Postgraduate training in cardiology in Sudan during wartime: a story of perseverance and resilience
Background and objectives: The Sudan postgraduate cardiology training programme was launched in 2010 by the Sudan Medical Specialisation Board (SMSB). Four training centres were located in the capital, Khartoum, and a fifth in the nearby city of Wad-Madani. We discuss the interventions undertaken to...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Future Healthcare Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2514664525002048 |
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| Summary: | Background and objectives: The Sudan postgraduate cardiology training programme was launched in 2010 by the Sudan Medical Specialisation Board (SMSB). Four training centres were located in the capital, Khartoum, and a fifth in the nearby city of Wad-Madani. We discuss the interventions undertaken to circumvent the interruptions to the programme following Sudan's war of April 2023 and evaluate their outcomes. Materials and methods: We used a narrative analysis of the events and evaluated the exam pass rate and trainees' portfolios. The trainees' views were assessed through a questionnaire. Results and discussion: The number of registered cardiology trainees was 38; five were preparing for the final/exit exam. Due to the war, trainers (cardiologists), trainees and medical staff had to relocate from Khartoum centres to Wad-Madani and, thereafter, to safe towns (namely Marawi, Atbara and Shendi), which only had basic cardiology services. This encouraged the cardiology board to hold the exam in February 2024 in Atbara as a priority.Eligible candidates were notified in person and through scarce media channels. One candidate had to be informed by physically reaching his village. The written, objective, structured practical examination and clinical sections were held under the same strict criteria. All candidates passed and received electronic certification of completion of training. The SMSB efficiently supported the logistical and financial aspects of the examination.Subsequently, the clinical training programme was resumed in June 2024 for the ten trainees who remained in Sudan after tremendous efforts to upgrade the cardiology set-up within the three towns/units above. Funded primarily by the National Cardiac Centre, these included providing essential non-invasive and invasive lab equipment and established coronary care units, dedicated cardiology wards and outpatient services. Cardiothoracic surgery was only available at the Marawi unit. Arrangements were made for trainees to rotate between the three units to broaden their training opportunities. Free accommodation was offered to trainees, notwithstanding the challenges posed by inflation and the mass influx of internally displaced people.Despite the war conditions, the Cardiology Council Committee continued to function and meet remotely, addressing emerging challenges and resolving issues. Several trainers who were displaced and settled abroad contributed to the online educational component and continued to provide essential guidance and expertise.Trainees continued to log workplace-based assessments to demonstrate the attainment of competencies. The evaluation of their training logbooks showed excellent performance and evidence documentation. The results of the trainees' questionnaire revealed a high satisfaction level with the quality of training. Interestingly, 80% of the trainees felt that the training was better than pre-wartime, and they all felt they had greater accessibility to their trainers and more opportunities for hands-on training due to the higher case volume. However, 40% were dissatisfied with the accommodation and financial support. Conclusion: Sudan postgraduate training in cardiology was successfully maintained during wartime, achieving good trainee satisfaction and educational outcomes through perseverance and resilience. Decentralisation of training, imposed by the war, resulted in quality cardiology services reaching a wider population and more peripheral areas. |
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| ISSN: | 2514-6645 |