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Review article
Uncorrected Proof. Available online 6 August 2025
Global neurosurgery training. Part 1: Skills and challenges for equity
Formación neuroquirúrgica en África. Parte 1: habilidades esenciales y desafíos estructurales para la equidad
María J. García-Rubioa, Jose Piquer-Martíneza, Jose Piquer-Bellocha,b, Ruben Rodríguez-Menaa,b,
a Cátedra VIU-NED de Neurociencia Global y Cambio Social, Universidad Internacional de Valencia, Valencia, Spain
b Servicio de Neurocirugía, Hospital Universitario de La Ribera, Alzira, Valencia, Spain
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Abstract

Neurosurgery requires rigorous training, yet access remains limited in low-resource countries, particularly in Africa, creating a crisis in specialised care.

This paper, grounded in the principles of global neurosurgery, examines the essential competencies required in neurosurgical training, distinguishing between clinical skills—such as technical proficiency and decision-making—and non-clinical skills, including leadership, emotional management, and communication. Deliberate practice is emphasised as a key methodology for improving skill acquisition through structured repetition, continuous feedback, and expert supervision.

Additionally, the main challenges of specialisation in East Africa are analysed: inadequate infrastructure, overburdened health systems, limited and heterogeneous residency programmes, and a shortage of qualified mentors. Finally, the development of innovative educational strategies is proposed to enhance training in resource-constrained settings and contribute to the sustainable advancement of the specialty.

Keywords:
East Africa
Development
Education
Skills
Deliberate practice
Global neurosurgery
Resumen

La neurocirugía es una especialidad que requiere una formación rigurosa, pero su acceso sigue siendo limitado en los países con bajos recursos, especialmente en África, lo que ha generado una crisis en la atención especializada.

Este trabajo, enmarcado en los principios de la neurocirugía global, analiza las habilidades esenciales que debe adquirir un neurocirujano en formación, distinguiendo entre competencias clínicas —como el dominio técnico y la toma de decisiones— y habilidades no clínicas, como el liderazgo, la gestión emocional y la comunicación. Se destaca la práctica deliberada como metodología clave para mejorar la adquisición de competencias mediante la repetición estructurada, la retroalimentación continua y la supervisión experta.

Asimismo, se examinan los principales desafíos en África del Este: la deficiencia en infraestructura, la sobrecarga de los sistemas de salud, la escasez y heterogeneidad de los programas de residencia y la falta de mentores capacitados. Finalmente, se propone el desarrollo de estrategias educativas innovadoras para optimizar la formación en entornos con recursos limitados y contribuir al desarrollo sostenible de la especialidad.

Palabras clave:
África del Este
Desarrollo
Educación
Habilidades
Práctica deliberada
Neurocirugía global

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