Master of Medicine in Psychiatry

Purpose

The purpose of the Master of Medicine in Psychiatry is to equip candidates with skills to manage different problems found in the daily specialist psychiatrist practice, provide knowledge and understanding of common diseases, and the skills to intervene at the points where patients need real assistance to save lives and maintain mental health and well-being. The South African population requires well-grounded psychiatry registrars with knowledge, understanding, and skills in a variety of pathological conditions. This qualification aims to meet these demands.

Furthermore, this qualification will enhance the ability and competence to assist and empower patients in the rural environment through families, groups, organisations and communities to do health promotion and the problem-solving capacities, the ability to promote, restore, maintain and enhance through prevention measures the health of individuals, families, groups and communities by enabling them to accomplish tasks, prevent and alleviate distress and use resources effectively and the skills to work effectively within teams, through knowledge and understanding of both the South African and the global health context and the ability to implement development approach.

Secondly, the qualification will develop the higher-order research skills of medical practitioners to become capable psychiatrists by enabling the development of the attitudes and abilities needed to become an independent researcher and to accept the responsibility for continuous lifelong professional development. The qualification will develop the ability to critically evaluate and interpret the relevant literature and to apply it in the profession, which will enable the planning, execution, interpretation, and publication of advanced and independent research relevant to the discipline (program). It will, furthermore, prepare learners who aspire to move to the highest level of academic work for doctoral study and to promote an approach based on academic integrity and ethics and contributing to the pool of academics and professionals with the competence and critical intellectual abilities to ensure the future advancement of the chosen speciality and to make provision for the country's need for a skilled workforce of the highest calibre and to ensure that the country stays competitive in an era of growing global competition. The qualification will thus enhance evidence-based healthcare practice and stimulate further research for best practices in the rapidly evolving health field.

Rationale

South Africa, especially the Eastern Cape Province, is rated among the poorest areas with one of the lowest numbers of psychiatrists per 100,000 population. This qualification will address a specific scarce skills shortage. The qualification will therefore contribute to increasing local expertise in mental health, and it will consequently improve the care of patients with mental health problems in the rural areas.

The Eastern Cape MEC for Health revealed in August 2018 that there are only three medical specialists for every 100,000 people in the Eastern Cape. This supports the need for medical specialist training in the province. Research done indicates the necessity for medical practitioners and specialists to have research skills. The qualification will make a positive contribution to the provision of research-oriented medical practitioners and specialists in South Africa, especially in the Eastern Cape.

The institution, due to its geographic position, is serving a province with a huge shortage of specialists in the various fields of Medicine and with a need for knowledgeable, competent, and innovative researchers addressing problems in the different fields of Medicine. The availability of suitably qualified researchers is of cardinal importance to ensure high-level inputs towards dealing with healthcare in the province and nationally.

In terms of the Health Policy and Planning (2021), the distribution and attributes of practising psychiatrists were compared with international figures on the ratio of psychiatrists per 100,000 population. In April 2019, there were 850 qualified psychiatrists actively practising in the country, and based on the national population figure of 55.6 million people, the psychiatrists per 100,000 ratio was 1.53. This indicates no improvement between 2016 to 2019. From the South African Society of Psychiatrists database, it was determined that about 80% of psychiatrists are working in the private sector, a much higher proportion than is usually quoted. As the vast majority of psychiatrists are practicing in urban areas in two provinces, Gauteng (n=350) and Western Cape (n=292), the ratio of psychiatrists per 100 000 in these areas is relatively higher at 2.6 and 5.0, respectively, whereas rural areas in South Africa are largely without specialist mental health expertise at a rate of 0.03 per 100 000 population. This investigation provided a discipline-specific situational review of the attributes and distribution of the current workforce of specialists in the country.

