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Ambulatory and Emergency Services


Short-term Attachments


1 Year Diploma

DEPARTMENTAL STAFF

Head:
H A Buys, MB ChB (Zim) LRCP LRCS (Edinburgh) MRCP (UK) FCP (SA) MSc (Paed) (UCT)

Senior Lecturers Full-time:
Dr Shirani Naidoo
Dr Tamara Kerbelker, MBChB ATLS ACLS BLS PALS Cape Town DCH FCPaed SA DipHIVMan Griffiths Neuro DipAllergy CertPaedRheum Australia

Contact:
Email: heloise.buys@uct.ac.za

See more detail at: http://www.paediatrics.uct.ac.za/scah/clinicalservices/medical/ambulatory

LOCATION: 
Training in ambulatory and emergency paediatrics is based at Red Cross War Memorial Children’s Hospital in the paediatric emergency resuscitation room, paediatric trauma unit, triage and acute care, the outpatients department, the in-patient short stay and trauma wards. Children are accepted from all referral centres local and further afield, with discussion of stabilisation care. The department is dedicated to paediatrics and cares for acute paediatric medical conditions from primary to quaternary level needs. The unit is a dedicated children’s unit.

AREA OF TRAINING: 
The service is extremely busy caring for a wide range of acute paediatric conditions inclusive of common conditions such as pneumonia, seizures, gastroenteritis, neuroinfections, acute cardiac decompensation, acute kidney injury, paediatric infectious diseases, injury and trauma and other acute or chronic paediatric disorders that decompensate and require acute emergency care. The training is weighted towards clinical exposure and much of the training is through involvement in patient assessment and care. 

ONSITE EXPECTATIONS:
Trainees participate as full members of the clinical team. Out of hours attendance is expected for some of the time, but daytime attendance (08.00-17.00) is essential to attain adequate teaching and clinical exposure time. Only trainees registered for 1 or 2 year attachments will be eligible to be part of active patient care, shorter attachments will be eligible for observation only (see short attachment, period below).     

ADDITIONAL ACTIVITIES: 
All trainees will rotate to mandatory training attachments in Paediatric Anaesthesia, Paediatric Intensive Care, Paediatric Trauma, Neonatal Intensive Care and pre-hospital Emergency Medicine Services.  Time permitting, research projects are encouraged and the supervisors will facilitate this. Trainees are encouraged to become involved in the under and postgraduate teaching program providing their own tutorials and teaching sessions for junior doctors, students and other health practitioners. 

TRAINING OPTIONS: 
For specific focused training needs there is a 1 year PG Diploma in Clinical Paediatric Emergency Care and short-term observational attachments can be supported but these must have a specific and clear outcome in mind to be beneficial.    

PAEDIATRIC EMERGENCY MEDICINE

Currently there is no Masters programme in Ambulatory and Emergency Paediatrics. This area is under development.


ONE YEAR POSTGRADUATE DIPLOMA

POSTGRADUATE DIPLOMA IN CLINICAL PAEDIATRIC EMERGENCY CARE
[Qualification code: MG036. Plan code: MG036PED22]

The key objective of the Diploma is to develop foundational skills in practicing doctors in both routine and complex paediatric emergency care conditions in children, including those from vulnerable populations affected by the neglected diseases of poverty.
Convener: Dr H Buys (Department of Paediatrics and Child Health)

Admission requirements:
FPH1.1 
To be eligible for consideration for admission, a candidate 
(a) shall be a qualified medical doctor (MBChB or equivalent qualification);
(b) must have at least 12 months of general paediatrics or general emergency care experience;
(c) if applying via the African Paediatric Fellowship Programme, must be referred by a tertiary African centre allied to the programme and have demonstrated the need for clinical training in this discipline;
(d) if a doctor qualified in South Africa, must be practising in an outreach setting;
(e) must be registrable with the Health Professions Council of South Africa and registered thus by the time of registration
(f) must be proficient in written and spoken English (this may be assessed if necessary via a skype interview process); and
(g) must have an acceptable level of computer literacy.

FPH1.2
Candidates should be identified by their department heads as potential paediatric emergency care doctors for the care of children and guaranteed employment in that capacity on their return. Since the qualification is designed as an apprenticeship, training is based on a close trainer-to-trainee ratio.

FPH1.3
Applicants may be asked to attend an interview either in person or telephonically.

Duration and structure of the Diploma
FPH2
The Diploma may be completed over one year full-time or two years part-time. It consists of 6 related modules which total 12 months of contact time for the entire Diploma. Additional time should be set aside for self-study. The Diploma places much emphasis on the practical application of theory. Students are expected to practise their clinical skills in their current work environment.

