Preamble

As we approach December 2024, we mark a significant milestone in the history of the College of Surgeons of East, Central, and Southern Africa (COSECSA) – its 25th anniversary. It is with immense pride and heartfelt congratulations that we, the East and Central African Journal of Surgery (ECAJS), celebrate this landmark achievement with our esteemed College.

Brief History of COSECSA

Twenty-five years ago, the visionary forefathers of COSECSA laid the foundation of what has now become a beacon of surgical excellence in the region.1 Their foresight has not only established a “College without walls” that upholds the highest standards of surgical education and practice but also fostered a spirit of collaboration across borders. Their legacy is one of perseverance, commitment, and a relentless pursuit of excellence.

COSECSA’s Pivotal Role in the Sustainability of The ECAJS

In this journey, the ECAJS has been privileged to serve as a conduit for disseminating surgical knowledge, research, and innovations. The journal’s inception was driven by the same pioneering spirit that founded COSECSA, and it is with gratitude that we acknowledge the unwavering support of the College in ensuring our survival and growth. The journal’s continued existence is a testament to COSECSA’s dedication to nurturing research and academic discourse in the field of surgery.

COSECSA’s commitment to supporting research has been exemplary. By supporting an environment that encourages research and publication, COSECSA has played a pivotal role in advancing surgical care in our region, as evidenced by the papers published in this issue2–8 The College’s initiatives have empowered surgeons and surgical trainees to contribute to the body of surgical knowledge, thereby enhancing the quality of care for our communities. The journey of COSECSA and ECAJS has been one of shared purpose and mutual support. We have grown together, faced challenges together, and celebrated successes together.

Honoring the Past and Propelling the Future of Surgical Training

As we celebrate this silver jubilee, we look back with gratitude and forward with enthusiasm.

In a landmark address delivered on December 3, 1986, in Lusaka, Zambia, the late Professor Yusuf Kodwavwala, then President of the Association of Surgeons of East Africa (ASEA), made a historic reference to the concept of a regional Surgical College. During his inaugural speech, he drew inspiration from the title of his then-published book “Yesterday, Today, and Tomorrow”, to encapsulate the past, present, and future of ASEA. In his vision for the future, he foresaw the emergence of a College of Surgeons from the association, stating, “I can visualize one day a College of Surgeons arising out of the Association.”

Today, we honor the foresight and innovative spirit of those pioneering minds who laid the foundation for COSECSA. We also celebrate the dedication and leadership of those who have tirelessly worked to elevate the College to its current stature of excellence. Contextually, COSECSA currently conducts its surgical training overseen by 150 Programme Directors in 142 Hospitals across 21 Countries in the East, Central, and Southern Africa (ECSA) region.

Over the past 25 years, COSECSA has steadfastly pursued its core objectives. These include the promotion of the honor and dignity of the surgical and allied health professions, the organization of a standardized training program across recognized institutions, and the administration of examinations in various surgical disciplines. Furthermore, COSECSA has consistently championed postgraduate education and research pertinent to the region while organizing workshops, seminars, lectures, and conferences that regularly convene Members and Fellows of the College to advance the science and practice of surgery within the region. These objectives have been realized through the implementation of several strategic goals, which encompass achieving excellence in training and research, maintaining best practices in examinations and assessments, ensuring quality surgical care, and building organizational excellence and financial sustainability.

Initially, COSECSA partnered with a limited number of collaborators. However, the College has since garnered substantial support from a diverse array of collaboration partners, significantly contributing to its growth and development. This support spans a wide range of areas, including technical, operational, and administrative functions, scholarships, examinations, research, training of trainers, and exchange programs, among others.

Aligned with its established objectives and strategic goals, COSECSA has achieved several key milestones since its inception. Notably, by 2023, the College had graduated 910 surgeons. The COSECSA Strategic Plan 2021-2025 had set a target of graduating 1,000 surgeons by 2025, and the College is on track to surpass this goal, with projections indicating that over 1,100 surgeons will be graduated by the deadline, given the annual graduation of approximately 140-150 surgeons.9 The College has also identified and accomplished several key factors crucial for its growth and sustainability. These include the successful transition to online examinations, the provision and administration of over 450 scholarships (encompassing training, examination, exchange programs, program directors, post-fellowships, research, and travel), and the training of 830 trainers. Additionally, COSECSA has automated its trainee admission processes through the installation of a Salesforce Admission System, significantly reducing manual interventions.

To enhance the quality of training and surgical care, COSECSA has maintained a rigorous accreditation procedure for training sites (hospitals), now numbering 142 as of 2024. This process has been further refined with the development of an online accreditation system. The College has also collaborated with partners to support trainees through exchange programs, rotations, and post-fellowship programs lasting up to eight months. Furthermore, COSECSA has facilitated research initiatives, including research grants, travel grants, research attachments, publications, research workshops, and the establishment of mentorship groups. The College has also conducted Continuous Professional Development (CPD) programs and Essential Surgical Training in rural settings. COSECSA’s locally led and delivered training program, operating in 21 sub-Saharan countries, effectively promotes the retention of surgeons within the region, with approximately 88% of graduates remaining post-qualification, thus addressing the brain drain challenge.

In recent years, COSECSA has prioritized increasing the representation of women trainees and leaders in the surgical field, recognizing this as a critical factor in ensuring quality surgical care and patient-centered outcomes. Going forward, while upholding its original objective, COSECSA plans to refocus its efforts on enhancing the quality of training, developing a cadre of trainers, improving the quality of examinations, establishing specialty courts of examiners, improving the quality of training sites, and developing formative assessments.

To the founders, leaders, and members of COSECSA, we extend our deepest gratitude. Your vision, hard work, and dedication have built a legacy that will continue to benefit generations to come. To our readers, contributors, and the wider surgical community, we thank you for your continued support and engagement with the ECAJS.

To our Collaboration Partners, we would like to extend our deepest gratitude for your unwavering support over the past 25 years. Your commitment to our mission has been instrumental in our growth and success, helping us train and empower surgeons across the region. Together, we have made significant strides in improving surgical care and transforming lives. We look forward to continuing this journey with your invaluable partnership.

Partner with COSECSA in Celebrating the Silver Jubilee

Here’s to 25 years of excellence, and to many more years of growth, innovation, and success. We extend a warm welcome to the COSECSA Silver Jubilee Celebrations, at the end of the year in Harare, Zimbabwe, from December 2nd to 6th, 2024.

Happy 25th anniversary, COSECSA!