The qualification will offer an opportunity to develop young black doctors in rural communities in South Africa, especially in the Eastern Cape Province, to avoid migration to other parts of the country, which in turn will encourage retention of skills within the province. This will also mitigate against the challenges of difficulty in accessing services. With the inbuilt capability of research into the program, this can enable targeted research focused on identifying and solving province-specific and region-specific health challenges, thereby enabling homegrown innovation and solutions. This qualification provides opportunities for future training and development of registrars in Psychiatry in the medical schools in South Africa. The applied competence and skills derived from their training in Psychiatry are sufficient to allow them to be accredited specialists with registration recognition with the Health Professions Council of South Africa (HPCSA).

The Master of Medicine is a follow-up for the current Bachelor of Medicine and Bachelor of Surgery at NQF level 8. Additionally, the qualification provides a path for developing new knowledge in the field, which will also contribute to higher education.

Recognition of Prior Learning (RPL)

RPL for exemption from modules

Exemption from modules will apply to learners who have

• Passed the relevant Part 1 and/or Part 2 of the College of Medicine of South Africa (CMSA) or Master of Medicine examinations from another university in South Africa.
• Had Registrar training of one year or more in an accredited institution or hospital elsewhere in South Africa.

Entry Requirements

The minimum entry requirement for this qualification is

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

And

• Registration with the HPCSA as a medical practitioner, Independent Practice

And

• Appointment to a Registrar's post recognised by the HPCSA.

And

• All applicants must have satisfied all prescribed Medical Internship and Community Service requirements as stipulated by the HPCSA.

And

• Applicants must have passed Part I of the Fellowship of the College of Psychiatrists with the CMSA.

This qualification consists of the following compulsory modules at National Qualifications Framework Level 9, totalling 480 Credits.

Compulsory Modules, NQF Level 9, 480 Credits

• Introduction to Basic Psychiatry, 40 Credits.
• Neuroanatomy and Neurophysiology, 30 Credits.
• Psychopharmacology I, 20 Credits.
• Behavioural Sciences (Psychology), 30 Credits.
• General Psychiatry, 45 Credits.
• Neuropsychiatry, 15 Credits.
• Clinical/Practical Portfolio I, 60 Credits.
• Forensic Psychiatry, 20 Credits.
• Child/Adolescent Psychiatry, 20 Credits.
• Community Psychiatry, 20 Credits.
• Addiction Psychiatry, 20 Credits.
• Psychotherapy and Counselling, 20
• Psychopharmacology II, 20 Credits.
• Clinical/Practical Portfolio II, 60 Credits.
• Research Project, 60 Credits.

1. Establish and develop professional relationships founded on knowledge of and insight into the nature of client systems and their dynamics.
2. Demonstrate the ability to undertake a comprehensive analysis of the patient's medical, psychological and social problems, needs and strengths.
3. Demonstrate the ability to plan and implement appropriate social work intervention strategies and techniques at micro, mezzo and macro levels.
4. Demonstrate the ability to access and utilise resources appropriate to client systems` needs and strengths.
5. Demonstrate the ability to produce and maintain records of clinical work interventions, processes and outcomes.
6. Demonstrate the ability to evaluate the outcomes of clinical work intervention strategies, techniques and processes.
7. Demonstrate the ability to terminate a clinical work intervention.
8. Demonstrate the ability to negotiate and utilise contracts during clinical work intervention.
9. Apply clinical work values while interacting with human diversity.
10. Demonstrate the ability to appraise and implement the ethical principles and values of clinical work.
11. Demonstrate the ability to use, plan and execute clinical work research.
12. Work effectively with clinical support and other members of inter-sectoral and multi- and/or inter-disciplinary teams on the clinical service delivery platform.
13. Demonstrate the ability to identify, select and implement various techniques, methods and means of advocacy, raising awareness, developing critical consciousness about the structural forces of oppression, exclusion and disempowerment, and use such awareness to engage people as change agents.
14. Demonstrate the ability to assess and analyse human behaviour about the biopsychosocial, cultural and spiritual approaches and explanations.
15. Demonstrate the ability to critically appraise clinical work from a global, regional (African) and national perspective.
16. Demonstrate the ability to critically appraise the status and position of the Psychiatry profession within the South African welfare context.
17. Apply and uphold the basic values and principles enshrined in the Bill of Rights in the S.A. Constitution in relation to clinical work service delivery.
18. Elucidate national, provincial and local governance structures, and the general laws and charters governing the practice of psychiatry.
19. Practice the how of health policies and legislation on medical issues, impact on these issues, and how to use legislation ethically and accountably in order to protect and improve the quality of life of patients and to promote mental health and well-being
20. Practice the how of clinical welfare policy and legislation is developed and influenced.
21. Apply the roles, functions, knowledge and skills for effective clinical work supervision and consultation.
22. Apply roles, functions, principles and characteristics of management and administration within health service delivery.
23. Demonstrate the ability to formulate a business plan for the funding of health services.
24. Demonstrate the ability to identify the influence of the relationship between socio-political and economic factors on health services.
25. Apply the roles and functions of the clinical worker within relevant statutory frameworks.
26. Demonstrate the ability to identify how mental health and well-being are used optimally for the benefit of societies.
27. Demonstrate the ability to identify the purpose, functions and principles of medical work within the psychosocial and mental health paradigm.

