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MCAI Fellowship in Advanced Obstetric Training for the Gambia

This page provides information about the MCAI fellowship in the Gambia. Please note that this is not an RCOG fellowship and all enquiries should be made to MCAI directly.

This is an exciting opportunity to gain experience of obstetrics in a low resource setting whilst making a significant contribution to the local infrastructure as part of a sustainable training programme. 

Project information

Number of vacancies: 2

Start date and duration 

Starting between August and October 2016 for 10 to 12 months (annual leave and rest and relaxation time will be provided). Note shorter placements of 3 months or more will also be considered.

Minimum requirements for post

  • 5 years post-graduate O+G experience (i.e. ST6/equivalent or above)
  • ALSO or MOET provider
  • Membership of the RCOG (occasional exceptions may be made to this requirement)

Desirable

  • An interest and experience in medical education especially in resource limited settings
  • ALSO/MOET or equivalent instructor experience

Cost

  • All flights, travel, accommodation, insurance will be paid by MCAI
  • An in-country per diem of £10/day to cover out-of-pocket costs

Accommodation and living arrangements

MCAI has a comfortable spacious house within its own compound just 5 minutes walk from the hospital. The market and shops are easily accessible from the house on foot. MCAI also employs a cook/cleaner who will ensure fellows are well fed, the house clean and clothes laundered.

Less than an hour’s drive from Brikama are the beautiful and popular tourist resorts of Senegambia and Kololi. MCAI encourages volunteers to visit the resort for a weekend every 3-4 weeks for a period of rest and relaxation. There is a developed tourist industry in this area, so there is also the possibility of arranging other activities and trips. The cost of the accommodation during these trips is met by MCAI as it recognises the need for ‘time out’ from the hospital.

Project overview 

Staff at the Gambia hospital

To meet the need for in-country postgraduate training, we have developed a competency based Diploma in Advanced Obstetrics. Both doctors and senior midwives receive apprentice-style training to a defined curriculum. The programme has been successfully piloted in Liberia where the senior midwife trainees have continued to provide access to comprehensive emergency obstetric care, including the daily performance of caesarean section and other life saving surgery throughout the Ebola epidemic.

Training junior doctors and senior midwives in advanced obstetrics is a novel approach to this skills gap and our experience in Liberia suggests it is feasible and effective.

In 2014, we were asked by the Gambian Ministry of Health to pilot our diploma with local junior doctors and senior midwives. The new qualification will be recognised by the government and there are plans to incorporate it into any future postgraduate O&G training scheme. The current candidates are in post and are likely to complete the programme by October 2015, when a new group of trainees will be deployed to Brikama, by the government.

About the Gambia and Brikama Major Health Centre

The Gambia is a very small country on the West African coast with a population of 1,500,000. The maternal mortality rate is > 400/100,000 live births. As of 2009, there were 62 doctors in the entire country including many foreign medical personnel (largely Cuban) who provide essential support to its health service. 

Brikama Major Health Centre is located in the centre of the Brikama district (population around 250,000-300,000) and is approximately 40 minutes drive from the capital Banjul. Around 6000 women deliver in the health centre each year, but until recently there was a skeleton obstetric staff and no reliable operating theatre. Complex and surgical cases were therefore partially and often ineffectively stabilised and referred to Banjul hospital, with the inherent risk of transfer.

MCAI’s training initiative began in October 2014. MCAI international trainers in obstetrics, midwifery and anaesthetics have joined the obstetric team at Brikama Hospital/Major Health Centre and achieved a number of structural and organisational improvements to the unit. The operating theatre is now open, and the majority of obstetric procedures are now performed in-house. They have also successfully advocated for an increase in midwifery and nursing staff, and have successfully introduced a number of new protocols and working practises.

The MCAI Fellowship in more detail

The 2 Fellows will work alongside the one resident Cuban Gynaecologist to support the provision of emergency obstetric care at Brikama H/C. It is envisioned that at any one time, 3 Gambian junior doctor/midwifery trainees will work with our fellows to enable apprenticeship-style training in advanced emergency obstetric care.

The roles and responsibilities will be as follows:

  • The apprenticeship-style training, according to the MCAI curriculum, of 3 junior doctors/senior midwives who are on placement at the hospital.
  • To complement the apprenticeship training with formal teaching sessions on anatomy, physiology and any aspect of the syllabus not routinely covered in clinical practice
  • To engage in midwifery teaching and to involve the trainees in this task
  • To facilitate structural and organisational improvements in the running of the department and to involve the trainees in this process
  • To develop and support departmental teaching activities, such as reflective case review, skills drills, and maternal mortality audits and to involve the trainee’s in this process
  • To teach the trainee’s obstetric surgical procedures including complex caesarean section, ventouse delivery, eclampsia and PPH management

Educational and clinical support

The 2 Fellows will be supported by two senior international consultant obstetricians (one from the UK and one from the Netherlands) with experience of the facility and the working environment. Advice will always be available and supportive visits will be made intermittently through the year as needed.

MCAI will also provide logistical support, to include the provision of emergency equipment, medical and surgical supplies and essential drugs, to ensure that the fellows have the resources they need to train and provide quality care.

Contact us

For more information and to apply for this position please contact Professor David Southall, Honorary Medical Director as follows:

  • MCAI, 1 Columba Court, Laide, Achnasheen, Highland IV22 2NL
  • Email: director@mcai.org.uk
  • Telephone: 01445 731595, 01445 781354, 07710 674003

Project sponsors

Soroptimist International

World Health Organization

Gambia coat of arms

Elsewhere on the site

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Find out about the experiences of previous RCOG volunteers
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