Improving Neurology Training in Zambia: Challenges and Progress
Developing neurology training in Zambia faces obstacles such as limited neurologists, inadequate resources, and lack of specialized programs. The country's healthcare system, particularly at the University Teaching Hospital, is strained with neurology patients managed under internal medicine. Initiatives are being taken to introduce a structured neurology training program to bridge the gap and enhance neurological care in Zambia.
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Case Study: Case Study: Developing Neurology Training in Zambia Developing Neurology Training in Zambia DEANNA SAYLOR, MD, DEANNA SAYLOR, MD, MHS MHS ASSOCIATE PROFESSOR DIRECTOR, HOPKINS GLOBAL NEUROLOGY PROGRAM NEUROLOGY GRAND ROUNDS NOVEMBER 1, 2023
Poll 1 Poll 1 How many neurologists do you have in your country? None < 10 11-100 101-1000 > 1000
Zambia Zambia - ~20 million people 75% live on < $1/day 11.5% HIV prevalence 7th highest in the world One of the highest TB burdens in the world ~1/3 the recommended number of doctors 2009: 808 doctors, recommended 2300 4 expatriate neurologists 3 predominantly research
University Teaching Hospital, Zambia University Teaching Hospital, Zambia - Largest hospital in Zambia 1655 beds + patients in hallways, aisles, etc - National referral hospital - Primary teaching hospital in Zambia - No inpatient neurology service Neurology patients cared for on internal medicine service
University Teaching Hospital, Zambia University Teaching Hospital, Zambia Neurologic resources CT MRI EEG EMG/NCS LP
As a result, some days you just As a result, some days you just feel like you don t have the feel like you don t have the right tools for the situation right tools for the situation
But we persist! But we persist!
Poll 2 Poll 2 Do you have a post-graduate neurology training program (e.g. specialist training, neurology residency) in your country? Yes No
Neurology Training Program Neurology Training Program Structure 3 years of internal medicine + 2 years of neurology Blend traditional Zambian post-graduate training with traditional US post-graduate training Master s degree program with courses, assessments Intentionally creating an academic/ research focus
1 1st st Day of Neurology Training Day of Neurology Training
End of 1 End of 1st st Year Celebration Year Celebration
1 1st st Graduation Graduation
The Future & Sustainability The Future & Sustainability 12 graduates 10 adult and 2 pediatric neurologists 7 current trainees (6 adults and 1 pediatric neurology) First 6 graduates all serving as junior faculty within the program Most recent 6 graduates have been relocated to other hospitals to begin neurology services REGIONAL IMPACT Two post-graduate trainees joined in January 2023: - one from Liberia who will be the FIRST neurologist in Liberia one from Tanzania who will be the first neurologist outside of Dar es Salaam - Another trainee joining from Ethiopia next month
Questions? deanna@jhmi.edu
