The East, Central and Southern African College of Physicians (ECSACOP) provides generalist post graduate training to doctors in Kenya, Malawi, Tanzania, Uganda, Zambia and Zimbabwe - a region where 223 million inhabitants depend on only 1000 trained physicians. A shortage which is particularly acute in rural areas. In order to act as a ‘college without walls’ and maximise their reach, ECSACOP accredits training sites and supports post graduate training across the region, not just in major cities. Currently there are 100 trainees on the four year internal medicine training course and these numbers are growing. 2023 saw a record number of 58 applicants to the programme Sadly, over the past 12 months several trainees have been forced to interrupt their training for financial reasons. The college has faced financial challenges which are threatening its capacity to expand. This appeal will support ECSACOP in the life saving work it does in a massively medically underserved part of the world. All funds donated will support the vital work of the East, Central and Southern Africa College of Physician (ECSACOP) and have a direct, meaningful impact on patient outcomes across the member countries.