Master of Philosophy in Gastroenterology

Purpose

Gastroenterology is a wide and complex specialty, including a wide variety of digestive diseases that require competence in clinical as well as in procedural skills. The purpose of the Master of Philosophy in Gastroenterology is to provide an adequate intellectual environment for acquiring the knowledge, clinical judgment, skills, attitudes, and professional values that are essential for practicing Gastroenterology. This qualification covers only medical gastroenterology which leads to the registration as a medical gastroenterologist who is competent to provide unsupervised comprehensive medical care in gastroenterology at consultant level.

This MPhil (Gastroenterology) also has as its purpose to advance research and training in the sub - speciality.

Rationale

Gastroenterologists perform the bulk of research involving gastrointestinal endoscopic procedures as well as the interpretation of results, and are considered experts in the field. Studies have shown that Gastroenterologists perform higher quality colonoscopy examinations and comprehensive consultative services when compared to other physicians. This translates into more accurate detection of polyps and cancer by colonoscopy when performed by Gastroenterologists, fewer complications from procedures and fewer days in the hospital for many gastrointestinal conditions managed by trained gastroenterology specialists. It is this ability to provide more complete, accurate, and thorough care for patients with gastrointestinal conditions, which distinguishes Gastroenterologists from other physicians that provide similar services - this serves as rationale to present this sub - speciality. Gastroenterology is recognised and prescribed in terms of subsection (2) of section 35 of the Health Professions Act 56 of 1974, subject to regulation 4, as a Registrable Sub-speciality of the Basic Speciality Medicine with the designation Gastroenterologist. Gastroenterology as a subspecialty of Internal Medicine provides learners with the ability to provide high quality, comprehensive care for patients with a wide variety of gastrointestinal diseases.

South Africa has a critical shortage of qualified gastroenterologists to address the worldwide pandemic of gastrointestinal and liver diseases like inflammatory bowel disease, chronic viral hepatitis, HIV - related gastrointestinal complications. This qualification will aim to address the need to properly train clinicians with a thorough understanding of and experience in clinical research in the field of Gastroenterology. Similar to all subspecialty qualifications in medicine, learners will be qualified physicians whom have obtained their M Med (Internal Medicine) or Fellowship of the College of Physicians of South Africa (FCP) (SA) qualification.

The Master of Philosophy in Gastroenterology allows a learner to obtain a nationally recognized qualification that permits access to horizontally and vertically articulated qualifications within the National Qualifications Sub - Framework, enhancing the status and employability of medical specialists committed to Gastroenterology. This recognition underscores the investment in and necessity for scarce skills development, the building of specialised capacity and advanced competency in the field of Medicine, in particular Gastroenterology within the context of advanced learning and in depth research.

The Master of Philosophy in Gastroenterology is a qualification which aims at encouraging life - long learning skills that will enable learners to provide quality health care, particularly related to Gastroenterology. On completion of the qualification the learner will have acquired the necessary research skills and the ability to apply knowledge and solve problems in the field of Gastroenterology.

With regards to stakeholder needs the qualification also meets national requirements since it is aligned with the Higher Education Qualifications Sub - Framework (HEQSF) which supports the goal of expanded access and responsiveness to address emerging skills and knowledge needs and in addition to provide for greater flexibility and options with respect to this professionally-oriented subspecialty qualification to meet the varying needs of the stakeholders and communities they serve. The Health Professions Council of South Africa (HPCSA) as the professional body was consulted to determine whether this particular qualification meets the requirements for professional registration, membership or licensing thus adhering to the criteria that professional bodies have a role, derived from legislation or undertaken in terms of international professional conventions or agreements, to set requirements for professional registration, membership or licensing and to regulate professional conduct in the field of the subspecialty. In addition, the Health Professions Act 56 of 1974 stipulates regulations relating to this sub-speciality in medicine (published under government notice R590 in Government Gazette 22420 of 29 June 2001) sets the requirements for registration of the sub-speciality by a medical specialist with the board and declared that they recognise this sub-speciality qualification.

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 institutional RPL Policy. This includes approval of the faculty committee, on the recommendation of the academic Head of Department, with notification to the Executive Committee of Senate ECS. RPL is 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 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, gained at another institution. The maximum admissible period of exemption is 12 months.

Entry Requirements

Admission requirements for the following qualification are as follows

• Learners must be registered for independent practice as a specialist Internal Medicine physician with the Health Professions Council of South Africa or equivalent for the country of origin.
• Learners must be in possession of Bachelor of Medicine and Bachelor of Surgery (MB ChB) and M Med (Internal Medicine), FCP (SA) (College Fellowship).

