Neurology Education in Africa: Survey of People in Training in 18 Countries (P1.285)

Abstract

Objective: To provide a comprehensive understanding of neurology training from the African perspective. Methods: A 40-question survey was distributed in English to attendees of the 7th annual Sub-Saharan African teaching course in Khartoum (October 2015). Questions were devised by the authors with additional questions from the 2012 European survey of the World Federation of Neurology. Themes included the student body, faculty, curriculum, assessment, technology, and work hours and compensation. Results: There were respondents from 18 countries (Burkina Faso, Burundi, Cameroon, Djibouti, Ethiopia, Kenya, Madagascar, Malawi, Mozambique, Nigeria, Republic of Congo, Rwanda, Senegal, South Africa, South Sudan, Sudan, Uganda, Zambia). Ten countries had no formal neurology training programs; Cameroon, Congo, and Mozambique had an adult neurology program; Ethiopia, Madagascar, Nigeria, Senegal, and South Africa had adult and pediatric neurology programs (training duration range 4-6 years). There was a mean of 3.3 (median 2) full-time neurologists on teaching faculty at the respondent’s training institution (neurologists “on faculty: in-country” ratio 0.47) with the lowest ratios in Cameroon and Nigeria). Neurology is perceived as a competitive specialty for entrance in 75[percnt] of countries with 73[percnt] of respondents reporting a requisite entrance examination. Access to a personal smartphone was >95[percnt], more than occasional internet 78[percnt], and online neurology journals 78[percnt]. Average number of work hours was 42 weekly and average monthly salary among those earning income was 966USD (median 780USD). 17[percnt] of respondents reported paying for training. Most common curricular gaps were neurovascular imaging, nerve conduction studies, autonomic testing, and neurogenetics. Conclusions: Neurology training programs are relatively limited in number and have several unmet needs including a small cadre of faculty to carry out training. Access to technology is high. There is little standardization in financing and a wide range of compensation and payment strategies, with most countries reporting neurology to be a competitive career choice.

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