Postgraduate gastroenterology training and continuing medical education in Africa: challenges, opportunities, and future directions

Abstract

Africa faces a critical shortage of gastroenterologists amidst a growing burden of digestive diseases. Despite an alarming rise in gastrointestinal (GI) conditions - including peptic ulcers, GI cancers, and infectious colitis - postgraduate training in gastroenterology remains underdeveloped. This narrative review examines the structural, educational, and systemic challenges facing GI training across the continent, drawing from peer-reviewed literature, institutional surveys, and global health databases. Findings reveal substantial heterogeneity in training program length, curriculum standards, and procedural exposure. Advanced techniques like endoscopic retrograde cholangiopancreatograph and endoscopic ultrasound remain inaccessible to most trainees, while simulation facilities and didactic teaching are often limited. Faculty shortages, lack of protected research time, and minimal access to conferences further compromise academic development and contribute to workforce attrition. Despite these challenges, several innovative approaches offer hope. Low-cost simulation models, tele-education, and hybrid conference formats are improving access to training. Regional centers of excellence and North-South collaborations - such as partnerships between African institutions and the British Society of Gastroenterology (BSG) - have demonstrated success in building local capacity. The expansion of digital platforms, diaspora engagement, and public-private partnerships presents further opportunities. Recommendations include implementing competency-based assessments, supporting faculty development, creating regional accreditation bodies, and investing in infrastructure. Addressing systemic inequities in conference access and leveraging geospatial surveillance tools could also enhance disease mapping and policy planning. Ultimately, strengthening gastroenterology education in Africa requires coordinated regional and international action to develop sustainable, context-sensitive training ecosystems. This review provides a roadmap for achieving equitable specialist training and improving digestive health outcomes across the continent.

Keywords: Africa; Capacity building; Endoscopy; Gastroenterology training; Medical education; Workforce development.