The ability of the Haitian healthcare system to provide surgical care relies heavily on the training of doctors. The country faces a persistent shortage of specialists, high mobility among healthcare professionals and material constraints that limit access to care. In this context, on-site clinical training is one of the most concrete levers for maintaining functional hospital services over the long term.
The surgery department at Hôpital Sainte-Thérèse in Hinche contributes directly to this effort. It welcomes interns, externs and residents who train in an active hospital environment, faced with a high demand for care. Consultations, therapeutic decisions and the organization of daily work become learning situations in their own right, under medical supervision.
The coordination of this scheme relies on an organization capable of simultaneously providing care and supervision. Since April 2025, this responsibility has been assumed by Marline Fleury, a.i. Head of Surgery. Coming from Zanmi Lasante’s hospital residency program between 2019 and 2024, she is familiar with the clinical and teaching requirements associated with this training model.
Her role is to organize the work of the department, supervise junior doctors during consultations and surgical activities, and coordinate the action of the medical, nursing, operating room and support staff teams, as well as medical and administrative management. This organization aims to maintain consistent practices and limit disruptions in patient care.
“Training doctors in the field ensures continuity of care. When interns and residents are mentored in daily practice, patients benefit from safer decisions and more consistent care.”
The department operates in an environment marked by increasing patient numbers, regular transitions within teams and an unstable socio-political context. In these conditions, medical training helps to reinforce the progressive autonomy of young doctors and secure clinical practices, particularly in high-pressure situations.
Supervision is based on concrete mechanisms: review of clinical records, direct supervision during consultations and procedures, regular exchanges between senior doctors and junior doctors, and clarification of responsibilities according to level of experience. These elements enable common standards to be maintained despite structural constraints.
Through the day-to-day running of the surgical department, medical training appears to be a condition for maintaining care. It supports team stability, strengthens clinical skills and helps guarantee access to essential surgical procedures for the population.
Training doctors in active Haitian hospitals helps maintain functional surgical services despite persistent structural constraints. The supervision of interns and residents, clinical supervision and the organization of services require ongoing human, material and teaching resources.