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Paediatric Cardiology


Short-term attachment


1 Year Diploma

Masters' Programme

DEPARTMENTAL STAFF

Head of Department:
J Lawrenson, MBBCh Witwatersrand MMed Cape Town FCP SA

Senior Lecturers Full-time:
G Comitis, MBChB Cape Town DCH DipAnaes FCPaed SA
R De Decker, MSc MBChB Cape Town DCH London CertMedGenet (Paed) FCPaed SA

Contact:
Dr John Lawrenson
Email: John.Lawrenson@uct.ac.za

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

LOCATION:
The Paediatric Cardiology Service of the Western Cape is a cross-platform unit that serves patients both at the Red Cross Children’s Hospital in Rondebosch and the Tygerberg Children’s Hospital in Bellville.

AREA OF TRAINING:

consultative services and in-patient care is at both sites; children undergo cardiac catheterisation at Red Cross hospital. In addition, we see newborn patients suspected of having heart disease in the neonatal services at Groote Schuur, Tygerberg and Mowbray Maternity Hospitals. We also work closely with our colleagues in the fetal medicine units as well as in the Adult cardiology services of Tygerberg and Groote Schuur Hospitals. We help our surgical and critical care colleagues care for the patients who have undergone cardiac surgery at Red Cross Hospital. - See more at: http://www.paediatrics.uct.ac.za/scah/clinicalservices/medical/paediatriccardiology#sthash.BqQP0I9o.dpuf

Consultative services and in-patient care is at both sites; children undergo cardiac catheterisation at the Red Cross Children's Hospital. In addition, newborn patients suspected of having heart disease in the neonatal services at Groote Schuur, Tygerberg and Mowbray Maternity Hospitals are also seenl. The department also work closely with colleagues in the fetal medicine units as well as in the Adult cardiology services of Tygerberg and Groote Schuur Hospitals. The Department helps the surgical and critical care colleagues care for the patients who have undergone cardiac surgery at Red Cross Children's Hospital. - The trainees spend from one year up to 3 years training in the paediatric cardiology unit focusing on clinical and echocardiology skills; in addition newborn patients suspected of having heart disease in the neonatal services at Groote Schuur, Tygerberg and Mowbray Maternity Hospitals are seen as well.

ONSITE EXPECTATIONS:
Trainees participate as full members of the clinical team. Out of hours attendance is optional, but daytime attendance (08.00-17.00) is essential to attain adequate teaching and clinical exposure time.

ADDITIONAL ACTIVITIES:
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. Trainees are expected to participate in research activities.    

TRAINING OPTIONS: 
Three years (3 years) of clinical training. Tainees complete with an accredited exit examination  (College of Medicine exam).
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MASTERS PROGRAMME

MPHIL SUBSPECIALISATION IN PAEDIATRIC CARDIOLOGY
Convener: Dr J Lawrenson (Department of Paediatrics & Child Health)

Duration of training
FME41  Three years of clinical training, one year of research and completion of the dissertation.

Curriculum outline
FME42  The curriculum outline is as follows:

   NQFcredits  HEQSFlevel
PED7012W -    MPhil Paediatric Cardiology  Part 1  120  9
PED7022W -    Paediatric Cardiology minor dissertation       60  9
                                                                                                Total NQF credits:  180  

   
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 Subframework (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.
•    Master’s degree (exit level 9): Minimum total credits: 180. Minimum credits at HEQSF level 9: 120; maximum credits at
     HEQSF level 8: 60 (a full dissertation master’s will be 180 credits at HEQSF level 9). A Professional Master’s degree may
     have a reduced research component of at least 45 credits.

Courses for MPhil subspecialisation in Paediatric Cardiology:

PED7012W - MPHIL PAEDIATRIC CARDIOLOGY PART 1
NQF credits: 120 at HEQSF level 9
Convener: Dr J Lawrenson
Course entry requirements: None
Course outline: This training programme forms part of the credentialling process of specialist paediatricians to become subspecialists in paediatric cardiology. Students follow the relevant curriculum of the College of Paediatricians of South Africa and, on successful completion of the sub-specialty Certificate in Cardiology of the College of Paediatricians of South Africa: Cert Cardiology(SA) Paed, are granted credit towards PED7012W. The curriculum includes basic knowledge of relevant aspects of embryology; anatomy; genetics; epidemiology of congenital heart disease; physiology; vascular biology and pathology; haemostasis; pathophysiology; pharmacology; radiology imaging and radiation safety; ultrasound; some knowledge of new developments in cardiology; as well as clinical cardiac conditions and management strategies for congenital heart disease, acquired heart disease, resuscitation and advanced cardiac life support including care of the patient with a duct dependent circulation; diagnostic cardiac catheterisation; percutaneous interventions; echocardiography; cardiac imaging; ECG evaluation; exercise testing; electrophysiology; related knowledge of pacemakers; and the principles of post-operative management including haemodynamic monitoring and the use of inotropes and vasodilators. For the detailed curriculum, see the regulations of relevant College of Paediatricians at www.collegemedsa.ac.za.

