Master of Medicine in Family Medicine

Purpose

The purpose of the Qualification is

• To provide graduates who are specialist clinicians in the field of Family Medicine.
• Enable successful candidates to register with the Health Professions Council of South Africa in the category Family Physicians.

The qualified learner, as specialist family physician, will be able to practice as an independent family physician ready to provide and promote health care of the highest standard to the public and be willing to accept the challenge of continuing development for a high level of knowledge and expertise that is comparable with international standards in the field.

Rationale

The submission of this professional qualification is in essence the proposed major changes to an existing programme M Fam Med necessitated by developments in the professional educational sector of Family Medicine and also the identified lack of skills of doctors working in the district health sector as general practitioners.

Before a student may register for the M Med (Fam) degree, he/she must

• Have been in possession of the M.B. Ch.B degree from this University for a period of at least two years, or a qualification deemed equivalent by the University.
• Have been registered as a medical practitioner with the Health Professions Council of South Africa (HPCSA) for at least one year in terms of the Health Professional Act, Act 56 of 1974 in a category as approved.

Recognition of Prior Learning

The duration of training extends over four years. Exemption to a maximum of 24 months residency may be granted, subject to the following:

• In special cases of merit.
• With proof of sufficient experience.
• After successful completion of entry level examination.
• Proof of full registration at HPCSA.

Elucidation

• Special merit refers to being in possession of the M.Fam.Med (UFS) or equivalent qualification.
• Full registration with HPCSA.
• Sufficient experience must be proven by means of a logbook and certification of the head of the department where the experience was gained. The above information must then be evaluated by the head of the department of Family Medicine and approved.
• Diploma certification deemed equivalent to some of the elective modules.
• Applications for exemption from the residency period must be submitted within the first semester after enrolment as postgraduate student.

Access to the Qualification

Regulations for Magister in Medicine (Family Medicine).

Students who apply for the degree are subject to a selection process.

A student must comply with both the stipulations of the General Regulations for master's degrees and the Regulations of the Faculty of Health Sciences and HPCSA.

Reg. GH13.2: Duration of the progamme.

The duration of training extends over four years. Exemption to a maximum of 24 months residency may be granted, subject to the following:

• In special cases of merit.
• With proof of sufficient experience.
• After successful completion of entry level examination.
• Proof of full registration at HPCSA.

Elucidation

• Special merit refers to being in possession of the M Fam Med (UFS) or equivalent qualification.
• Full registration with HPCSA.
• Sufficient experience must be proven by means of a logbook and certification of the head of the department where the experience was gained. The above information must then be evaluated by the head of the department of Family Medicine and approved.
• Diploma certification deemed equivalent to some of the elective modules.
• Applications for exemption from the residency period must be submitted within the first semester after enrolment as postgraduate student.

Reg. GH13.3: Clinical experience

Before the M Med (Fam) degree is conferred on a student, he/she must convince the University that he/she

• Successfully completed training at hospitals of the Faculty of Health Sciences at the University of the Free State or at another hospital, institution and practice recognised as equivalent by the University for a period of four years, according to the requirements of the department.
• Received theoretical, practical and clinical instruction.
• Was registered as student at the University for the prescribed period.
• Successfully completed the prescribed University assessment - written, oral, logbooks, portfolios, practical and/or clinical - as prescribed.

At present the clinical services are subject to approval of the Department of Family Medicine. Specific sites approved include the academic platform at National District Hospital, Kimberley hospital, Bongani hospital (the last two sites being satellite sites of the University of the Free State). Other hospitals and practices are at present approved sites and will in future be accredited according to national criteria which are developed by FAMEC. These are the criteria which will be submitted to HPCSA for use to accredit training sites in future.

Reg. GH13.4: Exemption

Possible exemption, full or partial, based on comparable training and experience gained in another recognised institution, may be granted by the University in respect of the training and work stated in Reg.GH13.2. The maximum permissible period of exemption is 24 months.

Duration: 4 years.

NQF Level: 8 Credits.

Total credits: 480 (Credits per year: 120).

Fundamental: 40 Credits.

Core: 296 Credits.

Elective content: 144 Credits.

