










































West Africa Sub-Regional Training and Skills  
Transfer: Experience at the Genitourinary Division  
of the Korle Bu Teaching Hospital, Accra, Ghana
Abdullahi Khalid 

Institute of Urology and Nephrology, Usmanu Danfodiyo University and Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Soc Int Urol J. 2021;2(1):7–9

FIGURE 1.

Department of Surgery, Korle Bu Teaching Hospital

Introduction
Surgical training in the West Africa sub-regional countries produces specialist surgeons in most surgical disciplines, 
including urology, to ensure that people of the sub-region—and sometimes beyond—have access to surgical services. 
The training is conducted at tertiary health facilities accredited by the national and sub-regional postgraduate 
colleges. The countries in the sub-region established their national postgraduate colleges in addition to the sub-
regional postgraduate college known as the West African College of Surgeons. Surgical trainees are at liberty to select 
the college of their choice in the course of training.

The training involves a series of surgical clinical rotations of stipulated duration, with some variation between the 
National and West African Postgraduate College, but with essentially similar course content. Urological training 
requires a minimum of 5 to 6 years to complete depending on the postgraduate college[1]. During senior residency 
rotation trainees are encouraged to undertake postings outside their training centre to enhance knowledge and skills 
acquisition and transfer.

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Although this paper is intended to offer insights into 
the surgical training in West Africa, it should be noted 
that this is primarily an account of my own 3-month 
clinical rotation as a trainee from Sokoto, in the North 
West region of Nigeria, at the Korle Bu Teaching 
Hospital, Accra, Ghana. 

The Training Facility 
Korle Bu Teaching Hospital, in Accra, Ghana, was 
established in 1923[2]. It is one of the major tertiary 
health facilities in Ghana and the third biggest referral 
centre in Africa, with 2000 beds, 21 clinical and 
diagnostic departments, and 3 Centres of Excellence 
(the National Cardiothoracic Centre, the National 
Reconstructive Plastic Surgery and Burns Centre, and 
the National Centre for Radiotherapy and Nuclear 
Medicine)[2]. It is a postgraduate training centre in 
both surgical and medical subspecialties, and strives 
to become the “preferred centre of excellence and 
innovation for specialist care provision, training, 
research and advocacy in Ghana and West Africa”[2].

In addition to training urologists, the genitourinary 
division of the department of surgery (Figure 1) also 
provides urological care for the people of Greater Accra 
region—a population of 4 010 054 people[1]. Patients 
from other parts of the country—and even from other 
West Africa sub-regional countries—occasionally 
receive treatment here because the concentration of a 
wide spectrum of specialists and the better facilities and 
equipment allow the provision of advanced care.

The area’s network of rivers and dams, including 
the Volta River and the Akosombo Dam, mean that 
waterborne diseases, including bilharziasis and its 
chronic sequelae, such as bladder cancer, ureteric 
strictures, and upper tract stones, are seen in relatively 
high numbers, as are other common urologica l 
diseases such as benign prostatic enlargement and 
urethral strictures. Therefore, urologist trainees who 
rotate through this facility are exposed to a myriad 
of reconstructive, endourologic, laparoscopic, and 
other procedures. There is a need to introduce robotic 
urologic services to boost trainees’ exposure and keep 
the training institution on a par with similar facilities 
elsewhere in the world. Meeting this challenge—and 
many others in health care—will require further 
government, philanthropic, and donor agency support.

Institutional Structure and Clinical Rotation
The trainee urologists are privileged to be taught by 
all the consultants in the division, many of whom are 
renowned in the sub-region and internationally. During 
my time there, whether in the theatre, on the ward, in 
the clinic, or even in the corridors of the hospital, they 
seized every opportunity to teach both individuals and 

groups, and they were always aware of and responsive to 
the academic needs of their trainees. In my experience, 
the trainees also freely shared knowledge and experience 
among their fellows. All of which ensured trainees 
acquired a wealth of relevant knowledge and skills 
within a relatively short period, making this an excellent 
clinical rotation.

Benefits 
The theatre sessions included procedures that the trainee 
urologists were seeing or participating in for the first 
time. Even when procedures were more familiar, the 
volume of cases was far greater than we would have 
encountered at smaller centres. Watching the precision 
and gentleness of tissue handling by some trainers 
during reconstructive urological procedures was an 
added advantage. Trainees also benefitted greatly 
from attending a 1-day didactic and hands-on course 
on acute trauma operative management using live 
animals (Figure 2), as well as a week-long workshop on 
percutaneous nephrolithotomy.

Social Aspect
Even with such a busy schedule, trainees did have 
time on alternate weekends to tour the city of Accra—
in my case, with the aid of a reasonable and reliable 

FIGURE 2. 

During the acute trauma operative management course

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commercial taxi driver. Particularly memorable were 
the outings to 2 historic sites: Black Star Square, also 
known as Independence Square, and Kwame Nkrumah 
Memorial Park[4].

Final Word and Recommendations
Ideally, the West Africa health community and specialist 
training colleges should identify facilities of excellence 
that can be incorporated in the training rotations to 
achieve skilled specialists and clinicians to serve the 
West Africa sub-region. Support from governmental, 
non-governmental, and donor agencies will be needed to 
support these facilities as they work towards the further 
development of urological specialists in the sub-region.

Acknowledgements
I wish to thank Dr Moyijo Maishanu for his useful 
contribution to this work. I am also most grateful to my 
trainers, especially Professor Ismail Arzika Mungadi, 
Professor Jacob Ndas Legbo, Dr Abdullahi Abdulwahab-
Ahmed, Dr Abubakar Umar, and the entire management 
team of Usmanu Danfodiyo Teaching Hospital, Sokoto, 
Nigeria, for their unflinching support of my training. 
I sincerely appreciate the urology team at the Korle Bu 
Teaching Hospital, with special mention of Dr James 
Edward Mensah, Head of the Genitourinary Division, 
Professor George Klufio, Mr Samuel Gepi-Attee, and Dr 
Mathew Y. Kyei.

References
1. Shehu BB. Faculty of Surgery Training Programmes and Curricula. 

West African College of Surgeons: 64. http://www.wacscoac.org/
downloads/SURGERY%20CURRICULUM. Accessed October 24, 
2020.

2. Korle Bu Teaching Hospital: A Brief History. https://kbth.gov.gh/
brief-history. Accessed December 6, 2020.

3. PHC National Analytical Report 2010. https://statsghana.gov.gh/
gssmain/fileUpload/pressrelease. Accessed December 6, 2020.

4. Visit Ghana Tourism Authority. https://visitghana.com/attractions/. 
Accessed December 17, 2020.

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http://www.wacscoac.org/downloads/SURGERY%20CURRICULUM
http://www.wacscoac.org/downloads/SURGERY%20CURRICULUM
https://kbth.gov.gh/brief-history
https://kbth.gov.gh/brief-history
https://statsghana.gov.gh/gssmain/fileUpload/pressrelease
https://statsghana.gov.gh/gssmain/fileUpload/pressrelease
https://visitghana.com/attractions/i
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