POSTGRADUATE DIPLOMA in FAMILY MEDICINE (MGO15) Division of Family Medicine School of Public Health and Family Medicine University of Cape Town Summary Aim: To promote the practice of high quality health care at primary level. The programme runs over one two years. Seminars are held every Wednesday afternoon. We believe that the course enriches the participants motivation and satisfaction with practicing medicine in the community. Courses are: Principles of Family Medicine (includes the Patient-centred care) Clinical Medicine A and B Chronic Diseases, Prevention and Promotion Child and Family Health Ethics Evidence-based practice (There is an option to do individual courses - ie not as part of the Diploma) HEAD OF DIVISION of FAMILY MEDICINE Professor Derek Hellenberg MBChB (UCT), MFam Med (Stellenbosch); FCFP (SA) CONVENORS Dr Beverley Schweitzer MBBCh (Wits) MPrax Med (Medunsa) Dr Maryam Navsa MBChB (UCT), MPhil (Family Medicine and Primary Care) (UCT) 1
WHO SHOULD DO THE COURSE? Any doctor in general / primary care practice (private or public sector) or district hospitals who want to develop and improve their abilities to deliver high quality, cost-effective care using a biopsychosocial approach..and enjoy their work more, have fun and be part of group-learning What it does not give you The Postgraduate Diploma in Family Medicine is not recognised as a means to specialise in Family Medicine. Since the establishment of Family Medicine as a speciality in August 2007 doctors are required to complete a 4 year registrar rotation and a MMed (Family Medicine) degree in order to specialise as family physicians (unless they meet the requirements of the grandfather clause). The course is also not just an update of clinical medicine, rather we aim to facilitate on-going, life-long learning. LEARNING METHODS Weeky Wednesday afternoon seminars are held at the Health Science Faculty. Seminars are usually based on pre-readings and the discussion is around application to our daily practice of medicine. The atmosphere is supportive and respectful, often vibrant and a fair deal of humour! Our aim is to facilitate doctors to be life-long, self-directed learners who are able to reflect on their practice, define problems and find solutions. We also run practical skills workshops and review videotaped consultations together. Learning is aided by computer resources and participants need to have basic computer skills and internet access. TIME COMMITMENT Seminars for the Postgraduate Diploma in Family Medicine will take place on Wednesday afternoons from 2pm to 5.30pm. Some modules will require time over weekends (maximum of 2 per year). The majority of the learning will take place in the time between the seminars, during the course of your work, and at home and the library. This includes reflection on your daily practice of medicine and reading to answer the needs that you identify. There are set readings in preparation for seminars and assignments. Formal preparation, self-study and assignments will require 6-10 hours per week on average. 2
FORMAT The duration of the ourse is two years. The academic year runs from early February to November, with a three week break in June/July. As contact time is on a weekly basis, participants need to be living in Cape Town or close enough for attend on a weekly basis. ENTRY REQUIREMENTS FOR THE POSTGRADUATE DIPLOMA IN FAMILY MEDICINE MBChB or equivalent degree Participants are required to practise predominantly in primary care (private or public) or district hospital settings for the duration of the course. Prior experience in primary care practice will be an advantage Registration with the HPCSA Computer literacy basic knowledge of a word processing package and use of email and internet. Proficiency in English Basic clinical skills equivalent to that expected of a community service doctor. Clinical skills may be assessed at the interview or at a practice visit, prior to acceptance onto the course As some modules are web-based, students will be required to have a computer and access to the internet and e-mail. APPLICATIONS APPLICATION FORMS are available from Ms Salega Tape, Dean s suite, Faculty of Health Sciences, University of Cape Town, Anzio Rd, Observatory, 7925. Phone: 406 6751. Email: Salega.Tape@uct.ac.za Applications must be in by 31 October and interviews will take place early in December. Curriculum vitae and the names of two referees must be supplied. One of the referees should be your current employer or your most recent employer if you are self employed. Late applications may be considered. For further information Please contact: Dr Bev Schweitzer at 406 6441 (work hours) Beverley.Schweitzer@uct.ac.za, Professor Derek Hellenberg at 406 6510, Derek.Hellenb@uct.ac.za or Dr Maryam Navsa at 021 697 4933 (after hours) email navsa@telkomsa.net 3
