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Developing a Perioperative Training Model in Uganda

June 2011

Paul Firth, MDPaul Firth, MBChB, is a pediatric anesthesiologist in the MGH Department of Anesthesia, Critical Care and Pain Medicine (DACCPM) with an interest in humanitarian work and global health.

Earlier this year, he traveled to Uganda to work with anesthetists at the Mbarara University of Science and Technology (MUST). The purpose of the trip was to investigate the potential of building an outreach program between MGH and MUST.

Although there are a variety of international aid programs, most focus on "treating individual patients and not underlying problems. As a department, our expertise is not just service, but also teaching and research. The best way for us to improve healthcare, other than improving wealth, status and education, is to educate the healthcare workers."

His objective for the collaboration with MUST is therefore to provide academic support and training for Ugandan providers, rather than simply clinical care for patients. Gate

MUST is one of only four medical schools in Uganda and currently most anesthesia there is provided by anesthesia officers. Officers have a high school degree and one year of formal anesthesia training. There is a need for physician anesthetists with advanced training.

Uganda does have a small, but growing anesthesiology education program for medical doctors. So far there are only 15 trainees enrolled, but Dr. Firth said the program has a lot of promise and enrollment is expected to increase.

The hope is that this advanced training will improve delivery of perioperative care, especially in preoperative resuscitation and post-operative pain; two areas where Dr. Firth sees the most opportunity for improvement. The patient outcomes that result from this endeavor are very important to Dr. Firth.

He noted that "there is a lot of aid that is funded with no effect or even a negative effect. Our intention is to measure outcomes and if we don't produce good results, we'll have to change our strategy." OR

Driving this type of change, however, will require a multidisciplinary effort. Dr. Firth therefore also hopes to engage not just anesthesiologists, but also nurses and surgeons. His idea is to establish a fellowship program in Mbarara, supported by regular visits by MGH faculty and residents.

Through this collaboration, Ugandan providers will receive expert training and MGH clinicians will have the opportunity for exposure to conditions and diseases they're not used to seeing.

Dr. Firth's commitment and ambition extend beyond his work in Uganda. He wants to use his experience working with MUST to develop a training model that could be applied broadly across additional hospitals in other countries.

The long-term goal is to set up a program where DACCPM faculty members routinely travel to educate and train foreign providers. He believes that "there is tremendous interest internationally in this sort of thing, and it's very important for the Mass General to be at the forefront of any developments."

Dr. Firth's other academic interests include high-altitude physiology and sickle cell anemia. To get in touch with Dr. Firth or learn more about his research, visit his page.

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