Identify strengths, areas for improvement and perceptions of a new neurology training program in Zambia.

The first Zambian neurology training program commenced in 2018. We report its first programmatic evaluation.

All current and former neurology trainees, internal medicine (IM) trainees who rotated with neurology in the past year, all IM faculty, and all international visiting providers from the past four years were sent electronic surveys. Neurology trainees and graduates, IM rotators, international faculty who had visited for at least three months, and one hospital administrator were invited to focus groups or semi-structured interviews. Participants were asked what they perceived as the “most significant change” at the hospital since program implementation.  

62/78 (80%) completed surveys, 17 contributed to focus groups and interviews. Neurology trainees noted protected didactic time, emphasis on bedside teaching, and one-on-one attending exposure were program strengths and requested more exposure to outpatient subspecialties and electrophysiology training.

When asked about the “most significant change”, participants noted providers in other specialties across the hospital also seemed to be learning neurologic examination and diagnostic skills, leading to widely improved neurologic care. Additionally, they noted a stronger research emphasis among trainees, even those outside neurology.

The Zambian neurology training program has created positive department-wide changes in teaching and research. Other training programs in resource-limited settings may benefit from prioritizing one-on-one bedside teaching and protected didactics. Similarly, trainees in resource-limited settings may benefit from the development of regional collaborations to provide better exposure to subspecialty clinical experiences and mentors that may be limited at single institutions.

Our study employed a comprehensive, mixed-methods approach to program evaluation in this resource-limited setting that identified strengths and actionable solutions to areas for improvement. This program evaluation method could provide valuable insights in other training settings, regardless of available resources.