Bachelor of Medicine and Bachelor of Surgery

The MBChB aims to

1. Reflect the institution's commitment towards redressing past imbalances of race, gender and class in the context of the education and training of Health Professionals.
2. Produce a graduate doctor who is able to manage diverse health problems in the individuals, families and communities whom she/he will serve.

She/he will utilise clinical skills, applying fundamental biomedical, behavioural and social science learning as appropriate in arriving at a clinical decision, incorporating also professional judgement, communication abilities and ethical practice.

This degree will allow the graduate, following a complementary internship, community service and upon registration with the Health Professions Council of South Africa, to practice as a medical doctor with confidence at diverse levels of health care delivery within multi-professional settings.

Matriculation level Mathematics, Physical Science and English at the Higher Grade level.

The programme makes provision for a proportion of learners who do not meet the regular admission criteria to gain access, i.e. learners who have lower scores in the above matriculation subjects. These learners are given academic support.

Senior Certificate with Matriculation Exemption or equivalent university admission qualification

Additional requirements

Matric Mathematics, Physical Science and English on the higher grade

a). Critical cross-field outcomes (generic to all teaching and learning)

1. Identify and solve problems, in which responses display that responsible decisions using critical and creative thinking, have been involved.
2. Collect, analyse, organise and critically evaluate information
3. Organise and manage one's own and others' activities responsibly and effectively.
4. Communicate effectively, using visual, mathematical and language skills in oral and written modes.
5. Work effectively with others as a member of a team, group and community.
6. Use science and technology effectively and critically, showing responsibility towards the environment and health of others.
7. Be culturally sensitive across a range of social contexts
8. Demonstrate an understanding of the world as a set of related systems by recognising that problem-solving contexts do not exist in isolation.
9. Reflect on and explore a variety of strategies to learn more effectively.
10. Participate as responsible citizens in the life of local, national and global communities.
11. Facilitate practice in a number of settings (public and private) and develop research management skills.

b). General outcomes

The Programme is determined by the Primary Health Care (PHC) philosophy and the cultural, economic, political, social and scientific contexts within which the graduates will work. The PHC principles informing general outcomes of the Programme ate that the learner will:

1. Demonstrate a comprehensive and holistic approach at all levels of heath care.
2. Integrate biomedical, behavioural and social sciences and apply to relevant clinical practice.
3. Demonstrate awareness of complementary and informal health practice.
4. Demonstrate an understanding of the role and function of multi-professional and inter- sectoral collaboration in health service delivery.
5. Demonstrate the ability to work effectively as a member of a multi-cultural health care delivery team.
6. Demonstrate sensitivity to socio-cultural and economic diversity in various contexts.
7. Participate in research relevant to various community and health population perspectives.

c). Specific outcomes

In general, the learner will

1. Understand ethics and human rights
2. Demonstrate competency in appropriate numeric, information literacy, critical thinking and computer literacy
3. Following graduation, the learner will maintain continued competence (CPD)
4. Be competent to engage in life-long learning through well-developed learning skills

In patient care the learner will

1. Be aware of the need to act professionally and ethically and to take responsibility within own limits of competence
2. Be aware of the need to exercise judgement commensurate with knowledge and experience

The learner will demonstrate

1. An understanding of human growth, development, structure, function and social functioning in health and illness
2. Ability in taking a history, conducting a physical examination and using ancillary diagnostic procedures
3. Competence in clinical problem-solving and decision-making
4. Ability to develop and implement an appropriate and holistic management plan and to monitor and evaluate the outcome
5. Competence in the documentation of transactions with patients and in clinical record keeping

Public Health Practice the learner will demonstrate

1. An understanding of human rights and ethics as applied to population oriented health care and research
2. An understanding of the pattern, aetiology and natural history of common diseases and disabilities in rural and urban South Africa
3. An understanding of public health skills in conducting a community health "diagnosis" (assessment) and developing a management plan appropriate to the assessment
4. An ability to communicate the findings and the plan
5. An understanding of laws and policies governing health care and health practice in South Africa

a). The CCFOs will be included in the general and specific outcomes

b). The learner makes an assessment of the patient in her/his family, community, socio-economic and political context with all associated risk factors. The learner employs the assessment to develop an appropriate comprehensive intervention

The learner will select and apply appropriate knowledge and skills from the biomedical behaviour and social sciences to clinical situations

The learner's intervention takes account of the influence of and collaboration with complementary and informal health practitioners

Learners will

Identify and involve appropriate health professionals and providers in a team to manage individual and public health issues.