Curriculum
FPH3  The curriculum outline is as follows:

   NQFcredits  HEQSFlevel
PED4040W -   Clinical Management in Paediatric Emergency Care 30    90  8
 PED4032W -  Essay: Transition and Translation of Knowledge    30  8
Total NQF credits:   120  

   
NQF credits and HEQSF course levels: 
All South African tertiary institutions are required to align their qualifications with the prescriptions of the Higher Education Qualifications Sub-framework (that forms part of the National Qualifications Framework). Each qualification has an exit level that relates to the skills that may be expected of candidates who have completed a qualification or course at that HEQSF level. Each qualification also has a minimum number of NQF credits at that HEQSF level. One credit equals 10 notional hours of learning.

The NQF requires the following minimum credits per qualification:
•    Postgraduate Diploma (exit level 8): Minimum total credits: 120. Minimum credits at HEQSF level 8: 120.Assessment, progression and readmission
[Note: These rules must be read in conjunction with the General Rules in the front section of the Handbook.]

FPH4.1 
Assessment is both formative and summative. A student who fails two formative oral, case-based assessments will not obtain a DP and may be required to withdraw. Formative assessment is built on continuous feedback on both knowledge and clinical competence.

FPH4.2
Each course is made up of individual, discrete modules. Unless indicated otherwise, students must pass each module in order to pass the course.

FPH4.3 
Students are required to maintain a logbook of clinical procedures and to submit this by the due date.

FPH4.4
Students are required to submit all supervisors’ reports before the final mark for the relevant course will be released. Should this not be done by the due date, the student will fail the course.

FPH4.5 
Students may be permitted to repeat a module they have failed, at the convener’s discretion. No course may be repeated more than once. Where a candidate fails a course twice, or fails three or more courses, a recommendation will be made to the Faculty Examinations Committee to refuse readmission.

Distinction:
FPH5 
The Diploma may be awarded with distinction (75% – 100% average with not less than 70% for any module). All modules must be passed at first attempt.

Courses for Postgraduate Diploma in Clinical Paediatric Emergency Care:

PED4040W CLINICAL MANAGEMENT IN PAEDIATRIC EMERGENCY CARE
NQF credits: 90 at HEQSF level 8
Convener: Dr H Buys
Course entry requirements: None.
Course outline:  There are six related modules, covering the following: (a) Paediatric Medical Emergency Unit Orientation: the trainee needs to be thoroughly familiar with the workings of the Unit, the communication issues and the laboratory facilities before progressing to the rest of the training module; (b) Trauma Unit module: i.e. initial stabilisation and priority management of children with both complicated and uncomplicated trauma of variable aetiology, both accidental and non-accidental; (c) Emergency Medicine Service module: knowledge and application of the principles and practice of care of children outside of the hospital, including in Emergency Medical Services (EMS.); (d) Paediatric Anaesthesia module: advanced airway management and vascular access for both treatment and monitoring purposes in children. Sedation and analgesia techniques in children; (e) Paediatric Intensive Care (PICU): clinical management of critically ill children and the comprehensive technical aspects surrounding this including monitoring, life support devices, pharmacology, organisational structures, and ethics; (f) Neonatology: knowledge and application of the principles and practice of care of the new-born including premature infants; (g) Paediatric Medical Emergency Unit Consolidation phase (B): a final case-based oral assessment and structured report by the HOD of Emergency and Ambulatory Paediatrics.
DP requirements:  Satisfactory progress reports (formative assessment) from the HODs at the end of each module and submission of completed logbook by the due date.
Assessment: At the end of each module an integrated formative assessment is done. A student failing to obtain 50% for the individual modules will have one opportunity to repeat the module they have failed, at the convener’s discretion. No module may be repeated more than once. The marks for the individual module tests are aggregated to become the course mark. No final examination is written for this course and the aggregate of the module marks comprise the final mark.


PED4032W ESSAY: TRANSITION AND TRANSLATION OF KNOWLEDGE
NQF credits: 30 at HEQSF level 8
Convener: Prof David Woods
Course entry requirements: None
Course outline:  This course equips students to apply the knowledge and insights gained during their training to their home settings. Students will analyse the epidemiology of the centres at which they practise health care and will analyse the healthcare needs of the region, then plan ways in which to apply the knowledge they have gained in the diploma programme to such settings.
DP requirements: Full attendance and completion of all coursework requirements by due dates.
Assessment: Completion of an essay (100%). This is preceded by ongoing assessment of performance through regular clinical supervision/tutorial sessions and coursework tasks. A pass mark of 50% is required for the long essay, failing which the student will be required to make the necessary corrections or improvements and submit the assignment for reassessment. The terms of resubmission of the assignment will be at the discretion of the convener.


SHORT-TERM ATTACHMENTS/OBSERVORSHIP

Duration of training: 1 month maximum
Convener: Dr H Buys

Short term attachments are accepted in the department but require careful planning. Examples are trainees who wish exposure to a very specialised area such as the paediatric trauma unit, or the paediatric resuscitation room. Trainees attend for short attachments to gain insight into how the service is structured to assess which models could be duplicated in their home setting. HPCSA registration is not attained for short attachments and as such observation only is possible (i.e. no direct patient care).