• Fraser Henderson, Khalif Abdifatah, Mahmood Qureshi, Avital Perry, Christopher S Graffeo, Michael M Haglund, David Oluoch Olunya, Edwin Mogere, Ben Okanga, and William R Copeland.
• Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
• World Neurosurg. 2020 Apr 1; 136: 172-177.

BackgroundThe College of Surgeons of East, Central, and Southern Africa (COSECSA) is a regional accrediting body for general and specialty surgical training programs that has recently expanded to include neurosurgery. As neurosurgical services expand in sub-Saharan Africa, the structure of training and accreditation has become a vital issue.MethodsWe review the founding and current structures of COSECSA neurosurgical training, identifying accomplishments and challenges facing the expansion of neurosurgical training in this region.ResultsThe COSECSA model has succeeded in several countries to graduate qualified neurosurgeons, but challenges remain. Programs must balance the long duration of training required to promote surgical excellence against an overwhelming clinical need that seeks immediate solutions.ConclusionHarnessing global collaboration, rapidly expanding local infrastructure, and a robust multinational training curriculum, COSECSA has emerged as a leader in the effort to train neurosurgeons and is anticipated to dramatically improve on the markedly unmet need for neurosurgical care in sub-Saharan Africa.Copyright © 2020 Elsevier Inc. All rights reserved.

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