Ready to respond: training our surgical teams

Surgical care in MSF includes essential life- and limb-saving reconstructive surgery for patients affected by bomb explosions, bullet wounds, shrapnel or severe burns, as well as emergency operations for women with life-threatening pregnancy complications. Nearly one in four of the major surgical operations we performed in 2023 were caesarean sections. 

Surgery on the rise 

There has been a progressive rise in surgery in MSF in the past ten years, primarily in unstable or conflict-affected countries such as Afghanistan, Central African Republic, Democratic Republic of Congo, Haiti, Syria and Yemen. These are contexts that require comprehensive technical and logistical skills to provide high quality surgical treatment.  

To ensure healthcare professionals are prepared for the contexts in which we work. MSF offers a range specialised training programs and courses. 

Types of training 

Surgeons need to master a set of surgical competencies and skills, from broad to specialised, from obstetrics to vascular interventions, and be able to apply these in typically low-resource settings where facilities, equipment and pharmaceuticals may be very basic and limited.  

Training courses are available to staff throughout their career with MSF, and even before your first assignment, to ensure that you are given guidance and technical direction to provide the highest quality of care to our patients. 

Multi-disciplinary training program (MEDICS) 

Location: Taiwan 

MSF holds a six-day multi-disciplinary training program with doctors and nurses from various specialties in emergency medicine, intensive care, surgery, gynaecology and anaesthesiology. This training prepares staff with the essential skills and knowledge for humanitarian work. In 2024, 25 participants from 15 countries and regions were trained by experienced MSF technical referents on project operations, emergency response and quality medical care delivery. The program combines theory and practice, with peer-to-peer learning and hands-on exercises to give participants the technical expertise and mental readiness needed for humanitarian medical work.

For new team members like Irma, a medical doctor heading to Khost, Afghanistan, the training builds their readiness for a humanitarian assignment. 

Surgical Training Program

Location: Cape Town, South Africa

There is also a two-month surgical training program available to MSF surgeons who want to broaden their surgical skills and to improve their competencies in trauma care. It consists of four possible rotations at Stellenbosch University-affiliated hospitals.

The program is tailored to the learning needs of a wide range of surgeons and functions as a high-quality clinical internship. A variety of different procedures are covered to prepare surgeons for the needs of patients in MSF hospitals. This includes trauma surgery, essential obstetric, orthopaedic and burns care, as well as covering the basics of reconstructive surgery.

Surgical Workshop

Location: Dusseldorf, Germany and Abidjan, Ivory Coast

This is a hands-on five-day workshop for surgeons and medical doctors looking to expand their skills in a variety of surgical procedures that are needed in MSF projects and with the resources available in those contexts.  

Discussion of case studies based on MSF country programs are also an essential part of the training.  

The workshop covers:

• Reconstructive surgery in precarious situations, skin grafts, muscular/fasciocutaneous flaps, essentials of burn treatment  
• External fixation history, advantages, indications, pitfalls and practical aspects in MSF project areas  
• Hand surgery especially treatment of tendon and nerve lesions  
• Neurosurgery especially craniotomy and when, why and how to do  
• Vascular surgery particularly indications and procedures for vascular lesions  
• Amputation where and why  
• Obstetric surgery difficult cases

The workshop is structured as two days of theoretical lessons and three days of practical courses on cadavers.  

Advanced Course in Comprehensive Obstetrics (MACCO) 

Location: Dusseldorf, Germany

This course is for obstetrician-gynaecologists or medical doctors practising obstetric or gynaecological surgery who have already completed an assignment with MSF. It aims to strengthen their surgical and medical skills to manage surgical complications and seriously ill patients in the contexts within which MSF works.

The course includes the management of:

surgical complications such as bowel perforation, bladder injury, ureteric injury and uterine rupture

obstetrical complications such as postpartum haemorrhage, difficult foetal extractions and embryotomy

patients with serious illness related to obstetric and gynaecological conditions, notably shock, respiratory distress in pre-eclampsia and severe anaemia.

Attendees will learn the above through a combination of practice and theoretical learning. 

Other surgical courses 

MSF also offers a range of remote training opportunities such as online surgical discussions covering topics related to surgical project experience.