1. Managing self and the practice (in public or private sector) effectively with visionary leadership according to the principles of medical practice management.
2. Evaluating and managing patients with both undifferentiated and more specific problems cost-effectively and independently and in any practice setup according to the holistic bio-psycho-social approach.
3. Facilitating the health and quality of life of the community.
4. Continually adjusting the medical practice according to own research and other valid research to improve quality of care.
5. Undergoing continuing professional development from own practice set-up by recognizing, evaluating and reflecting on personal and professional strengths and weaknesses to appropriately change professional practice and behaviour according to available evidence.
6. Conducting all aspects of health care in an ethical, compassionate and responsible manner.

Specific Exit-Level Outcomes

1.1 Manage him/herself optimally (personal management).

1.2 Manage resources and processes effectively (Finance, HR, Assets, Tools, Information, Time management).

1.3 Understand, evaluate and manage the systems the learner may be working in. (macro environment) Demonstrate the ability to participate in the management of a professional practice (portfolio).

1.4 Manage people in the medical practice to create an optimal working climate. (Leading, motivating, providing strategic input, conflict management, encouraging teamwork).

2.1 Evaluate a patient according to the bio-psychosocial approach.

2.2 Formulate and execute, in consultation with the patient, a mutually acceptable, cost-effective management plan.

3.1 Integrate and co-ordinate the preventive, promotive, curative, rehabilitative and palliative care of the individual in the context of the family and community.

3.2 Utilize and integrate resources for rational provision of affordable and accessible health care.

3.3 Identify and address problems influencing the health and quality of life of the community.

3.4 Understand the role of the family physician in empowering individuals and the community to improve their health status.

4.1 The qualified learners will be able to perform research in practice involving audit, qualitative and quantitative methods.

5.1 Identify strengths and weaknesses and develop capacity for implementation of quality improvement.

5.2 Demonstrate implementation of change according to identified needs and show willingness to seek help when necessary.

5.3 Critically review literature and apply the evidence in professional practice.

Associated Assessment Criteria for Exit-Level Outcome 1 and Specific Exit-Level Outcome 1.1

The learner should be able to demonstrate knowledge and ability to apply knowledge in practice by means of clinical performance, written assignments and examinations, oral, practical/clinical examinations throughout the 4 years of the programme in accordance with standards laid down by the University and professional board, and:

• Demonstrate that he/she addresses personal learning needs continually by participating in and selecting appropriate selective modules and CPD activities (portfolios, CPD certificates).
• Demonstrate responsible and efficient methods of self organization, management and care (case studies, oral examinations).

Associated Assessment Criteria for Specific Exit-Level Outcome 1.2

• General: Demonstrate and apply the laws with respect to labor relations, medical practice accounting, and running dispensing practices (case studies, written examinations, oral examinations).
• Finance: Demonstrate the ability to interpret basic financial statements, understand and apply principles of budgeting for medical practice, health economics, tax management, and principles of financial planning for medical practice (case studies, written examinations, portfolio).
• HR: Demonstrates that he/she understands and is able to apply the laws with respect to employment practices and labor relations related to medical practice (case studies, written papers and oral examinations).
• Demonstrate the ability to plan viable health service incorporating the appropriate use of resources, including human and material resources (case studies, oral examinations and written examinations).
• Information: Demonstrate the ability to plan, implement and maintain information- and record keeping systems (case studies, written examinations, oral examinations).

Associated Assessment Criteria for Specific Exit-Level Outcome 1.3

• Demonstrate the ability to participate in the management of a professional practice (portfolio).
• Demonstrate the ability to work effectively as member of a primary or secondary health team (public or private sector) (OSCE).
• Demonstrate an understanding of the principles of the district health system (case studies).
• Demonstrate the ability to plan and conduct a practice audit (portfolio).

Associated Assessment Criteria for Specific Exit-Level Outcome 1.4

• Demonstrate the ability to communicate effectively with members of the health care team and peers (discussion groups).
• Demonstrate the ability to manage and motivate personnel (OSCE, discussion groups).
• Demonstrate the ability to deal with conflict successfully (OSCE, discussion groups).
• Demonstrate the ability to implement a strategic plan (case study).
• Demonstrate leadership skills within the context of a team (discussion groups, OSCE).

