Intern to independent doctor: basic surgical skills required for South African practice and interns' reports of competence

Abstract

Background: The role and scope of general practitioners in semi-urban (SU) and rural areas is poorly understood and documented. An absence of specialist support sees generalists being called to perform surgical procedures. It is imperative that they competently and confidently perform specific surgical skills. Methodology: This cross-sectional study identified a list of agreed surgical procedures that generalists should be competent in. It also enquired about generalists’ competence in performing and training these skills to junior doctors. Interns were asked about the quality of their exposure to and their perceived competence in the skills. A questionnaire to interns, who completed internship in 2008 in Mpumalanga and Gauteng, and another to generalists affiliated to the University of Pretoria were used. Data was analysed descriptively using Microsoft Excel. Results: The response rate was 31% and 21% for interns and generalists respectively. There was agreement on specific core skills for training. Most generalists (81%) lacked competence to train some aspects for independent practice. Most internships were completed in SU areas (62%). Most interns perceived themselves as competent in caesarean sections, excision of lumps and bumps and abscess drainage. Interns from urban areas rated themselves as incompetent in the core surgical skills. Interns who worked in SU regions felt competent. Conclusion: Training of interns should be supervised by senior doctors at in-service training settings. Basic surgical skills can be taught during family medicine rotation internships, as well as in-service training by surgically skilled family physicians and generalists in semi-urban areas and district hospitals. (Full text available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2015; DOI: 10.1080/20786190.2014.976954