September 8, 2023

Ghana gears up for a new surgical fellowship, with help from UMMS collaborators

Launched this fall, Ghana's first colorectal surgery fellowship program has a national scope.

Kwakye in Ghana with colorectal surgery fellowship team
Dr. Gifty Kwakye, center, leads a procedure while medical students, residents and physicians from Ghana's Korle Bu Teaching Hospital observe as part of the training for the country's new colorectal surgery fellowship program.

A Michigan Medicine surgeon is behind a collaboration to introduce Ghana’s first colorectal surgery fellowship.

The ambitious project is similar to prior training partnerships U-M has been involved with in Ghana, with one key difference: rather than being focused at a single institution, Ghana’s new colorectal surgical fellowship will be a national program, spread across multiple teaching hospitals in different cities.

“I had been doing work with one partner, trying to think through a training program. But healthcare leaders who have identified this as an area of national importance encouraged us to do something on a larger scale,” said UMMS Associate Professor of Surgery Gifty Kwakye, who is spearheading the project.

“We really went from thinking small to thinking much bigger,” she said.

The result is a sweeping collaboration that includes U-M, the Ghana College of Physicians and Surgeons, and the country’s three largest teaching hospitals, as well as US partner schools in Utah, Minnesota, and Arkansas. Their partnership is detailed in a recent publication in Diseases of the Colon and Rectum.

“The idea is to de-centralize the training. Instead of housing it within a specific hospital, which has traditionally been the approach, the fellowship is designed to have trainees rotate at different sites,” Kwakye said. “We can leverage the resources and teaching opportunities within the different hospitals, while also improving capacity in other services required to support a colorectal practice.”

By engaging multiple sites, the fellows upon graduation will be able seek employment opportunities across the country instead of only being retained at a single institution or region. The first fellow started the one-year program this summer, with a second expected to begin this fall and more to follow in 2024. For Michigan Medicine, the new program could mean potential opportunities for its fellows to rotate in Ghana, as well occasionally hosting a Ghanaian fellow for short-term visits. Along with opportunities for quality improvement projects, the program will open the door to rich research questions to explore by learners and faculty in Ann Arbor and in Ghana.

While each Ghanaian fellow will spend a few weeks learning the US, the bulk of the training will occur in-country. Kwakye and her team spent much of the past year training teams of Ghanaian general surgeons from three program sites: Cape Coast Teaching Hospital in Cape Coast, Komfo-Anokye Teaching Hospital in Kumasi, and Korle-Bu Teaching Hospital in Accra. Those physicians will lead the fellows’ training, supplemented by didactic modules as well as remote training sessions and in-person visits with US surgeons.

“Ideally, we would like to have someone on the ground every week. Because we have multiple locations, we have to divvy them up, so it is a definitely a balance thinking about ways that we can have a regular presence at each site,” Kwakye said. “I’m fortunate to have partners that are so supportive, people who drop everything and come along with me on this journey. It’s been just awesome.”

That group of collaborators includes medical school faculty at the universities of Utah, Arkansas, and Minnesota—colleagues that Kwakye has trained with and under during her career. And of course the teams in Ghana, where Kwakye is from.

“The entire design from beginning to end has really been led by my collaborators in Ghana. It’s a real community-based approach meant to help the whole nation,” Kwakye said. “When I left Ghana, I had every intention of returning. But that never happened because life got complicated. This collaboration has been a long delayed dream, providing service in a very meaningful way.”