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Bringing surgical training to female medical students in Zimbabwe

IMG_1468Earlier this summer, I shared the story of how two pioneering women are challenging the status quo in Zimbabwe by saying it's okay for women take up careers in surgery. Now, this professor-student duo – Stanford surgeon Sherry Wren, MD, and surgeon-in-training Annete Bonigwe Moyo – have launched the first surgical skills training for female medical students at the University of Zimbabwe's College of Health Sciences.

For a girl growing up in Zimbabwe like Moyo, expressing interest in surgery can be met with ridicule and doubt. But when Moyo met Wren two years ago, Moyo was inspired to change this perception.

She founded DREAM (Dedicated to Reach, Empower And Mentor women in surgery) to empower her female peers and increase participation in the profession. Wren has been a core advisor since the organization’s inception, helping to achieve their mission by providing mentorship and new educational opportunities for the women of DREAM.

“Surgery is a core subject in our medical undergraduate curriculum requiring the acquisition of cognitive diagnostic demands, as well as procedural skills,” Moyo, a senior medical student at the University of Zimbabwe, told me. “However, in spite of the advent of skills laboratories and simulators, undergraduate trainees are barely exposed to the procedural aspect of training. For many graduating medical students in these circumstances, surgery is a far-off thought, and few have the confidence to carry out basic surgical procedures as they go through their internship.”

IMG_1473In an effort to help medical students translate the knowledge gained in the classroom to the operating table, Wren recently facilitated a basic surgical skills training session hosted by DREAM – a first for medical students in Zimbabwe. The training was attended by 21 third, fourth and fifth year MBChB students – all of them women.

Moyo reported to me:

[Wren] began the session by helping the women appreciate standard operating room etiquette and protocol, sterile procedures, sharps and fluid safety, scrubbing, gowning and gloving. For most of the students present, this was the first time they were being walked through these important basic principles of surgery.

Excitement grew as [Wren] began teaching the women some basic surgical sutures on sterile towels... Soon the ladies were ready to apply their newly learned skills on loops of bowel procured to give a more real feel to the exercise. It was amazing to see how quickly what was initially a barely discernible pattern of uneven sutures transformed into neat even sutures…

By the end of the 3-hour session, the timid girl who was clueless as to how to handle the most basic of surgical instruments, or let alone tie a surgical knot, had become a confident future surgeon raring to do whatever it took to realize her dream.

For Wren, the training fulfilled two important missions: to empower the next generation of female surgeons, and to build surgical training and capacity in Zimbabwe, a cornerstone of the Stanford-UZCHS Surgery Initiative, which grew out of an NIH grant from the Medical Education Partnership Initiative (MEPI).

MEPI was established in 2010 as a five-year NIH-funded initiative to build medical education and capacity in 11 sub-Saharan countries. Stanford’s Center for Innovation in Global Health partnered with the University of Zimbabwe and the University of Colorado, Denver in receiving a $10 million grant to establish the Novel Education Clinical Trainees and Researchers (NECTAR) Program in Zimbabwe.

Over the last five years, more than 75 faculty members from the partner universities have rotated to Zimbabwe to teach and fill gaps in the medical curriculum. In addition to faculty training, efforts have focused on building technological capacities like setting up Internet connectivity and online library resources, as well as research and administration capacity building.

“Our surgery initiative grew out of a strong mutual interest in building surgical skills, research collaborations and mentorship of trainees and junior faculty,” said Wren. “Part of the initiative involves a bi-lateral exchange in which Stanford general surgery residents spend four weeks in Zimbabwe, and we host visiting Zimbabwean residents here. As the MEPI grant comes to an end, we look forward to continuing these programs with our Zimbabwe partners.”

The surgical skills training session was held in conjunction with the 2015 MEPI Symposium, which took place from July 14-16 in Harare.

Previously: How two women from different worlds are changing the face of surgery and Providing medical, educational and technological tools in Zimbabwe
Photos courtesy of Annete Bonigwe Moyo

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