Abstract Background Surgeons are scarce in African countries. There is still a need to rely on general practitioners to perform a number of selected procedures. Their training needs to take these facts into consideration. The aim of this study was to evaluate the pattern of surgical procedures performed in a level III institution in an African city. We then analyzed the implications for training. Methods This descriptive retrospective study was conducted at the Regional Hospital, Limbe in Cameroon. This hospital had just been selected as the main training hospital for a newly created medical school. The postoperative notes of all procedures performed over 1 year were used to assess exposure of fourth‐year medical students to various procedures and how much they matched their educational objectives. Results A total of 1,351 procedures were carried out during the study period, including 620 major and 731 minor procedures. Most procedures (84 %) were carried out by a trained specialist. The most frequently performed procedures were cesarean section ( n = 131), circumcision ( n = 148), laparotomy for various indications ( n = 144), appendectomy ( n = 81), and hernia repair ( n = 81). Analysis of exposure of students to procedures indicated adequate exposure to cesarean section and some selected abdominal procedures. Conclusions If students are trained only in our institution, they are likely to perform appendectomy, cesarean section, and hernia repair correctly. Their skills in common orthopedic procedures are likely to be poor. There is need to continue prospects to identify other institutions with a more comprehensive pattern of activities to ensure proper training for students.