MODULES 2014 Principles of Family Medicine Prevention and Promotion and Chronic illness Clinical Medicine A 2015 Child and Family Health Ethics Clinical medicine B Evidence-based Medicine GRADUATES OF FOREIGN UNIVERSITIES It is a university rule that all graduates of foreign universities who have English as a second language must produce evidence of having passed an accredited test of English as a foreign language. The definition of a "non-english speaking country" is defined in the rulebook as is the list of tests acceptable. Information for prospective international students can be obtained at http://www.uct.ac.za/about/iapo/intstud/ COURSE RULES ASSESSMENT In course assessment Each module will be assessed individually at the end of the module. This will be by means of assignments and / or exams. All modules need to be passed (minimum 50%) before the candidate may do the final exam. Assignments and / or end of module exams will make up 50% of the coursework mark. The final exam will make up the other 50%. The final exam will be held in October/November at the end of the second year of study. This will include written exams (modified essay and multiple choice questions) and practical exams (skills stations, computer-based component, and a clinical exam. Both the written and practical components of the exam need to be passed in order for the candidate to pass. EXCLUSIONS Candidates who fail two modules, or one module more than once, will not be allowed to continue with the course. 4
RULES FOR THE FINAL EXAM OF THE POSTGRADUATE DIPLOMA IN FAMILYMEDICINE Both components of the exam - Written (Modified essays questions and MCQs) and Practical (Clinical exam, Skills stations and Computer-based exam) must be passed with a minimum of 50%. DEFERRED EXAMS Applications for deferred exams need to be sent to the deferred exam s office in Bremner Building. Applications need to be in one week before or after the missed exam. A doctor s certificate is required if the deferment is on the grounds of ill health. The student may be required to motivate in person to the committee. ATTENDANCE Please inform one of the convenors if you are unable to attend a session. You can leave a message with Mrs Naomi Fray at 021 406 6707 or Naomi.Fray@uct.ac.za (admin assistant). You will need to make arrangements to obtain the material missed. ASSIGNMENTS Assignments need to be handed in by the specified date or you will lose 5% per day late. Assignments will not be marked if more than a week late. Under exceptional circumstances an extension may be given if applied for in advance. No further extension or mark will be given beyond that date. One re-submission may be allowed if the candidate fails the assignment but obtains more than 45%. The maximum mark given for an assignment that is resubmitted is 50%. FEES GENERAL INFORMATION Students are charged per module. See fees brochure at http://www.uct.ac.za/apply/fees/ FINANCIAL ASSISTANCE Contact Postgraduate Scholarships Office, University of Cape Town pgalv@bremner.uct.ac.za Bursaries may be available from the province for doctors working in the public sector. 5
MODULES CLINICAL MEDICINE A and B Convenor Dr B. Schweitzer Clinical competence is the cornerstone of good family medicine and needs to be achieved in order to graduate. Students are expected to know about all conditions that are common in general practice, as well as more rare conditions that are especially important to recognise. Contact sessions are to stimulate interest and allow an opportunity for discussion. We cannot cover the full spectrum of clinical problems in the course. Learning needs should be identified in your practice on a continual basis and it is up to you to meet these needs by reading, attending CPD meetings, discussing with colleagues etc. Structure Students will present information about patients that they have consulted, for discussion. Sometimes we will have a resource person present. We may use chart reviews and journal presentations. Skills workshops will be opportunities to develop practical skills. You will have the opportunity to spend time at clinics in various hospital departments, if you are able to arrange the time in which to do it. In addition, there are a wide range of CPD activities in Cape Town. Objectives To gain skills in diagnosing and managing common and important clinical conditions and to develop approaches to common symptoms with which patients present in primary care. Content Clinical Medicine A will include common surgical conditions and surgical specialities such as ENT, Eyes, Urology; acute medicine, rheumatology, emergency medicine, Occupational Health. Clinical Medicine B will include Women s Health, Mental Health, HIV, TB, STIs, Pharmacology, Radiology, Medical specialities eg Geriatrics, Neurology, Dermatology etc. ASSESSMENT 6
Assignment Ongoing learning requires that you identify learning needs in your everyday work. This assignment is designed to demonstrate your ability to do this. You are required to identify about 10 learning needs in which you state your clinical learning needs from your practice and write what you learned and how you learned it. Learning needs may be varied and require varied lengths of answers. Examples could be: what is the cost of a script for a particular patient, how to perform a certain procedure, what is the most cost effective treatments for warts in children, what is the current understanding of selfmutilation and how is it managed, what is the anatomy of the brachial nerve and could it account for the parasthaesia experienced by your patient, etc You will be marked on your ability to define a question