, and 72% described severe training-related stress. Critically, only 24% accessed mental health services. Surgical training experienced major disruptions, with 84% reporting a decline in procedural participation and 86% a reduction in case diversity. Resource shortages affected 68%, and while 67% of programs underwent curriculum changes, remote learning was deemed ineffective by 51% of trainees. Confronting these systemic challenges, trainees proposed actionable solutions, prioritizing enhanced remote education (71%), secure funding for supplies (69%), and curriculum modification (66%).
conclusionThe Sudan conflict has profoundly disrupted urological surgical education, creating a mental health crisis and threatening future surgical capacity. Trainees are not passive victims but architects of a potential hybrid-resilience model. Their insights point to the urgent need for a collaborative, internationally supported "Surgical Training Support Framework" that integrates psychological support, a structured blended-learning curriculum, and guaranteed resource funding.
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