Make appropriate referrals where necessary and advocate for and mediate other sectors' involvement in improving the health of communities

Learners will demonstrate the ability to work constructively with all members of the team, irrespective of profession, status, age, gender, race, class or beliefs. This will include proficiency in group skills, skills of advocacy, mediation and negotiation

The learner will demonstrate respect for different opinions, appreciation of diversity and the ability to adapt

Learners will understand the scientific method, the bio-medical and psycho-social bases of health and disease, as well as common disease patterns in South Africa, in planning, conducting and evaluating research

c). Specific outcomes

In general, the learner will

• Know the contents of, and be able to interpret the main ethical and human rights documents pertaining to health
• Be able to make use of ethical codes and human rights documents in dealing with clinical and public health dilemmas
• The learner uses appropriate technologies and media to access contemporary research findings
• Critically evaluates the data and assesses relevance of the findings to the clinical case being examined
• The learner has knowledge of Continuous Professional Development (CPD) as specified in the Health Professions Council of South Africa
• The learner will incorporate timely and appropriately new research, insights and technologies in clinical practice
• The learner is able to participate in research
• Critically evaluate research findings and relevant material for practice
• Displays attributes of being a reflective practitioner

In patient care, the learner will

• Know when to seek help and guidance
• Be aware of what constitutes unprofessional conduct
• Understand the difference between legal and ethical obligations and when actions may be needed that are not legal in order to maintain ethical practice

The learner will

• Understand the place of referral for specialised diagnosis and care
• Be able to identify relevant health professionals at the appropriate levels of referral
• Recognise acute life-threatening emergencies and initiate appropriate treatment or refer

Select and apply relevant biomedical, behavioural and social sciences to

• Distinguish between normal and abnormal, health and illness
• Understand the mechanisms by which health is lost and illness established

The learner will

• Elicit a competent history
• Conduct a skilled examination, which includes the physical, mental and psycho-social status of a patient appropriate for age, sex and clinical presentation
• Understand and use appropriate diagnostic aids in a cost-effective manner

The learner will

• Interpret the clinical and diagnostic findings in a logical and rational manner, demonstrating skills such as pattern recognition, relationship examination and hypothesis generation and testing where appropriate
• Arrive at a reasoned diagnosis and three-stage (bio-psychosocial-cultural) assessment
• Present this as an accurate and succinct formulation of the problem
• Identify appropriate interventions for cure, alleviation and rehabilitation of the problem
• Understand and identify those interventions appropriate to the clinical problem that may result in the restoration of health and health promotion in the future
• Recognise the value of an emphasis on health behaviour and choice in the management plan
• Employ management skills effectively
• Take cognisance of environmental, socio-economic, political and class determinants of health and illness
• Take cognisance of the structure, organisation and function of the South African health care system
• Communicate clearly and courteously, both verbally and in writing, with the patient, her/his family and with other health professionals and practitioners
• Exercise skill and discretion in referring patients to the most appropriate level of care

The learner will understand

• The importance of rigorous documentation of clinical records
• The necessity for effective systems, both mechanical and electronic, for the storing and retrieval of medical records
• The importance of comprehensive and accessible clinical data for the audit of clinical practice and the facilitation of health care research

3. In Public Health Practice, the learner will be able

• Critique a public health policy for any ethical and human rights faults and to suggest alternatives that are ethical and respect human rights
• Understand the potential impact of race, gender and other forms of discrimination on health care policy and on research
• Conduct research in ways that respects the rights of participants and vulnerable groups

The learner will

• Select and define and set of priority health status indicators for an area
• Understand what each indicator would be used for and where the data can be accessed
• Derive the relevant pattern from the set of indicators
• Describe the aetiology and natural history of common diseases and disabilities in South Africa
• Have knowledge of demography as well as the dynamics of communities
• Be able to apply behavioural sciences in population practice (disease prevention and health promotion)
• Identify ethical and human rights dilemmas in typical clinical encounters and in public health interventions and policies
• Know how to act as an advocate for groups with particular health needs
• Use their understanding of ethics and human rights to make appropriate management or advocacy decisions

The learner will be able to

• Communicate clearly and courteously, both verbally and in writing, with relevant health professionals and practitioners, health service managers, professionals in relevant sectors and policy developers
• Know where to obtain information and support for dealing with ethical / human rights conflicts

INTEGRATED ASSESSMENT

Assessment is formative and summative.

A variety of assessment tools is employed.

The degree of integration and application of knowledge, skills and attitudes is increasingly demanded of the learner as s/he moves through the programme towards the high exit clinical examinations

In these the learner is placed in the role of doctor and is required to demonstrate acquisition of the competences outlined above in specific outcomes

The following tools are used

• Written: MCQs; True/False Questions; Essay (long, short); short answer; patient management problems; case summaries/patient studies.
• Practicals and Group Project Presentations (in the latter a group of approximately 8 students explore a community health issue, submitting a written report and giving an oral presentation).
• Oral: Traditional and Structured
• Clinical: 'on the job' evaluation (by senior members of the clinical teams to which the learner is attached during clinical clerkships), permitting assessment of knowledge, skills and values/attitudes; Objectives Structured Clinical Examination (OSCE); Simulated Office Oral Examinations (SOOs); performance-based testing using real patients

In the clinical examinations learners are observed and judged by clinicians, i.e. experts.