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South African Journal of Surgery

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Barriers to accessing ATLS provider course for junior doctors at a major university hospital in South Africa

J.J. Odendaal, V.Y. Kong, T. Liu, Y Liu, B. Sartorius, G.V. Oosthuizen, D.L. Clarke

Abstract


Background: Advanced trauma life support (ATLS) is the international standard of care and forms the basis of trauma training in South Africa. Previous local studies demonstrated a low completion rate among junior doctors (JD). This study was designed to determine the reasons and identify possible barriers of JDs to accessing the ATLS course at a major university hospital.
Methods: This was a prospective study utilising a structured survey that included all JDs who were undertaking their internship training.
Results: A total of 105 JDs completed the survey. Sixty-two percent were female (65/105) and the mean age was 25 years. Forty-eight percent (50/105) of all JDs were post graduate year 1 (PGY 1) and the remaining 52% were post graduate year 2 (PGY 2) JDs. Sixty-two percent (65/105) of all respondents had completed their mandatory rotation in surgery. The reasons for non-attendance of ATLS were: unable to secure a place on course (52%), unable to afford course fee (18%), permission for attendance not granted (14%), unable to obtain study leave (10%) and lack of interest (5%). Subgroup analysis comparing the reasons for PGY1s vs PGY2s demonstrated that not being able to secure a place on course was more common among PGY2s [19% vs 33%, p < 0.001] while financial reasons were more common among PGY1s [18% vs 0%, p < 0.001].
Conclusions: The primary barriers for JDs to attending ATLS training is difficulty in accessing the course due to oversubscription, financial reasons, followed by  difficulty in obtaining professional development leave due to staff shortage. There is an urgent need to improve access to the ATLS training course for JDs in our environment.



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