Associated Assessment Criteria for Exit-Level Outcome 2 and Specific Exit-Level Outcome 2.1

• Demonstrate the ability to take a relevant history in a patient centered manner (OSCE, patient case presentations).
• Demonstrate the ability to perform a relevant and accurate examination and appropriate special investigations (OSCE, case presentations).
• Demonstrate the ability to formulate a plan and assessment according to patients problems (case studies, OSCE).

Associated Assessment Criteria for Specific Exit-Level Outcome 2.2

• Demonstrate the ability to communicate effectively with patient to inform them of interpretation of findings and seek consensus on a management plan (OSCE, case presentation).
• Formulate a cost-effective management plan including follow-up arrangements, appropriate referral and re-evaluation (case studies).
• Formulate a management plan for patients with family-orientated or other social problems (case studies).
• Apply science and technology efficiently and in a manner demonstrating responsibility towards health of the patient and the demands of society (case studies, portfolio).
• Perform technical and surgical skills necessary for functioning as a generalist (OSCE).
• Include the family in management (case studies).
• Recognize and manage discord in relationships impact on health, using appropriate tools e.g. geno- grams, eco-maps where necessary to identify potential problems (portfolio).

Associated Assessment Criteria for Exit-Level Outcome 3 and Specific Exit-Level Outcome 3.1

• Demonstrate knowledge of the resources available in the community and the ability to coordinate and integrate team efforts (case studies).
• Demonstrate the understanding of the role of the team members (peer group discussions, team discussions).
• Demonstrate knowledge and understanding of the 5 mentioned dimensions (oral examinations).

Associated Assessment Criteria for Specific Exit-Level Outcome 3.2

• Apply science and technology efficiently and in a manner demonstrating responsibility towards the health of the patient, society and the environment (including the occupational environment) (case studies, oral examinations).
• Demonstrate the ability to apply principles of cost-effectiveness in the utilization of resources (case studies and case presentations).

Associated Assessment Criteria for Specific Exit-Level Outcome 3.3

• Be able to define and work with a "community" (case studies on community project).
• Demonstrate an awareness of socio-economic and environmental causes of ill health and the limits of the biomedical approach in addressing these (oral examinations, written examinations, OSCE).
• Surveillance skills: Demonstrate knowledge of the process and procedures for monitoring community health (case studies and projects).

Associated Assessment Criteria for Specific Exit-Level Outcome 3.4

• Demonstrate the ability to impart relevant knowledge (case presentations, peer group discussions).
• Demonstrate the ability to influence attitudes of the community towards safer health practices (case studies, community project).

Associated Assessment Criteria for Exit-Level Outcome 4 and Specific Exit-Level Outcome 4.1

The learner should be able to demonstrate

• An understanding of qualitative and quantitative research method and audit methods and knowledge and ability to apply results in practice (research protocol and dissertation).
• Submit a protocol, data and dissertation throughout the 4 years of the programme in accordance with standards laid down by the University and professional board.

Associated Assessment Criteria for Exit-Level Outcome 5 and Specific Exit-Level Outcome 5.1

• Perform an audit of personal professional practice by, for instance peer review.
• Identify learning needs, for instance through compiling a learning portfolio.

Associated Assessment Criteria for Specific Exit-Level Outcome 5.2

• Perform an audit of personal professional practice by, for instance peer review.
• Identify learning needs, for instance through compiling a learning portfolio.

Associated Assessment Criteria for Specific Exit-Level Outcome 5.3

• Formulate and submit a plan to address learning needs.
• Evaluate success of actions (case report).

Associated Assessment Criteria for Exit-Level Outcome 6 and Specific Exit-Level Outcome 6.1

• Demonstrate knowledge of principles of confidentiality, counseling and consent (oral examination and OSCE).

Integrated Assessment

Integrated assessment consists of research protocol and dissertation, case studies, elective module portfolios (CPD reports, case studies, articles read, clinical supervision report, workshop report and CPD report), written, oral and clinical/practical examinations.