The Impact of Colonialism on Surgical Training Structures In Africa Part 1: Contextualizing the Past, Present And Future

Document Type

Journal Article

Publication Date



World neurosurgery




Africa; colonialism; global neurosurgery; global surgery


Since the first African country attained independence from colonial rule, surgical training on the continent has evolved along three principal models. The first is a colonial, local master-apprentice model, the second is a purely local training model, and the third is a collegiate inter-country model. The three models exist currently and there are varied perceptions of their relative merits in training competent neurosurgeons. We reviewed the historical development of training and in an accompanying study, seek to describe the complex array of surgical training pathways and explore the neocolonial underpinnings of how these various models of training impact today the development of surgical capacity in Africa. In addition, we sought to better understand how some training systems may contribute to the widely recognized "brain drain" of surgeons from the African continent to high income countries (HIC) in Europe and North America. To date, there are no published studies evaluating the impact of surgical training systems on skilled workforce emigration out of Africa. This review aims to discover potentially addressable sources of improving healthcare and training equity in this region.


Neurological Surgery