Building thoracic surgical capacity for tuberculosis care in India: Experience from a Residential Skill Training...

Tuberculosis (TB), particularly multidrug-resistant TB (MDR-TB), continues to pose a major public health challenge in India (1). Thoracic surgery plays an important adjunctive role in selected patients with complex pulmonary TB; however, access to trained thoracic surgeons remains limited. Under the guidance of the Central TB Division, the National Institute of Tuberculosis and Respiratory Diseases (NITRD), New Delhi, in collaboration with The Union, initiated a 3-month Residential Skill Training Programme in Thoracic Surgery in 2022. This short communication describes the experiences and perceived outcomes of surgeons who participated in the programme. A descriptive qualitative programme evaluation was conducted among nine surgeons from government institutions across India who completed the training across five batches. Data were collected using structured feedback forms and narrative interviews. Participants reported perceived improvement in thoracic surgical decision-making, perioperative management and operative confidence. Training exposure included video-assisted thoracoscopic surgery (VATS), decortication, lobectomy, pneumonectomy, pleural cavity window procedures, rib resection, and diagnostic thoracoscopy. Following training, several participants initiated or expanded thoracic surgical services at their institutions, with reported surgical volumes ranging from 1 to 12 procedures per month. Major challenges identified included inadequate infrastructure, shortage of trained supporting staff, and low referral rates because of limited awareness regarding surgical indications in TB management. The programme demonstrated potential for strengthening thoracic surgical capacity and improving access to surgical care for patients with complex TB in high-burden settings.