Master of Medicine in Emergency Medicine

Purpose

The purpose of this qualification is to provide learners with a systematic understanding of and in-depth knowledge of emergency medicine to enable them to be engaged in solving problems related to Emergency Medicine. These specialists will also be able to carry out research and soo contribute to the science and practice of Emergency Medicine. Learners will also be able to manage common emergency conditions occurring in pre-hospital and in-hospital emergency medical departments. Lastly, learners will develop the necessary skills to be able to communicate with the various stakeholders and also be able to manage the Emergency Units within the parameters of the Health Professions Council of South Africa (HPCSA) rules and policies.

Rationale

Emergency Medicine is a well-known speciality worldwide that has been in existence for more than twenty five (25) years in countries such as Australia and the United States of America. In South Africa, the Health Professions Council of South Africa (HPCSA) granted approval for this qualification to be developed in 2006 and accepts the Master of Medicine in Emergency Medicine [MMed (Emergency Medicine)] for registration as an Emergency Medicine Specialist.

In response to the above and to the need for Emergency Medicine specialists in the Northern Cape, part of Eastern Cape and the North West whereby patients are referred to health facilities in Bloemfontein or Kimberley, the School of Medicine has developed the MMed (Emergency Medicine). This qualification aims to provide General Practitioners with the ability to deal with the communities' specialist emergency medical needs in an efficient and professional way. In addition, the advances made in the understanding, diagnosis, management and treatment of diseases, chronic illness and deformity were incorporated into the development of the qualification to enable the specialists in Emergency Medicine to render comprehensive services to their patients and to also contribute to innovative research in this field.

The qualification has been developed according to international standards and practices, occupational demands and requirements, and community needs. It is also aligned with the national priorities in the health sector and complies with the criteria, norms and standards set by the Health Professions Council of South Africa (HPCSA). Thus, it can be established that the MMed (Emergency Medicine) qualification is comparable to all other Master of Medicine Degrees offered by South African Universities and the Fellowship College of Emergency Medicine (FCEM) South Africa (SA) and is also supported by the Emergency Care Institute of South Africa.

. After successful completion of the qualification, as stated above, learners will receive full certification with the HPCSA as an Emergency Medicine Specialist. The MMed (Emergency Medicine) also enables a successful learner to obtain a nationally recognised qualification that permits access to horizontally and vertically articulated qualifications within the Higher Education Qualifications Sub-framework (HEQSF), improving the professional status and employability of learners.

Recognition of Prior Learning (RPL)

RPL will be applied according to the institutions RPL policy. Possible exemption, for a maximum period of twenty four (24) months, on the basis of comparable training and experience gained at another recognised academic institution could be granted, subject to the following conditions:

• The said periods of training must have occurred within at most two years before registering for the MMed (Emergency Medicine).
• Sufficient experience must be proven by means of a logbook/critical performance portfolio and certification by the Head of the Department where the experience was gained. The above information will then be evaluated by the Head of the Department of Surgery or Emergency Medicine at the Bloemfontein or Kimberly Hospitals and approved as equivalent.
• With consent of the Head of the Department of Surgery or Emergency Medicine and the Executive Committee of the School of Medicine.

Entry Requirements

The minimum entry requirement for access to this qualification is

• Bachelor of Medicine, Bachelor of Surgery (MBChB) Degree, Level 8 or equivalent.
• A learner must be registered with Health Professions Council of South Africa (HPCSA) as a Medical Practitioner for independent practice in terms of the Health Professional Act, Act 56 of 1974.

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

Modules

• Clinical Anatomy, 60 Credits.
• Physiology, 60 Credits.
• Pathology, 60 Credits.
• Research Methodology, 12 Credits.
• Emergency Medicine that includes an Internship, 224 Credits.
• Mini-Dissertation, 64 Credits.

1. Manage common emergency conditions occurring in pre-hospital and in-hospital emergency medical departments.
2. Create new knowledge and research initiatives.
3. Understand human rights, ethics and the health law.
4. Use communication resources effectively to communicate with various stakeholders involved in the care of patients.

