Edward Francis Small Teaching Hospital (EFSTH), formerly The Royal Victoria Teaching Hospital (RVTH) is a 547-bedded tertiary hospital built in 1853 by the British Government. This hospital has served as the principal hospital of the Gambia over the years, gaining legal status and accreditation as the only Teaching hospital in 2006.

In 2013 the hospital was renamed Edward Francis Small Teaching Hospital.  ESFTH offers consultant /general services in the following clinical disciplines: including Obstetrics & Gynaecology, Paediatrics, Internal Medicine, Pathology & Laboratory Medicine, General Surgery, Orthopaedics, Radiology (including CT Scan), Physiotherapy and Pharmacy services. EFSTH also operates the only Psychiatric hospital (Tanka-Tanka Psychiatric hospital) and Tuberculosis Sanatorium units in the country both located some distance from the main EFSTH premises in Banjul. The EFSTH Polyclinic, located some 200 meters away, provides essential primary care services as well as dental services for the whole country.

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