Master of Medicine in Chemical Pathology

Purpose

The purpose of the Master of Medicine in Chemical Pathology is to equip learners with practical skills, and expertise knowledge relevant to professional service in the health context. Learners will gain a clear understanding of the disease processes and their diagnosis. They will be competent in Emergency, Critical and Chronic Laboratory Medicine. The qualification will provide learners with expertise in research, which includes the ability to evaluate and implement research findings in the practice of the branch of specialisation and the ability to guide junior candidates if the learner is in an educational setting. Learners will acquire research skills to become part of a research team and eventually form their research groups.

The qualification prepares learners to contribute to the development and dissemination of knowledge at an advanced level by fostering scholarship and intellectual independence, equipping them with skills and knowledge relevant to the research practice and professional communication. The qualification produces competent learners for admission to doctoral qualification preparing them for a life of self-directed continuing learning, reflective practice, and professional development. The qualification will enable the learners to practice as Chemical Pathology specialists to provide consultative, diagnostic and management care at Medical Laboratory Services as well as specialised research.

Upon successful completion of the qualification, qualifying learners will be able to

• Display knowledge and application of the basic principles of Chemical Pathology.
• Use the instrumentation and apply the principles of laboratory techniques.
• Relate biochemical tests to the disease process as applied to diseases commonly present in the rural environment.
• Apply the principles of research and research planning in Medical Sciences.
• Manage different problems found in the daily Chemical Pathology practice.
• Critically analyse common diseases and the diagnosis act at the points where patients and clinicians need assistance to make a diagnosis.
• Assist and empower patients and doctors in the rural environment through families, groups, organisations, and communities to do health promotion and their problem-solving capacities.
• Promote, restore, maintain, and enhance thorough prevention measures for the health of individuals, families, groups, and communities by enabling them to accomplish tasks, prevent, alleviate distress, and use resources effectively.
• Implement a development approach within the South African and the global health context.
• Work effectively within teams and individually.

Rationale

According to the Accreditation Council for Graduate Medical Education, Clinical Pathology or Clinical Chemistry the practice of Pathology is devoted primarily to the use of biochemical and molecular techniques in the laboratory diagnosis and management of human disease. Chemical pathologists advise clinicians on the selection and interpretation of clinical chemistry tests and can manage and direct the clinical chemistry section of the clinical laboratory. Clinical chemistry is unique since it produces more patient results than other subspecialties, and it is a relatively uncommon profession with few individuals entering the field. Chemical Pathology focuses on the study and investigation of the biochemical and molecular changes that occur as part of a disease process.

Chemical pathologists take responsibility for managing the laboratories by undertaking.

biochemical investigations and providing them with clinical and scientific direction. They

are heavily involved in developing guidelines and protocols for disease management. A major part of their role is to advise clinicians about the appropriate use and interpretation of tests in managing individual patients in general practice and all specialities of secondary care. Where tests are not provided locally, they act as a link between local clinicians and specialist laboratories, for example for rare endocrine, toxicological, or genomic testing. Chemical pathologists are involved in dealing with large amounts of data.

and with the Information Technology Systems required to manage these, and in using the

data to support research and audit across the whole field of medicine. Chemical pathologists are also involved in disease screening and risk management. In addition to their role in cardiovascular risk management, they also manage antenatal, neonatal and cancer screening programmes.

Chemical Pathology brings together science and medicine and relates to all medical specialities and the investigation and management of patients with rare abnormalities. Certain investigations overlap with other Pathology disciplines such as Immunochemistry and Haemochemistry. Major subsections of Chemical Pathology such as Endocrinology, Dyslipidaemia, Cytogenetics, and Inherited Metabolic Disorders constitute large sections under metabolic medicine requiring molecular techniques to confirm the diagnosis. The development of the qualification was informed by the need to have Medical Specialists who understand the science and the clinical aspects of disease and/or pathology. The qualification adheres to the rules and regulations of the Colleges of Medicine South Africa (CMSA) and the Health Professions Council of South Africa (HPCSA) which regulates medical practice in South Africa.

The qualification is designed to forge the acquisition of deep knowledge and sustainable learning skills demanded by laboratory professionals in South Africa and internationally. The qualification consists of a high level of reflective learning and deep knowledge to produce learners, address all laboratory aspects and research through innovation using autonomic and creative problem-solving methods. Therefore, learners will excel and adapt to the most critical working environments. The qualification is also designed so that each module applies specialised knowledge relevant to research avenues in the discipline.

