Background: In eastern DR Congo, a survey revealed 35% of households required a surgical procedure in the preceding 12 months. Surgery, Obstetric, Trauma and Anaesthesia (SOTA) care is a critical part of primary health care and most surgery is performed by general doctors. 25% of those requiring surgical care did not present due to poor care previously Methods: A Diploma in SOTA Care Course was begun in 2023 to train general doctors from rural health centres. They spend 2 months at a regional centre undergoing skills and knowledge training. Approval for the course and data collection was obtained from Provincial Health Authorities. Data is collected from participants by pre and post testing of knowledge and each participant rates their surgical skills confidence on a 0 to 10 numerical scale before and after the course. Results: Initial data from the first cohorts shows an improvement in knowledge (58% pre-testing to 74% post-testing). Skills confidence increased from a mean of 5 pre-course to 8 post-course. For Bellwether procedures, the skills confidence increased for each of 3 procedures (Laparotomy 5-> 8; C-section 7->9; Management of an Open Fracture 3->7). Participant surveys revealed most rural doctors performing surgery had not previously been trained in the basics of surgical care or patient safety. Summary: The aim of this structured practical skills-based upskilling for rural doctors, is to reduce morbidity and mortality from surgery - and improve clinical outcomes and patient presentation. Such a hands-on based curriculum like this may be required in many LMICs.