Master of Philosophy in Clinical Haematology

Purpose

The purpose of this qualification is to build cognitive, clinical and practical skills specific to Clinical Haematology.

Upon qualifying the learner will be able to

• Acquire theoretical knowledge about haematological disorders as well as practical skills and experience in clinical haematology in order to assess patients clinically, request, perform and interpret the necessary laboratory tests and prescribe the appropriate prophylactic and / or curative treatment.
• Engage in independent research and produce findings in the form of a research report from a range of appropriate research designs, methods, techniques and technologies in the chosen focus area.
• Critically assess existing literature, clinical and laboratory data, and solve complex or unusual clinical haematological problems, based on a thorough understanding of disease mechanisms and pathophysiology.

Rationale

Clinical Haematology is recognised and prescribed in terms of Subsection (2) of Section 35 of the Health Professions Act, Act 56 of 1974, subject to Regulation 4, as a Registerable Subspeciality of the Basic Speciality Medicine, Paediatrics and Pathology (Haematological) with the designation Clinical Haematologist. The Master in Clinical Haematology addresses the need for capacity building and the development of scarce skills in the management of haematological disorders in South Africa. Although various stakeholders in the health services sector, such as physicians, paediatricians, and pathologists are daily confronted with haematological problems, minimal opportunities for training in this subspecialist area exist. In alignment with the vision of the National Department of Health, this qualification intends to develop expert knowledge and competencies in the subspeciality Clinical Haematology. The requirement for the services provided by Clinical Haematologists is expected to increase, with the growth in consumer demand due to population growth, ageing, the increasing incidence of haematological malignancies, and the expanding treatment options.

The advancement of knowledge and expertise with in such a subspeciality based on the currently identified emerging developments includes the:

• Advances in medical technology.
• Expected increase in availability of complex and expensive investigative tests and procedures.
• Expected technological advances in chemotherapy and immunotherapy.
• Increased use of powerful and expensive drugs. These developments will result in a need for Haematologists to provide expert interpretative analysis and opinion and a growth in consumer demand specifically with the increasing incidence of

haematological malignancies.

The Master of Philosophy in Clinical Haematology also relates to the Minister of Health's creation of the sub-specialty of Clinical Haematology in Notice 67, Regulation 5838 published in Government Gazette no. 17721 of 17 January 1997. This addressed the need to bridge the gap between the general physician and the haematological pathologist. A Clinical Haematologist must be able to manage both the clinical and laboratory aspects of haematology. The Clinical Haematologist manages both non-malignant and malignant haematological disorders. The diagnosis and management of haematological cancers (like leukaemia) differ significantly from those of solid tumours. The latter are treated by medical and radiation oncologists. Clinical Haematologists are ideal professionals to perform stem cell transplants. Haematological conditions cannot be managed without the constant support of the diagnostic haematology laboratory. These laboratories also apply special techniques like flow cytometry and molecular biology.

At the moment there are �60 Clinical Haematologists in South Africa. The ratio of 60 per 50 million South Africans is far below that in the UK, where there is a ratio of 13.2 Haematologists per million of the population. This would translate into South Africa needing over 600 Clinical Haematologists.

The Health Professions Council of South Africa (HPCSA) recognise this sub-speciality qualification.

In addition the Medical and Dental Professional Board of the Health Professions Council of South Africa created the new sub-speciality of clinical haematology in response to the request to unify the laboratory and clinical aspects of haematology.

Recognition of Prior Learning (RPL)

RPL for access

In exceptional cases, based on merit, where applicants do not meet the minimum admission requirements a learner will be considered for access in compliance with the institution's RPL Policy. This includes approval of the faculty committee, on their commendation of the academic Head of Department, with notification to the Executive Committee of Senate ECS. RPL will be granted on the strength of a standard of proficiency that is sufficient for the purposes of postgraduate advanced study in the sub-speciality. The rules and regulation of the HPCSA and the Colleges of Medicine of South Africa (CMSA) will be adhered to.

RPL for exemption

Based on the RPL Policy of the institution, learners may be granted exemption from required components of the qualification, fully or partially, on the basis of comparable training and clinical experience in the specific sub-speciality.

Entry Requirements

Admission requirements for the qualification are as follows

• Learners must be registered for independent practice as a Specialist Physician or Haematological Pathologist with the Health Professions Council of South Africa or equivalent for the country of origin.

And

• Learners must be in possession of Bachelor of Medicine and Bachelor of Surgery (MBChB) and M Med (Haematology), FCP (SA) (College Fellowship).

This qualification comprises compulsory modules at NQF Level 9, totalling 300 Credits. Two directions can be followed in this qualification:

Option 1, Specialists in Medicine

• Clinical Haematology for Physicians (Module I and Module II), 240 Credits.
• Mini-dissertation, 60 Credits.

