Surgery in South Africa
P. C. Bornman, J. E. Krige, J. Terblanche, H. Rode and J. C. de Villiers
Department of General Surgery, University of Cape Town, South Africa.
The practice of surgery in South Africa ranges from full-time service in
state-funded and academic hospitals serving a largely indigent population
to a private sector for medically insured patients. Surgical training
occurs at eight medical schools, and specialist registration is obtained
after 4 to 5 years with either a university-conferred degree or a
fellowship from the College of Surgeons of South Africa. The wide spectrum
of First- to Third-World diseases and the high incidence of trauma provide
comprehensive experience for practical training. Surgical standards are
uniformly high, matching and sometimes pioneering the very best of Western
medicine. The health care system is undergoing radical change to correct
the imbalances of the apartheid era. Academic institutions are under
pressure, and with incipient major financial cutbacks, there is concern
that the proud record of service, teaching, and research excellence may be
compromised. To facilitate the mission of broadening health care services,
diploma training in surgery for rural practitioners is being developed.
Outreach programs and closer liaisons with surgical societies in
sub-Saharan African countries have also been initiated.