State of Neurosurgical Education in Africa: A narrative review.

INTRODUCTION There is no comprehensive report of neurosurgery postgraduate education in Africa. This narrative review aimed to map out the landscape of neurosurgery training in Africa while highlighting similarities and differences in training. METHODS The authors searched the keywords "neurosurgery," "education," and "Africa" on PubMed and Google Scholar from inception to 17/01/2021. Next, they conducted a complimentary hand search on Google using the keywords "neurosurgery," "residency," and the individual African countries in English and official languages. The relevant data were extracted and compiled into a narrative review. RESULTS We identified 76 African training programs that recruit more than 168 trainees each year. Less than half (40.7%, n=22) of African countries have at least one neurosurgery training program. Egypt (n=15), Algeria (n=14), and Nigeria (n=10) have the highest number of training programs, while Algeria (0.33), Egypt (0.15), and Libya (0.15) have the highest number of training programs per 1 million inhabitants. The College of Surgeons of East, Central, and Southern Africa has 16 programs in eight countries, while the West African College of Surgeons has 17 accredited programs in three countries. The duration of training varies between four and eight years. There is limited information available in the public domain and academic literature about subspecialty fellowships in Africa. CONCLUSION This review will provide prospective applicants, African and global neurosurgery stakeholders to advocate for increased investment in African neurosurgery training programs.