The qualification will allow the local training of new specialists to increase the shortage of Pathology specialists in the country, especially in the Eastern Cape. The qualification will allow South African Doctors, especially those who live in the Eastern Cape Province, to become specialists. The qualification will not only contribute to the national development of the services but will also enhance the Chemical Pathology services provided to the regional population, which is currently required in rural communities.

The qualification will be responsive to the health priorities in the local, regional, national, and global development by producing learners who can deal with clinical diagnostics situations which will improve the quality of the health care system, and laboratory results and reduce the duration of hospital stay. The qualification will embrace the African culture and epistemology and improve the national and African medical professional standards to provide a better service to the community. Learners will develop competence in the practice of a specialist field and contribute to the need for specialist practice and research skills in the South Africa Health Sciences.

Recognition of Prior Learning (RPL)

The institution has an approved Recognition of Prior Learning (RPL) policy applicable to equivalent qualifications for admission into the qualification. RPL will be applied to accommodate applicants who qualify. RPL thus provides alternative access and admission to qualifications, as well as advancement within qualifications.

RPL for access

• Learners who do not meet the minimum entrance requirements or the required qualification that is at the same NQF level as the qualification required for admission may be considered for admission through RPL.
• To be considered for admission in the qualification based on RPL, applicants should provide evidence in the form of a portfolio that demonstrates that they have acquired the relevant knowledge, skills, and competencies through formal, non-formal and/or informal learning to cope with the qualification expectations.

RPL for exemption of modules

• Learners may apply for RPL to be exempted from modules that form part of the qualification. For a learner to be exempted from a module, the learner needs to provide sufficient evidence in the form of a portfolio that demonstrates that competency was achieved for the learning outcomes that are equivalent to the learning outcomes of the module.

RPL for credit

• Learners may also apply for RPL for credit for or towards the qualification, in which they must provide evidence in the form of a portfolio that demonstrates prior learning through formal, non-formal and/or informal learning to obtain credits towards the qualification.
• Credit shall be appropriate to the context in which it is awarded and accepted.

Entry Requirements

The minimum entry requirement for this qualification is

• Bachelor of Medicine and Bachelor of Surgery, NQF Level 8.

Or

• Bachelor of Medical Science Honours in Chemical Pathology, NQF Level 8.

Or

• Bachelor of Science in Medical Laboratory Sciences, NQF Level 8

Or

• Bachelor of Science Honours in Chemical Pathology, NQF Level 8.

Or

• Postgraduate Diploma in Laboratory Management, NQF Level 8.

And

• Registration as a Medical Practitioner Independent Practice with HPCSA.

This qualification consists of the following compulsory modules at NQF Level 9 totalling 480 Credits.

Compulsory modules, Level 9, 480 Credits

• Applied Physiology, 20 Credits.
• Biochemistry, 20 Credits.
• Basic Laboratory statistics, 20 Credits.
• Laboratory Methods, 20 Credits.
• Basic research methodology and biostatistics, 20 Credits.
• Ethics, 30 Credits.
• Internal Quality Control, 30 Credits.
• Method validation, 30 Credits.
• Laboratory Standard Procedures, 20 Credits.
• External Quality Control, 10 Credits.
• Occupational Health and Safety, 10 Credits.
• Interpretation of Laboratory Results, 10 Credits.
• Laboratory statistics, 30 Credits.
• Pathophysiology of Disease in various systems, 150 Credits.
• Research Project, 60 Credits.

Exit Level Outcomes

1. Demonstrate the ability to apply the specialist scientific knowledge and associated practical experience appropriate to the discipline.
2. Apply professional and technical skills required to competently diagnose disease processes based on clinical correlations.
3. Perform appropriate biochemical investigations and interpret results.
4. Demonstrate the ability to compile an appropriate diagnostic chemical pathology report and advise on additional investigations or therapeutic aspects.
5. Facilitate the learning of others regarding the Chemical Pathology field.
6. Apply the scientific research methodology, implement a research project, and write a mini dissertation.
7. Demonstrate the ability to present academic, professional, or occupational ideas and texts to a range of audiences, offering creative insights, rigorous interpretations, and solutions to problems within the ethical and professional boundaries.

Associated Assessment Criteria for Exit Level Outcome 1

• Apply the instrumentation and the principles of laboratory techniques, research skills and research planning in medical sciences.
• Carry out research and manage data appropriately and computational skills.
• Describe and explain relevant legislation, including that related to Health and Safety requirements for laboratories.

