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Required – Three surgeons (at a minimum) who will be the surgical faculty. On occasion, we will start with two if the third can be added by the fifth year.

Each surgeon must be:

1. A mature Christian who can disciple others
2. An excellent surgeon with a broad range of surgical skills
3. Someone with a strong calling to train surgeons in a resource-poor settings
4. At least three years out of training and willing to stay for at least five years
5. A fellow of an internationally recognized college of surgery and/or board eligible/certified in their specialty
6. In agreement with the PAACS doctrinal statement.

At least two of the three surgeons should:

1. Have academic experience in running a training program
2. Be of the specialty being taught (and the third enthusiastic).
3. Have experience with the North American training paradigm (as compared to the British, European, or African paradigm).

The hospital must meet all the requirements of a training site for the West African College of Surgeons (WACS) or the College of Surgeons of East, Central, and Southern Africa (COSECSA) as well as:

1. Actively promote the teaching of the Gospel.
2. Be in agreement with the PAACS doctrinal statement.
3. Be willing to sign an MOU with PAACS.
4. There must be a sufficient number of surgical cases for training.
5. There must be satisfactory numbers of anesthesia providers.
6. Have housing and facilities for faculty, trainees, and short-term faculty.

An administrative team who values the addition of a training program, is able to overcome obstacles, makes charitable care for the poor a high priority, and has a flexible approach to problem-solving. They must realize that adequate administrative support of the program and personnel by reinvesting profits for the first decade of service is critical.

Initially, PAACS provides approximately 75% of the total cost of training the resident but, by year six, the hospital will increasingly provide more of the cost of training until there is a 50/50 split at year 10. However, the hospital often has to invest a few hundred thousand dollars in infrastructure before or during the first few years of the program (housing; updates to the operating theaters, recovery rooms, intensive care units, casualty department; outpatient department and any required improvement to other supporting departments). PAACS does not provide money for infrastructure.