Option 2, Specialists in Pathology (Haematological)

• Clinical Haematology for Pathologists (Module I and Module II), 240 Credits.
• Mini-dissertation, 60 Credits.

1. Acquire theoretical knowledge about haematological disorders as well as practical skills and experience in clinical haematology in order to assess patients clinically, request, perform and interpret the necessary laboratory tests and prescribe the appropriate prophylactic and / or curative treatment.
2. Engage in independent research and produce findings in the form of a research report from a range of appropriate research designs, methods, techniques and technologies in the chosen focus area.
3. Critically assess existing literature, clinical and laboratory data, and solve complex or unusual clinical haematological problems, based on a thorough understanding of disease mechanisms and pathophysiology.

Associated Assessment Criteria for Exit Level Outcome 1

• Problems and issues are analysed to reflect a purposeful and critical application of advanced theory, current knowledge and expertise in the chosen focus area.
• Interventions and/or recommendations are applied to reflect purposeful and creative plans to seek solutions based theory and proven methods in the chosen field.
• Application of appropriate skills, strategies and techniques are used in discussions and/or interventions in accordance with corresponding theoretical assumptions in the chosen field.
• Evaluations comprehensively describe outcomes of interventions, techniques, strategies or processes in relation to the stated goals and in accordance with corresponding theoretical assumptions.
• Outcomes and evaluations are critically analysed in accordance with the identified needs and issues within the chosen focus area.
• Evaluations are purposefully used as the basis for planning, implementing and making recommendations.

Associated Assessment Criteria for Exit Level Outcome 2

• Current literature and research are accessed, analysed and organised systematically in the chosen focus area.
• Effective application of the principles of research practice are applied in the chosen focus area.
• Conclusions and recommendations are justified by the use of appropriate evidence and arguments.

Associated Assessment Criteria for Exit Level Outcome 3

• Clear, answerable research questions as they pertain to the discipline of Clinical Haematology are formulated.
• The most appropriate methodology to address the research question(s) is identified and used.
• All relevant information, including research and review articles, textbooks and guidelines are found by accessing internet databases and employing appropriate search strategies.
• The relevant literature is critically evaluated and an appropriate literature review is written.
• A research protocol is formulated and written.
• The study is conducted, the data analysed and logical, evidence-based conclusions from the data are drawn.
• The results of the research are presented and defended in an acceptable scientific format.

Integrated Assessment

The qualification provides for both formative and summative assessments. The formative assessment will focus not only on theoretical knowledge, but also on the integration of knowledge and competencies during practical examination sessions that include clinical cases. For the purposes of this qualification's summative assessment learners will be subjected to the Colleges of Medicine of South Africa examination (CMSA) and Fellowship in Clinical Haematology of the Colleges of Physicians and Pathologists of South Africa Exit Examinations of the Colleges of Medicine of South Africa examination (CMSA). Learners will be required to write an exit examination and practical examinations, learners will also be required to engage in a research project and to submit a mini-dissertation.

The assessment approach of the qualification is based on the principles of integrated assessment since the assessment activities are focused on the different dimensions of the purpose of the qualification which is to reflect critically on theory and its application. Integrated assessment will take the form of an appropriate variety of assessments methods for example; written and oral examinations, problem-solving assignments, projects, presentations, case studies, portfolios, logbooks, clinical reports, assessment of clinical competence through simulated and clinical assessment in situ, Objective Structure Clinical Examinations (OSCE) and the successful completion of a mini-dissertation.

Assessment associated with the Clinical Haematology curriculum is undertaken within the context of the learner's every day clinical practice. As such it is implemented within their ability of current workplace and work force issues and the needs of health service provision. Where applied competence is required, theory and practice are integrated and aligned with the level descriptors of an NQF Exit Level 9 qualification. Each module consists of both theoretical (assignments, Objective Structure Clinical Examinations (OSCAs) and tests) and clinical assessments (case studies and demonstration of clinical procedures) which challenges learners to integrate the knowledge and skills acquired and to deal with complex issues both systematically and creatively. The research project challenges learners to design and critically appraise research, make sound judgments using data and information at their disposal and communicate their conclusions clearly to specialist and non-specialist audiences in the Clinical Haematology environment.

The Colleges of Medicine (CMSA) also requires a critical portfolio of evidence.

Three major elements are drawn together in the assessment of the experiential learning in the programme, i.e. preparation, collaboration and reflection. In addition, networking forms apart of learners' self-assessment through discussion with peers and experts in the field. Learners will attend departmental seminars where issues of progression in their tasks and clinical practice are raised, assessed and corrective action, if needed, arranged. Learners' involvement in their research project and the logbook and/or portfolio also serves as assessment of the experiential learning since their progress and actions are needed to close the gap between desired and actual levels of performance are reflected on and addressed.