from practice (10%), competence gained (this may be concretised by describing how it would be better done in future consultations) (80%), and show your ability to use resources for learning eg books, internet, practical experience (10%). The assignment should be about 10 pages (doublespacing). Clinical Exam The aim of the clinical exam is to assess your ability to integrate your learning. You will be observed as you consult with a patient at a community health centre. After the consultation the examiner will discuss the consultation with you. Clinical Skills and Computer-based Exams The focus of this exam is pattern recognition and skills. You may be shown slides depicting patients with dermatological or other conditions and asked questions. This also includes diagnostic skills such as interpreting ECGs and X-rays. 7
PRINCIPLES OF FAMILY MEDICINE Convenors Dr Maryam Navsa and Dr Graham Bresick Structure Sessions will take place on Wednesday afternoons Objectives On successful completion of this module you should be able to: Understand and apply the principles of family medicine Understand the dynamics of the primary care consultation Be able form and maintain a therapeutic doctor patient relationship with a variety of patients Use basic counselling skills in the context of the consultation Use brief motivational interviewing skills in the consultation Learning methods Seminars based on readings, role play and video review, peer practice visits will be used to help integrate learning into practice Assessment Assignment 8
CHILD AND FAMILY HEALTH Convenors Dr B Schweitzer and Dr M Navsa Objectives On completion of this module you should be able to: Identify and manage common conditions in childhood and adolescence Institute key preventive and promotive activities in children and adolescents Demonstrate an understanding of the human life-cycle and how this can be applied in practice Demonstrate a family-orientated approach to primary care The study of human growth and development enables the learner to understand the person in the context of his or her own stage of human development in the life cycle. Focus is on the development of self-awareness for the doctor and the development of sensitivity to the various life stages. Content This module aims to cover key topics in child health, clinical paediatrics, family orientated primary care, human growth and development. Topics include the therapeutic relationship, theories of development, developmental aspects of infancy, the toddler, the pre-school child, the primary school child, the adolescent, adulthood, ageing and death and dying Family-oriented care facilitates an understanding of how families function and how illness impacts on the family and how the family impacts on illness and the management of illness. You will gain skills to conduct family interviews. Topics will include family dynamics, genograms, understanding the effects of one s own family on you as a doctor, stages of the family life cycle, and a family-oriented approach to specific problems. Role-plays will be used to practice skills. Child health and paediatrics is learned by means of self-assessments and patient presentations. Assessment 9
Each aspect of the assessment must be passed in order to pass the module. One written assignment counting for a total of 25% End of module clinical exam - 25% End of module MCQ exam - 25% 10
PREVENTION, HEALTH PROMOTION AND CHRONIC ILLNESS Convenors Dr B. Schweitzer and Dr M Navsa Structure This is a 12 week course. Contact sessions will be used for patient discussions and skills workshops. Objectives Understand the principles of care of patients with chronic illnesses, disease prevention and health promotion Implement a quality improvement cycle in your practice to improve the quality of care, promote health and prevent complications for a chronic condition Diagnose and manage common chronic medical conditions (cardiovascular, respiratory, rheumatologic, neoplastic) according to the principles of family medicine Describe the principles of ageing and caring for the elderly Manage common clinical problems in the elderly Describe the principles of rehabilitation and perform a functional assessment of a patient Manage common disabilities and impairments Describe the importance of the doctor-patient relationship in the context of patients with chronic conditions Content Introduction to principles of chronic care, health promotion, disease prevention and the QI cycle, Chronic medical conditions: ischaemic heart disease, hypertension, diabetes, obesity, Chronic medical conditions: asthma, COPD, smoking, occupational lung disease, Rheumatology, the Elderly, Cancer, Rehab and the Dr-pt relationship. Assessment Formative self-assessment will be by means of weekly MCQ questions. Summative Assessment You will be required to pass the end of module MCQ exam (50% minimum), and both assignments in order to pass the module as a whole. MCQ exam 40% 11
ETHICS Convenor Dr M Navsa, Dr Schweitzer and input from the Ethics, Humanities, UCT Objectives Learners will gain an understanding of the theoretical background to ethical analysis and develop the skills for identifying and addressing ethical dilemmas in primary care. Assessment Assignment 12