Associated Assessment Criteria for Exit Level Outcome 1

• Develop and maintain professional doctor-patient relationships with patients while supporting relatives
• Establish professional relationships characterised by the purposeful implementation of ethical principles, respect for the patients, family, group, and community.
• Demonstrate an understanding of ethical parameters in professional relationships.
• Create enabling environments for patients and families to develop their full capacity.

Associated Assessment Criteria for Exit Level Outcome 2

• Assess patients` social and occupational functioning
• Analyse the patients' needs to reflect strengths and apply appropriate theoretical frameworks.
• Use appropriate clinical work tools and data in the assessments.
• Reflect the influence of medical, psychological, cultural, and social circumstances and social systems, with a focus on the patient's functioning in the assessments.
• Apply the holistic assessment approach to the patient's problems.
• Agree upon reasonable and possible mutual goals in the assessment result.
• Systematically and accurately record assessment processes and conclusions.

Associated Assessment Criteria for Exit Level Outcome 3

• Take into account patients' circumstances in the Intervention plans and discuss the impact on functioning.
• Compile assessment intervention plans and use appropriate strategies and techniques to achieve identified goals.
• Base intervention strategies, models, and techniques on comprehensive assessments.
• Apply intervention strategies and techniques to achieve identified goals.
• Appropriately apply a range of skills, for example, communication, problem-solving, networking, negotiation, mediation, advocacy, and interviewing skills in the interventions.
• Appropriately implement intervention strategies and techniques following relevant theoretical assumptions.

Associated Assessment Criteria for Exit Level Outcome 4

• Identify and utilise resources appropriate to the patient's systems` needs, strengths, and goals.
• Refer appropriate resources according to agreed-upon referral methods.
• Link networking with resources and organisations directly to the needs of the patient and relatives

Associated Assessment Criteria for Exit Level Outcome 5

• Accurately and thoroughly take notes and file all relevant reports according to agreed-upon time frames, standards, and procedures.
• Accurately document all intervention activities, processes and outcomes in the reports according to agreed-upon or prescribed formats.
• Channel reports as per prescribed procedures, when necessary.

Associated Assessment Criteria for Exit Level Outcome 6

• Clearly describe the outcomes of the intervention strategies, techniques, and processes utilised to achieve the stated goals and client systems` strengths and needs in the evaluations.
• Purposefully use evaluations for planning, termination, and implementation of ongoing services.
• Demonstrate a capacity for self-awareness and reflection in the evaluations.

