Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

RCSI/COSECSA collaboration programme

Helping to train and retain surgeons in sub-Saharan Africa

Irish Aid

Since 2007, RCSI and the College of Surgeons of East, Central and Southern Africa (COSECSA) have been working together to increase the number of trained surgeons and improve the quality of surgical care in sub-Saharan Africa.

This collaboration programme between the two colleges is funded by the Irish public, through the State’s development arm, Irish Aid. It is governed by a steering committee which is 50% Irish-based and 50% African-based.

Chronic need for surgeons

East Africa has a population of over 320 million served by just 1700 surgeons. This is an average of one surgeon per 200,000 people compared to 35 per 200,000 in Ireland.

The Lancet Commission on Global Surgery (2015) estimates that 93% of people in Sub-Saharan Africa do not currently have access to timely and effective surgical care.

The results of lack of access to surgery are often devastating. What are seen in the developed world as very routine illnesses and accidents which need minor low-tech surgery often turn into life-threatening, life-altering or fatal events.

Innovative training solution

RCSI and COSECSA have developed a low-cost training programme that allows trainee surgeons to stay in their home country and train on-the-job in an accredited hospital, supervised by an accredited trainer. This decentralised model has been described as a college without walls.


COSECSA is now present in 12 member countries and has over 500 surgical trainees enrolled.

RCSI ‘whole-college’ support

RCSI provides COSECSA with expertise to design curricula, run exams, develop e-learning systems and set quality benchmarks. It has also provided support in college administration, registration processes, finance and leadership finance.

COSECSA has now grown to become the largest surgical training body in sub-Saharan Africa. 261 specialist surgeons have graduated to date, and there are currently 500 trainees enrolled at various stages of the five/six-year programme.

Graduation graph Graduation photo

Training and retaining surgeons

Research has shown that 93% of surgeons trained in Africa are retained in Africa.

COSECSA retention table 

Hutch, A., Bekele, A., O’Flynn, E. et al. World J Surg (2017) 41: 3046.

Contact us

Mr Eric O'Flynn, Programme Director: +353 (0) 85 117 8005,

Ms Deirdre Mangaoang, Assistant Programme Director: +353 (0) 87 708 7274,

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