The State of Plastic Surgery Training in South Africa
1From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Background:
Since the early postapartheid period, the South African government has implemented policies to strengthen the public health system. However, structural challenges continue to affect registrar training in plastic surgery.
Methods:
A prospective, descriptive survey was distributed to approximately 180 plastic surgery trainees and consultants across South Africa. Thirty-seven responses were received. The questionnaire collected demographic data and opinions on training content, teaching quality, research support, mentorship, and proposed reforms.
Results:
The majority of respondents believe the current 5-year training period is appropriate but highlighted significant gaps in aesthetic, craniofacial, oculoplastic, and nonsurgical rejuvenation training. There was strong support for private practice rotations, a shift toward competency-based curricula, and improved mentorship and research support. Journal clubs and interuniversity meetings were rated poorly, whereas short courses and operative lists were highly valued. Consultant supervision and teaching time were widely seen as inadequate.
Conclusions:
Respondents identified both strengths and weaknesses in the current training system. Key strengths included the structured program length and foundational training in skin cancer surgery. However, improvements are needed in subspecialty exposure, consultant-led teaching, and academic mentorship. There was broad support for integrating competency-based training, private sector exposure, and enhanced research infrastructure to improve trainee preparedness and program quality.