Associated Assessment Criteria for Exit Level Outcome 1

• Manage patients with unselected conditions, who initially do not clearly fall within the field of one of the other medical disciplines, and co-ordinate and oversee the management of patients with multiple conditions.
• Interrogate and judge when to seek the help of another medical discipline.
• Evaluate and assess interventions to act as the patient's advocate, advisor and guide within the discipline of Emergency Medicine.
• Use problem-solving techniques, which draw on multi-faceted knowledge, in order to arrive at a management plan.
• Use instruments and equipment competently and responsibly in the practice of emergency medicine.

Associated Assessment Criteria for Exit Level Outcome 2

• Write a comprehensive mini-dissertation (Research Report) that includes a critical academic analysis of at least five peer-evaluated publications or a meta- analysis.
• Read scientific articles with insight regarding the methodological aspects.
• Critically evaluate published literature in the field on the practices of Evidence-Based Medicine and apply it in practice.
• Evaluate research, review literature, design and perform a study, collect data, perform and interpret statistical analyses on data, interpret results and draw conclusions.
• Conduct all research with due regard for the moral, legal and ethical accountability and requirements of the profession.

Associated Assessment Criteria for Exit Level Outcome 3

• Understand the meaning of "ethics" in general as it manifests in the health care environment and in particular the principled underpinnings of ethics in health care in South Africa.
• Understand the importance of human rights in health care ethics and how to apply these in concrete situations faced by health care practitioners in South Africa.
• Demonstrate an understanding of the complexity of ethical dilemmas; recognise ethical issues in health care management and follow a systematic approach in dealing with such issues.
• Analyse what international and national ethical rules are required of health care practitioners in terms of the funding of health care.
• Understand the concept "social security" and how that relates to the South African health care funding systems.
• Deal with various instances of financial or resource pressures in an ethical manner in the medical scheme environment, the private insurance environment and the public sector environments.
• Apply the rules and policies of the Health Professions Council of South Africa (HPCSA) as it pertains to managed health care and related business practices such as accounts, billing and finances.
• Understand what it means to obtain the informed consent of a patient and how to facilitate obtaining consent in a healthcare practice.
• Apply the confidentiality principle in practical situations that arise in everyday health care practice and apply the exceptions thereto.
• Create and utilise channels and mechanisms to protect the interests of patients and professional ethics.

Associated Assessment Criteria for Exit Level Outcome 4

• Develop communication strategies to avoid conflict and reduce risk of potential complaints leading to litigation.
• Understand and recognise that effective communication contributes towards a more cost-effective provision of care to patients.
• Develop knowledge and skills in the field of doctor-patient communication
• Communicate efficiently and effectively with the patient, other health care workers and the community in order to obtain a history, to explain procedures, etc.

Integrated Assessment

The assessment will be according to the Fellowship College of Emergency Medicine (FCEM) South Africa's regulations for Emergency Medicine with the following components:

• Formative assessment: Experiential learning will be recorded in a logbook based on authentic evidence. This training shall occur in the HPCSA recognised and accredited unit of the institution. Training shall be under the supervision of a Specialist, registered with the Health Professions Council of South Africa (HPCSA).
• Summative Assessment: An examination will be administered by the College of Medicine of South Africa (CMSA) and a mini-dissertation in the specialty of Emergency Medicine completed under supervision. Summative assessments in Emergency Medicine also comprises a Primary and Final Examination:

> Primary Examination: In addition, the learners will write two papers on the basic sciences and complete one multiple choice question paper. In order to pass the Primary examination, the candidate must achieve 45% or more for each written paper (including the Multiple Choice Question paper), and an overall average of 50% or more across the written examination.

> The final Examination will also comprise two written papers and one multiple choice question paper.

> An Objective Structured Practical Examination (OSPE) will be administered to assess problem solving, clinical judgement, and interpretation of investigations, practical procedures and cost-effective management issues.

> Clinical and Simulation examination of two (2) short clinical cases and two (2) emergency simulations will be presented. Candidates will be expected to be able to elucidate and demonstrate relevant clinical signs, special investigations and procedures, and to synthesise and interpret their findings. Candidates will also be assessed on their interpersonal skills and their professional attitude and approach.

• Finally an oral examination will be conducted whereby candidates will be asked to undergo two (2) 30-minute oral examinations with different sets of examiners, which may include aspects of their critical performance portfolio.

The CMSA will conduct these examinations, with the individual examiners being appointed by the College of Surgeons of South Africa.