Master of Philosophy in Paediatric Oncology

Purpose

The purpose of this qualification is to build cognitive, clinical and practical skills specific to the Paediatric Oncology to specialists in Oncology.

Upon qualifying the learner will be able to

• Conduct a comprehensive review of leading and current research in the subspecialty to produce significant insight.
• Engage with and critique current practices in Paediatric Oncology.

Rationale

Paediatric Medical Oncology entails the science and clinical care of children with malignancies. It is a multidisciplinary specialty that requires proficiency in medical sciences, clinical medicine, diagnostic medicine, and pharmacology. There is also the need for an understanding of surgical oncology, radiation oncology, and psycho- oncology, including management of grief, palliative care, and bereavement. Paediatric Medical Oncology care involves not only the patient, the child or adolescent, but the child or adolescent's family. It is a clinical subspecialty underlined by the constant interface between science, on-going research, and translation into clinical practice.

An estimated quarter of a million children develop cancer worldwide each year. Of these, approximately 200 000 live in low- and middle-income countries with an estimated survival rate of less than 25%, while in high-income countries the survival rates of 80% have been achieved. With no reliable data from Africa, where only one dedicated national children's cancer register exists, the burden of childhood malignant disease can only be presumed. Assuming a similar rate of childhood malignant disease as in other geographical areas, of between 112 and 140 million, between 46 000 and 57 000 new childhood cancer cases may occur every year in Africa. With continued improvement of urban paediatric primary care and increasing access to medical care of rural populations, the number of diagnosed paediatric cancer cases is expected to increase, adding to the high demands made upon a deficient medical system. Africa has only about 250 paediatric haematologists-oncologists.

While a notable demand for this field of specialisation exists in the country as a whole there are certain provinces in South Africa that do not have neither a Paediatric Oncologist nor a Paediatric Oncology unit. Responding to these challenges the School of Medicine aims to address the longstanding shortage of qualified subspecialists that exist in the field of Paediatric Oncology.

With regards to the 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. In addition, the Health Professions Act 56 of 1974 stipulates regulations relating to this subspeciality in medicine (published under government notice R590 in Government Gazette 22420 of 29 June 2001) which sets the requirements for registration of the subspeciality by a medical specialist with the board and declared that they recognise this subspeciality 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 subspeciality. The rules and regulation of the Health Professions Council of South Africa (HPCSA) and the Colleges of Medicine of South Africa (CMSA) will be adhered to.

Entry Requirements

Admission requirements for the qualification are as follows

• Learners must be registered for independent practice as Paediatric Oncology with the Health Professions Council of South Africa or equivalent for the country of origin.

Or

• Learners must be in possession of a Bachelor of Medicine, Bachelor of Surgery (MBChB) and MMed (paediatrics).

Or

• Followship of the College of Paediatricians; Certificate Paediatric (PAED), the Colleges of Medicine (CMSA).

Or

• Equivalent qualification.

In addition to the above-mentioned entry requirements, the learner must also comply with the HPCSA requirements for registration of a subspeciality 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 complied with all the requirements for registration as a specialist in the basic or one of the basic specialities listed against the relevant subspeciality in regulation 4 of the Act and that they had been registered as a specialist in that speciality.
• 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 subspeciality which had been approved by the board.

The Government Gazettes 17721 Notice No 67 of 1997, in addition stipulates that: "In the case of the subspeciality medical oncology he or she shall, subsequent to having complied with all the requirements for registration in the speciality medicine or paediatrics, obtain two years' clinical experience in medical oncology 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 medical oncology".

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 Paediatric Oncology I, 120 Credits.
• Module 2, Advanced Endocrinology II, 120 Credits.
• Mini-dissertation, 60 Credits.

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

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 Paediatric Oncology practice is chosen.
• Current practices in Paediatric Oncology are appropriately engaged with and critiqued.
• Autonomous ethical decisions are suitably made and effectual contributions to the development of ethical standards in a Paediatric Oncology context are made.
• A range of advanced and specialised skills and discourses appropriate to the practice of Paediatric Oncology 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 Paediatric Oncology 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 Paediatric Oncology.
• A wide range of specialised skills in identifying, conceptualising, designing and implementing methods of enquiry to address complex and challenging problems within the Paediatric Oncology 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, summative assessment is subjected to the Colleges of Medicine of South Africa examination. Fellowship in the Sub-Specialty in Medical Oncology of the College of Paediatricians of South Africa 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 Paediatric Oncology 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, OSCAs and tests) and a clinical assessment (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 Paediatric Oncology environment and leading to the presentation or acceptance for presentation of an original first author research poster or paper at a local or international congress or submission or acceptance for publication of an original first or co-authored manuscript in a peer reviewed journal.

The CMSA also requires a mandatory logbook recording all procedures verified by the Head of the training.

Assessment of a logbook will be kept by the learner to record procedures of the training period. These logbooks are reviewed, monitored and assessed by the Head of Department. The Fellowship examination has two components a written component and an Objective Structure Clinical Examinations (OSCE) component. Each of the two components contributes 50% to the overall mark while the pass mark for the overall exam is 50%. A sub-minimum pass mark of 50% is expected for each of the two (written and the oral/OSCE/clinical) components of the examination.

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.