Associated Assessment Criteria for Exit Level Outcome 7

• Mutually agree, wherever feasible, on the termination of services with relevant parties following social work principles.
• Timeously and realistically prepare client systems for termination of services.
• Base termination of services on the achievement of goals and the client systems` ability to function independently.
• Complete all administrative aspects of termination per professional requirements.

Associated Assessment Criteria for Exit Level Outcome 8

• Include reasonable and mutually agreed upon principles, expectations, goals, and procedures in contracts.
• Use contracts to guide practice with clients.
• Include in contracts an exposition of possible results/consequences of breaching the mutually agreed upon principles, expectations, goals, and procedures for both the specialist and the patient.

Associated Assessment Criteria for Exit Level Outcome 9

• Analyse assessments, intervention plans, strategies, techniques, and outcomes for sensitivity and diversity.
• Work with diverse patients from different cultures and backgrounds.
• Accommodate different viewpoints and values in the practice, and appreciate these with one`s own views and values.
• Explicitly assess and analyse possible elements of diversity impacting the professional relationship.

Embrace diversity and acceptance in interactions and teamwork within the practice context.

• Conduct appropriate referrals per the unique needs of client systems.

Associated Assessment Criteria for Exit Level Outcome 10

• Demonstrate awareness of ethical principles and implement clinical work values in the practice.
• Critically appraise the practical implications of ethical principles and values for clinical work practice.
• Critique the provisions in the Code of Ethics of the College of Medicine of South Africa with its potential limitations and benefits.
• Recognise the potential impact of personal life experiences and personal values on clinical work practice.

Associated Assessment Criteria for Exit Level Outcome 11

• Apply knowledge and skills in clinical work and research reports.
• Discuss the relationship between knowledge construction, research, and clinical work practice in research reports.
• Develop a well-formulated plan for the research in the research proposals.
• Identify and apply research ethics in the design and implementation of research activity.
• Discuss and apply quantitative and qualitative research paradigms; research designs; sampling procedures, data collection methods, and data analysis.
• Analyse and interpret data and the recommendations in the study findings.
• Apply clinical science theory and research in practice.
• Execute research processes per accepted research protocol.

Associated Assessment Criteria for Exit Level Outcome 12

• Indicate the purpose and value of the team approach in clinical work services.
• Appropriately distinguish between the individual roles and functions of the clinical work team members.
• Practice reflects a critical understanding of the contribution made and valuable role played by volunteers in clinical service delivery.
• Identify and work with sectors relevant to the clinical problem or issue.
• Discuss the roles and functions of team members in a given context, relevant to the learner`s field placement.
• Practice reflects the ethics of teamwork.

Associated Assessment Criteria for Exit Level Outcome 13

• Select techniques, methods, and means of awareness-raising appropriate to the specific clinical issue, the social context, and the level at which such awareness-raising needs to take place.
• Describe the clinical issue (e.g., DSD (Disorder of Sex Development), HIV/AIDS or any disability) that must be targeted for intervention.
• Assist individuals, families, groups, and/or communities to explore alternative approaches to enhance self-esteem.
• Engage people as change agents, advocates, and/or lobbyists by building on the strengths and resources.

Associated Assessment Criteria for Exit Level Outcome 14

• Analyse and elucidate how individual, family, group, and community identities are formed concerning socio-structural forces of oppression and/or exclusion.
• Provide clear indications of how social differentiation and social stratification pave the way for prejudice, ethnocentrism, and discrimination.

Associated Assessment Criteria for Exit Level Outcome 15

• Analyse the key elements, functions, and principles of Psychiatry and mental health.
• Critically examine various psychiatric practice models and assess their impact on clinical service delivery.
• Discuss the historical and current trends in mental health services and clinical work on individuals, families, groups, and communities.

Associated Assessment Criteria for Exit Level Outcome 16

• Outline the core characteristics and qualities of a profession regarding the different disciplines in the clinical medical profession.
• Articulate the characteristics of psychiatry as a profession among different branches of medical practice, with responsibilities and functions.
• Critically appraise the influence of the language and content of policy documents on the image and status of clinical work in South Africa.