Document Links:
Certificate in Cardiology (SA) Paed Portfolio 
Certificate in Cardiology (SA) Paed Regulations

DP requirements:  At least 24 months’ training as a subspeciality trainee in an accredited subspeciality unit; a written report from the head of the institution/programme; a satisfactorily completed portfolio; 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-author or co-authored manuscript in a peer-reviewed journal.
Assessment: Candidates write the relevant examination of the College of Paediatricians of South Africa. The examination comprises a written and an oral/OSCE/OSPE/clinical component. Each of the two components contributes 50% to the overall mark. The pass mark for the overall examination is 50%.

PED7022W - PAEDIATRIC CARDIOLOGY MINOR DISSERTATION 
NQF credits: 60 at HEQSF level 9
Convener:  Dr J Lawrenson
Course entry requirements: None
Course outline: The minor dissertation, prepared under supervision, is a requirement for those senior registrars who wish to graduate with the MPhil degree. Those who choose not to complete a dissertation may register with the HPCSA as subspecialists after successful completion of the relevant College of Medicine Part 1 examination. The dissertation must be between 15 000 and 20 000 words in length, and must be on a topic in paediatric endocrinology. It must be based, moreover, on a study the work for which was commenced while the candidate was registered as a postgraduate student. The dissertation should generally be on a clinical topic and of a standard publishable in a peer-reviewed medical journal. Students are trained in statistics, in research methods, in conducting literature reviews, and in designing a research proposal. Having obtained formal ethics approval, where necessary, they analyse the results of their research and write up the dissertation. In some disciplines they are also required to present the work at a congress and submit the research for publication.
DP requirements: None
Assessment: External examination of the minor dissertation.
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ONE YEAR POSTGRADUATE DIPLOMA

POSTGRADUATE DIPLOMA IN CLINICAL PAEDIATRIC CARDIOLOGY
Convener:  Dr R De Decker (Department of Paediatrics and Child Health)

The key objective of the postgraduate diploma is to allow practising doctors to develop foundation skills in clinical paediatric cardiology. This will enable the accurate diagnosis, effective resuscitation, triage and initial management of children with congenital and acquired heart disease safely and effectively in resource-limited areas, without the immediate supervision of a paediatrician or subspecialist paediatric cardiologist.

The qualification aims to strengthen and deepen their knowledge in the field of paediatric cardiology, thereby building capacity to improve child health in Africa. This empowers these working professionals to undertake advanced reflection and development in this sub-area of their practice by means of training which is targeted at current thinking and practice methods in the area of paediatric cardiology, and allows these skilled workers to use their knowledge gained to lobby for improving child health
.

Admission requirements:
FPD1.1
To be eligible for consideration for admission, a candidate shall
(a) have an approved Bachelor of Medicine and Bachelor of Surgery degree (MBChB) or equivalent qualification as a medical doctor, proven experience working in the field of paediatrics, and be registered as a medical practitioner with the HPCSA for the entire duration of the course or an equivalent Health Professions authority in the foreign candidate’s country of origin;
(b) have submitted a letter of support from his/her employer(s) granting the applicant study leave for the time requiring full-time attendance;
(c) have proven proficiency in written and spoken English, including medical terminology (this may be tested if necessary); and
(d) have an acceptable level of computer literacy, and access to a computer and the internet.

FPD1.2
Preference shall be given to candidates who are currently working in the field of paediatrics and have demonstrated a need for this training to the benefit of their medical practice.

FPD1.3
Applicants may be asked to attend an interview or to take part in a telephonic or Skype interview.

FPD1.4
Written assurance must be given that the candidate will be able to return to his/her clinical practice of origin before the onset of the course, or show that the candidate will be accepted into clinical practice where the newly attained skills are required and will be implemented.

Structure and duration of Diploma
FPD2.1
The Diploma may be completed over one year full-time or two years part-time. It consists of three courses, which total 12 months of contact time for the entire Diploma. Additional time should be set aside for self-study, practical work and the completion of assignments.