Associated Assessment Criteria for Exit Level Outcome 2

• Relate the biochemical tests to the disease process based on diseases commonly present in the rural environment.
• Formulate and implement an appropriate therapeutic regimen, evaluating and adjusting elements of the plan.
• Apply the latest techniques and technology in the practice.
• Act within accepted norms of the professional protocol.

Associated Assessment Criteria for Exit Level Outcome 3

• Perform all biochemical diagnostic tests used in modern Chemical pathology laboratories.
• Apply basic biochemical principles to the design of new diagnostic tests and troubleshooting of existing tests.
• Analyse clinical laboratory data and provide interpretation of such data of clinical diagnostic or prognostic value.
• Perform appropriate specialised investigations and interpret the results to arrive at a clinical diagnosis.
• Determine signs and symptoms of disease or injury and perform advanced physical examination appropriate to the level of Chemical Pathology.
• Use cost-effective investigations which provide sufficient relevant information to aid diagnosis.

Associated Assessment Criteria for Exit Level Outcome 4

• Describe and explain the biochemical mechanisms of human diseases.
• Discuss the theoretical principles of all generally used biochemical diagnostic tests.
• Apply appropriate quality control programs to ensure a high standard of laboratory test results.
• Describe and explain the theory and principles of practical operation of widely used biochemical diagnostic instruments.
• Critically appraise the clinical usefulness and technical performance of biochemical diagnostic tests.

Associated Assessment Criteria for Exit Level Outcome 5

• Successfully liaise between clinicians and technical laboratory staff to optimise the clinical value of the laboratory.
• Work effectively as a member of the multi-disciplinary health care team towards defined outcomes, and where appropriate assume leadership, apply negotiation, and conflict resolution skills, and motivate others.
• Interact and engage in debate in a professional manner within a learning or professional group context.
• Demonstrate self-direction and independence in own learning to become a lifelong learner, recognise personal education needs, utilise appropriate learning situations and evaluate own progress.

Associated Assessment Criteria for Exit Level Outcome 6

• Conduct all research with due regard for the moral, legal, and ethical accountability and requirements of the profession.
• Critically assess the literature and draw valid conclusions from the data.
• Interact with text (oral and written) through critical listening/reading skills.
• Produce texts which integrate information from different sources using appropriate academic and professional conventions.
• Gather information from various sources, reflect critically on knowledge and information and in consultation with the patient and other health care professionals (where appropriate) plan and implement to complete a treatment option.
• Initiate and complete a research project.
• Produce a research report which demonstrates skills in evaluating research, review literature, design and perform a study, collect data, perform, interpret statistical analyses on data, interpret results and draw conclusions.

Associated Assessment Criteria for Exit Level Outcome 7

• Communicate professionally as a multi-disciplinary healthcare team member towards defined outcomes while complying with legal, ethical, and medical principles.
• Communicate the findings and treatment options effectively with the patient and the referring doctor taken from a medical history at a level appropriate to the specialty.
• Report the results according to scientific norms.

INTEGRATED ASSESSMENT

Integrated assessment is performed on a continuous basis through evaluation of performance in clinical and laboratory practice. Further, the research report that the learner submits is used in the integrated assessment of research mastery.

Formative Assessment

Formative assessments are carried out continuously. The tutors evaluate and provide feedback on knowledge, attitudes, and skills.

The exit level outcomes are assessed by using integrated formative assessments such as the following assessment techniques.

• Observed performance (bench training) and reporting of clinical biochemical test results.
• Collection and processing of human specimens for biochemical diagnostic analysis
• Observed diagnostic reporting of chemical pathology results.
• Performance, interpretation, and reporting of laboratory results of biochemical investigations.
• Diagnostic discussions and case presentations.
• Logbook.
• Portfolio of evidence.
• Observed teaching sessions to the undergraduate learners/ health care team.
• Seminar, journal club and case presentations.
• Mentor learners and other trainees and advise on effective preparation for examinations.
• Writing a research concept paper and research proposal.
• Presentations at meetings and congresses.
• Publication in peer-reviewed journals.

Summative Assessment

Summative Assessment consists of the completed mini-dissertation and the written and practical components of the Part One and Two examinations administered by the CMSA.

• Part One consists of the two written examinations for all learners in all South African training institutions.
• Part Two consists of the two written examinations and practical examinations (OSPE) that are common for all learners in all South African training institutions.
• The mini-dissertation is marked by an internal and external examiner using university policies and regulations.