Associated Assessment Criteria for Exit Level Outcome 17

• Clearly describe the provisions of the Bill of Rights with their principles and values.
• Discuss the registrar`s role and functions in promoting health services.
• Develop an appropriate plan/strategy to address the infringement of human rights.

Associated Assessment Criteria for Exit Level Outcome 18

• Outline the respective structure, roles, and functions of each sphere of government and their inter-relationships.
• Discuss the roles and functions of the three spheres of government in the provision of health services and the development of health policy plans and legislation.
• Describe relevant sections of legislation and charters and asses their impact on health policy and clinical work practice.

Associated Assessment Criteria for Exit Level Outcome 19

• Describe the nature and extent of social issue/s and clearly explain the impact of health issue/s on individuals, families, groups, and communities.
• Evaluate key strengths and weaknesses of current health policies and legislation concerning the medical problems affecting the population, including clinical work values and principles.
• Identify and describe limitations of the health policy/policies that negatively impact social service delivery and beneficiaries.
• Utilise welfare legislation ethically and accountably in the interests of client systems.

Associated Assessment Criteria for Exit Level Outcome 20

• Describe the steps and phases involved in the social policy and legislation development process.
• Identify role players involved in formulating social policy and legislation at national and provincial levels in terms of the functions that they perform.
• Discuss how individuals, families, groups, organisations, and communities can influence policy and legislation.
• Develop an appropriate plan/strategy to influence social policy and/or legislation in at least one social issue.

Associated Assessment Criteria for Exit Level Outcome 21

• Discuss the roles and responsibilities of the supervisee and the supervisor
• Describe the transition from the role of supervisee to the role of supervisor and discuss the advantages and disadvantages of the different models (including conventional one-to-one supervision, group supervision, peer supervision, and the use of case-conferences and staff development programmes as supervisory contexts) of supervision.
• Discuss the differences and similarities between supervision and consultation
• Discuss the role and responsibilities of the consultant.
• Explain the ethical implications of supervision and consultation
• Utilise supervision effectively in the practice.

Associated Assessment Criteria for Exit Level Outcome 22

• Discuss the qualities, principles, and characteristics of management and administration.
• Describe the skills, roles, and duties of a health manager and administrator.
• Discuss and critique types and theoretical underpinnings of modern management systems.
• Describe the management and administration functions and tasks.
• Explain the meeting procedures and the roles of office bearers.

Associated Assessment Criteria for Exit Level Outcome 23

• Plan, reflect explicitly, and set feasible aims and objectives consistent with an identified problem, as well as elucidate anticipated outcomes within designated time frames.
• Discuss measures for the sustainability of the program/project and indicate a realistic budget.

Associated Assessment Criteria for Exit Level Outcome 24

• Assess the impact of prevailing socio-political ideology and funding policies on organisational functioning and their relation to health development.
• Discuss the challenges facing social service agencies, technological advances, and diminishing clinical service expenditure.

Associated Assessment Criteria for Exit Level Outcome 25

• Analyse criminal justice, mental health, and child and family care policies and legislation.
• Work under statutory and legal requirements in the practice.

Associated Assessment Criteria for Exit Level Outcome 26

• Describe different types of social security benefits available to people in South Africa.
• Discuss how social security benefits are accessed and the relationship between social security benefits and poverty alleviation.

Associated Assessment Criteria for Exit Level Outcome 27

• Discuss the relationship between the purpose, functions, and principles of medical work and psychosocial disciplines, and the development is clearly described.
• Describe the relationship between economic, health, psychosocial, and mental health.
• Discuss the importance of local economic development through income generation and job creation strategies.
• Identify strategies for human and social capital formation within the psychological and mental health paradigm.
• Discuss the links between micro and macro development issues.