Or

• Equivalent qualification.

In addition to the above - mentioned entry requirements, the learner must also comply with the HPCSA requirements for registration of a sub-speciality as follows:

• Submit a certificate to the board, issued by the relevant faculty of medicine or health sciences in South Africa, to certify that - they have obtained education and training in the relevant sub-speciality of at least two years as the holder of a post of sub - speciality trainee approved by the board under control of a unit in a teaching hospital which had been accredited by the board as a teaching unit in the said sub-speciality.
• Submit proof to the board that he or she, prior to commencing with education and training in the relevant sub - speciality, complied with all the requirements for registration as a specialist in the basic or one of the basic specialities listed against the relevant sub-speciality in regulation 4 of the Act and that he or she had been registered as a specialist in that speciality.

Or

• If learner has qualified after 1 January 2002, the learner must submit proof to the board that he or she passed an evaluation in the relevant sub - speciality which had been approved by the board.

The Government Gazette, Gazette No 17721, Notice No 67, Regulation Gazette No. 5838 of 17 January 1997, in addition stipulates that: "In the case of the sub - speciality Gastroenterology he or she shall, subsequent to having complied with all the requirements for registration in the speciality surgery or medicine, obtain two years' clinical experience in Gastroenterology as the incumbent of a clinical appointment acceptable to the council under the control of a unit in a teaching hospital recognised by the council as a training unit in gastroenterology".

This qualification comprises compulsory modules at NQF Level 9, totalling 300 Credits.

Compulsory modules at NQF Level 9 (practical work, skills and procedures)

• Module 1: Advanced Gastroenterology I (Theory and Clinical Practice), 120 Credits.
• Module 2: Advanced Gastroenterology II (Theory and Clinical Practice), 120 Credits.
• Mini - dissertation, 60 Credits.

1. Conduct a comprehensive review of leading and current research in the subspecialty to produce significant insight in Gastroenterology.
2. Engage with current practices in Gastroenterology.

Associated Assessment Criteria for Exit Level Outcome 1

• Current processes of knowledge production are correctly evaluated and an appropriate process of enquiry for the area of Gastroenterology practice is chosen.
• Current practices in Gastroenterology are appropriately engaged with and critiqued.
• Autonomous ethical decisions are suitably made and effectual contributions to the development of ethical standards in a Gastroenterology context are made.
• A range of advanced and specialised skills and discourses appropriate to the practice of Gastroenterology are used to contribute to academic teaching and to the advancement of new knowledge in the subspecialty.
• Autonomous ethical decisions are suitably made and effectual contributions to the development of ethical standards in a Gastroenterology context are made.

Associated Assessment Criteria for Exit Level Outcome 2

• Methods, techniques, processes and technologies are appropriately and creatively selected and applied to complex clinical and theoretical problems in Gastroenterology.
• A wide range of specialised skills in identifying, conceptualising, designing and implementing methods of enquiry to address complex and challenging problems within the Gastroenterology practice are correctly and satisfactorily used.
• Interventions at an appropriate level are clinically correctly made and the intended and unintended consequences of such interventions are appropriately addressed.

Integrated Assessment

The qualification provides for both a formative and summative assessment. The formative assessment focuses 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 are subjected to the Colleges of Medicine of South Africa examination (CMSA). Fellowship in the Sub-Specialty Gastorenterology of the College of Physicians of South Africa: Cert Gastroenterology (SA) Phys. Learners are required to write an exit examination and practical examinations, learners are 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 takes the form of an appropriate variety of assessments methods for example; written and oral examinations, problem-solving assignments, projects, presentations, case studies, portfolios, log books, 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 Gastroenterology curriculum is undertaken within the context of the learner's everyday clinical practice. As such it is implemented within the reality of current workplace and workforce 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 judgements using data and information at their disposal and communicate their conclusions clearly to specialist and non-specialist audiences in the Gastroenterology environment.

The Colleges of Medicine (CMSA) also requires a mandatory logbook recoding all procedures verified, monitored and assessed by the Head of Gastroenterology Unit. Assessment of a logbook will be kept by the learner to record the details of all patients seen, details of research undertaken and manuscripts accepted or submitted for publication in the field of endocrinology and metabolism. These logbooks are reviewed, monitored and assessed by the Head of Department. The exit examination under the auspices of the CMSA consists of a written paper and clinical cases as well as oral examination which may include applied anatomy, physiology, pathology and radiology.

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 a part of learners' self - assessment through discussion with peers and experts in the field. Learners 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 needed to close the gap between desired and actual levels of performance are reflected on and addressed.