Abstract:
BACKGROUND : The role and scope of general practitioners in semi-urban and rural areas is poorly understood and documented.
An absence of specialist support results in generalists being called to perform surgical procedures. It is imperative that they
competently and confidently perform specific surgical procedures.
METHOD : This cross-sectional study identified a list of agreed surgical procedures in which generalists should be competent.
Enquires were made about generalists’ competence in performing such skills and training junior doctors how to use these them.
Interns were asked about the quality of their exposure to and their perceived competence in the skills. A questionnaire was
given to interns who completed their internship in 2008 in Mpumalanga and Gauteng, and another to generalists affiliated to the
University of Pretoria. Data were analysed descriptively using Microsoft® Excel®.
RESULTS : The response rate was 31% and 21% for the interns and generalists, respectively. There was agreement on specific core
skills in training. Most generalists (81%) lacked the competence to provide training on some of the specific core skills needed for
independent practice. Most of the internships were completed in semi-urban areas (62%). The majority of the interns perceived
themselves to be competent in Caesarean sections, the excision of lumps and bumps, and abscess drainage. Interns from
urban areas rated themselves as being incompetent in the core surgical skills. Interns who worked in semi-urban regions felt
competent in core surgical skills.
CONCLUSION : The training of interns should be supervised by senior doctors in in-service training settings. Basic surgical skills
and in-service training can be taught during family medicine rotation internships by surgically skilled family physicians and
generalists in semi-urban areas and district hospitals.
