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Clinical Rotations Year 4 and 5 Module co-leads: Hennie Botha (mhbotha@sun.ac.za) Liezl Koen (liezlk@sun.ac.za) Liezl Smit (ls@sun.ac.za) LEARNING OBJECTIVES OF THIS MODULE 1. Establish rapport with patients to appropriately gather information on history taking 2. Apply and improve on previously acquired skills in the clinical environment (both physical examination and other such as hand-washing) 3. Document and interpret information gathered on history and with physical examination in order to generate a reasonable range of diagnostic possibilities 4. Identify clinically and resource appropriate investigations to elucidate differential diagnosis 5. Recognize and initiate management of life-threatening conditions 6. Construct, document and present a feasible management plan that includes illness specific as well as rehabilitative and preventative approaches. 7. Critically reflect on feedback and revise or modify management plan 8. Document, implement and discuss management plan, including handover care, with the patient, family, colleagues and allied team members as appropriate 9. Display professional conduct and practice self-reflection Year Plan (Y4 EXAMPLE) T W O W E E K S H O L I D A Y B E I N G & B E C O M I N G + R E S E A R C H URO O T PSYCH SURG O T URO INTERNAL PAEDS URO O T ORTHO O&G O T PSYCH SURG URO URO O T 2 O T SURG PSYCH PAEDS INTERNAL O&G ANAES URO 2 W 2 W H O L I D A Y H O L I D A Y 2 W H O L I D A Y URO O T INTERNAL PAEDS ORTHO O&G PSYCH SURG O T URO URO O T O T PSYCH SURG O&G ANAES URO URO O T PAEDS INTERNAL W SURG O T PSYCH H O L I D A Y URO B E I N G & B E C O M I N G + R E S E A R C H 2 W 2 W H O L I D A Y H O L I D A Y INTERNAL PAEDS URO O T PSYCH SURG O T URO ORTHO O&G URO O T O T PSYCH SURG URO PAEDS INTERNAL O&G ANAES URO O T SURG O T PSYCH URO B E I N G & B E C O M I N G + R E S E A R C H E T H I C S CLINICAL ROTATIONS SUMMARY SELECTIVES YEAR 4 vs YEAR 5 • Orthopaedics: 5 weeks • Anaesthesiology: 5 weeks • Obstetrics and Gynaecology: 10 weeks (5 x 2) • Internal Medicine: 12 weeks (6 x 2) • Surgery: 8 weeks (4 x 2) + 2 weeks Urology Y4 + 2 weeks Trauma/Ophthalmology Y4 • ENT: 2 weeks Y5 • Emergency Medicine: 2 weeks Y5 • Paediatrics & Neonatology [including paediatric surgery]: 12 weeks (6 x 2) • Psychiatry: 8 weeks (4 x 2) ASSESSMENT • Promotion from Y4 to Y5 dependant on meeting minimum standards across all assessments as well as e-portfolio • Integrated Examination at end of Year 5 • Entry into exam based on ability to meet a predetermined set of criteria • All rotations as well as e-portfolio will contribute to aforementioned criteria • Examination will have to be passed in order for student to start Distributed Apprenticeship A B Individual students will have different but equivalent rotations Main focus will not be knowledge transfer but rather on professional development in team context Less students per environment but with more connection Develop professionalism and application The module will allow some level of choice for individual placements but at least 50% should be in clinical environments and the rest in related environments. 4 PERIODS OF 2 WEEKS EACH OVER 2 YEARS • Microbiology/Immunology • Forensic medicine • Rural • Community Paediatrics • Community Psychiatry • Oncology • Obstetric critical Care • Fetal Medicine • Obstetrics special care • Reproductive Medicine • Family Planning • Radiology • Clinical pharmacology • Dermatology • Palliative care • Plastic Surgery… …and counting • Largely similar except Orthopaedics and Anaesthesiology only in Y 4 or 5 as well as outlined below: • Ophthalmology/Trauma 2 weeks Y4 • Urology 2 weeks Y4 • Ethics Week Y4 • Being and Becoming and Research 3 weeks Y4 • ENT: 2 weeks Y5 • Emergency Medicine: 2 weeks Y5 • Being and Becoming and Research 1 week Y5 • Study Week and Integrated Assessment Week Y5 • Preparation for Distributed Apprenticeship 1 week y5 “The student experience during the clinical training will be an exciting and transformative period of being, and becoming, a health professional for and in the South African context.”
The Distributed Apprenticeship Year 6 Work-based learning , Integration of theory into practice & competency based outcomes The focus of this module The transition from being a student to a competent doctor who practices evidence based medicine cost-effectively and ethically with sensitivity to person and context. • Integration and refining of clinical reasoning • Applying of knowledge and skills • Clerking undifferentiated patients • Work-based learning and development • Forming good relationships with patients, tutors, health care teams and communities SELF Competence Clinical Skills PATIENT Evidence Based Practice Solving Ethical Dilemmas Maintaining Selfwellness COM - MUNITY Learning Objectives: • Diagnose core clinical conditions • Perform core procedures • Develop comprehensive and appropriate management plans • Refer patients appropriately • Stabilize critically ill patients. • Use guidelines and other resources to improve patient outcomes • Assimilate the graduate attributes into daily practice • Assessment of own wellness • Recognize when to seek help SYSTEM THE YEAR IN OVERVIEW Clinical environments for learning Clinics District Hospitals Secondary Hospital departments Community day/health Centres GP practices Emergency Medical Services Community Based Services Private hospitals Maternities Infectious diseases hospitals Learning Activities & Resources Working in clinical teams Activities & procedures as specified in logbook Own reading and reviewing of resources Actual & mock referrals Clinical simulations ATLS & ACLS training SunLearn based assignments Near-peer learning activities Electronic reflections QI project Administrative Skills Communication Skills Engaging with Systems and Communities Research (elective theme) • Completion of medico legal documents • Write appropriate referrals and discharges • Make appropriate clinical notes and use of ICD10 codes. B • Write legal medication scripts and clinical instructions • Communicate effectively with patients • Communicate effectively with team members Text Sizes • Communicate effectively with community members and health care role players • Develop and implement a quality improvement project • Use guidelines and other resources to improve systems • Apply Community Oriented Primary Care principles and skills • Perform a research project during the year. • Attempt to have a publication accepted by the end of the year. A Supervision & Support Students will be placed in learning hubs • 1-2 Regional Supervisors per learning hub • Quality assurance • Regional training events • Site Coordinator & student support • 1-2 site coordinators per facility • Local rosters, logistics & admin • Coordination of assessments • Supervisor & Student support • 1 Apprentice supervisor per student • Mentoring • Clinical supervision Assessment of Competencies Contact Information Coordinator: Francois Coetzee - franna@sun.ac.za UCRH website - Ukwanda blog@sun.ac.za - Ukwanda Centre for Rural Health - @Ukwanda_ Worc Please Scan The QR Code And Give Feedback
Page 1 and 2: Overview of the Renewed MBChB Curri
Page 3 and 4: Health Systems Skills Development R
Page 5 and 6: HEALTH AND WELLNESS Year 2 Semester
Page 7 and 8: Medical Detective Year 3 Semester 1
Page 9: CLINICAL CURIOSITY Year 4 and 5 Doi

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