Supernumerary registrars in orthopaedics at the University of Cape Town: a review of their training locally and in their countries of origin, compared to South African registrars

Background The Supernumerary Registrar (SNR) training program has been instrumental in providing non-South African medical practitioners, particularly from other African nations, with essential postgraduate training opportunities. However, despite its long history, there is a notable absence of formal evaluations that assess the program’s academic and clinical impact on both South African healthcare systems and the healthcare services in the registrars’ home countries. The aim of this study is to objectively evaluate the clinical and academic impact of University of Cape Town (UCT) SNRs in Orthopaedic Surgery by assessing theatre clinical outputs and academic research contributions and career progression post-graduation. Methods A cross-sectional study involving Registrars and Registrar Alumni attached to the Division of Orthopaedic Surgery at the UCT was done. The study collected information on registrar’s demographics, research output, academic progress, operating theatre involvement and progression post-graduation. The survey data was analyzed using descriptive statistics. Results The survey received 40 responses (89% response rate), of whom 8 (20%) were SNRs, 13 (33%) were South African Registrars (SARs), 11 (27%) were Supernumerary Registrar Alumni (SNRA), and 8 (20%) were South African Registrar Alumni (SARA). Academically, SNR have similar publication productivity to SARs. Clinically, SNRs have less operative experience than SARs, with SARs having nearly 50% more theatre exposure than SNRs. However, as years of training progress the gap of experience closes but never reaches equivalence. Conclusion Changes may be needed to optimize SNRs impact and output in the South African healthcare system, though SARs’ pre-exposure advantage complicates this. Overall, the program is largely successful in training and preparing SNRs for their home countries with many of them returning to their countries of origin. Further research could explore if this pattern exists across UCT’s Surgery Department and re-examine registrars’ experiences at UCT.