FPD2.2
Students are expected to be fully immersed in those routine clinical activities of the cardiology department at Red Cross War Memorial Children’s Hospital that add experiential learning content, including shared after-hours on-call duties.

Curriculum
FPD3: The curriculum outline is as follows:

   NQF credits HSQSF level
PED4034W   -  Clinical Management of Paediatric Cardiology    40  8
PED4035W   -  Echocardiography: Principles and Practice    50  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 Subframework (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.
•    Master’s degree (exit level 9): Minimum total credits: 180. Minimum credits at HEQSF level 9: 120; maximum credits at
     HEQSFlevel 8: 60 (a full dissertation master’s will be 180 credits at HEQSF level 9). A Professional Master’s degree may
     have a reduced research component of at least 45 credits.

FPF4.1
Students are assessed by means of clinical assessment, assignments, a logbook and final examinations. Assessments may be of a practical, written and/or oral nature.

FPF4.2
Students who obtain 45% – 49% in an examination may be reassessed before the final mark is submitted for approval of the Faculty Examinations Committee, and/or may be granted a supplementary examination at the discretion of the Faculty Examinations Committee.

FPF4.3
Students may be permitted to repeat a course they have failed, at the convener’s discretion. No course may be repeated more than once. Where a candidate fails any course twice, or fails more than one course, a recommendation will be made to the Faculty Examinations Committee to refuse readmission.

FPF4.4
Where a supplementary examination is granted, the mark obtained in the supplementary examination constitutes the final mark for the course.

Distinction
FPF5
The Diploma may be awarded with distinction (75% – 100% average with not less than 70% for any course). All courses must be passed at first attempt.

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Courses for Postgraduate Diploma in Clinical Paediatric Cardiology:

PED4031W:  CLINICAL MANAGEMENT IN PAEDIATRIC CARDIOLOGY
NQF credits: 40 NQF credits at HEQSF level 8
Convener:  Dr R De Decker
Course entry requirements: None
Course outline:  This course aims to train qualified general practitioners to practise clinical paediatric cardiology in order to enable the diagnosis, resuscitation, triage and management of children with congenital and acquired heart disease. It does not aim to train the candidate to become a paediatric cardiologist, but rather to practice safely and effectively in resource-limited areas without the immediate supervision of a paediatric cardiologist. Students should become proficient in the following: Routine management of new patients, including the initiation of appropriate acute treatment and long-term management plans; emergency management and resuscitation; selection and triage for tertiary referral; post-operative care; long-term follow-up of post-operative patients and their potential complications (i.e. not immediate post-op ICU care); ethics, rational case selection and difficult decisions; ECG, defibrillation and cardioversion; echocardiography; pericardiocentesis; proficiency in appropriate referral; and communication and counselling of parents. Clinical training takes place via grand rounds, general and speciality meetings, group meetings and interactive sessions, ward rounds and clinical outpatient interactions, and supervisions. Students also partake in supportive multidisciplinary meetings. Key to development of clinical skills is practical workplace experience obtained in one-on-one teaching sessions.
DP requirements: Satisfactory completion of a logbook.
Assessment: Coursework assessment (ongoing): 50%. Final examination: A one-hour clinical MCQ (multiple-choice question) paper (30%) and a one-hour clinical case-based oral (20%). The logbook will be assessed as a part of the final examination. A student failing to obtain 50% for the individual components will have one reassessment. If the student scores more than 40%, but less than 50%, the student will undergo a reassessment for which a minimum mark of 50% may be obtained.

PED4035W CLINICAL MANAGEMENT IN PAEDIATRIC ECHOCARDIOGRAPHY
NQF Credits: 50 at HEQSF level 8
Convener: Dr R De Decker
Course entry requirements: None
Course outline: This course aims to develop expertise in the use of echocardiography to make accurate assessments of the anatomy and function of normal and diseased hearts to inform management decisions. This includes the principles of ultrasonology, the technical capabilities and limitations of echocardiography, a sound knowledge and application of the various routine echocardiographic views of the heart and related structures, and relevant ancillary techniques (e.g. bubblegrams).
DP requirements: Attendance of and participation in all academic requirements and completion of assignments by the due dates.
Assessment: Final examination: 100%

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 healthcare 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 the 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

{Short term attachments are accepted in the department but require careful planning in consultation with referring supervisors. HPCSA registration is not attained for short attachments and as such observation only is possible.}