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African Paediatric Fellowship Programme

Paediatric Critical Care


Short-term attachment


1 Year Diploma

Masters' Programme

DEPARTMENTAL STAFF

Professor and Head:
Andrew Argent, MBBCh MMed (Paed) Witwatersrand MD (Paed) Cape Town DCH FCPaed, CertCritCare SA FRCPCH UK

Senior Lecturers Full-time:
M McCulloch, MBBCh Witwatersrand DCH FCPaed SA
S Salie, MBChB Cape Town DCH London FCPaed CertCritCare SA
J Ahrens, MBChB Cape Town DA DCH FCPaed CertCritCare SA
B Rossouw, MBChB DipTropMed (Paed) MSc (Sports Medicine) Pret CertCritCare SA

Contact:
Professor Andrew Argent
Email: andrew.argent@uct.ac.za

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

LOCATION:
Training in paediatric Critical Care is based at the Red Cross War Memorial Children’s Hospital on the C Floor  which houses the in-patient ward. The service takes care for about 250 post-oprative cardiac patients annually and provide support to general paediatric surgeons, neurosurgeons and transplant programs.  

AREA OF TRAINING:
The service is extremely busy caring for the entire spectrum of paediatric critical care. 

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:
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: 
The encouraged rotation is the 2 years Master’s program, trainees complete with an accredited exit examination and the Master’s. For specific focused training needs there is a 1 year PG Diploma. Short-term observational attachments can be supported but these must have a specific and clear outcome and the involvement of the referring institution is critical.
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MASTERS PROGRAMME

MPHIL SUBSPECIALISATION IN PAEDIATRIC CRITICAL CARE
Convener:  Prof A Argent (Department of Paediatrics & Child Health)

Duration of training
FME43  Two years of clinical training, one year of research and completion of the dissertation.

Curriculum outline
FME44 The curriculum outline is as follows:

   NQFcredits  HEQSFlevel
PED7027W -    MPhil Paediatric Critical Care Part 1  120  9
PED7028W -    Paediatric Critical Care 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 Critical Care:

PED7027W - MPHIL PAEDIATRIC CRITICAL CARE PART 1
NQF credits: 120 at HEQSF level 9
Convener: Prof A Argent
Course entry requirements: Qualification as specialist paediatrician (see FMD1; MPhil programmes in subspeciality disciplines).
Course outline: This training programme forms part of the credentialling process of specialists in paediatrics, internal medicine, anaesthesiology or surgery to become subspecialists in paediatric critical care. Students follow the relevant curriculum of the College of Paediatricians of South Africa and, on successful completion of the relevant Part 1 examination of the College, are granted credit towards PED7027W. Training takes places in critical care facilities for children with acute medical (including cardiac), surgical (including polytrauma), thoracic/cardiac surgical, neurological, neurosurgical and neonatal conditions. The programme extends over a 24-month period which may be divided into sections of not less than six months in length. It is possible to complete the programme at different institutions. Six months of this time may be spent in paediatric traumatology, paediatric cardiology, paediatric pulmonology or neonatology. For the detailed curriculum, see the regulations of the relevant College of Paediatricians at www.collegemedsa.ac.za.

Document Links:
Certificate in Critical Care (SA) Paed Portfolio   
Certificate in Critical Care (SA) Paed Regulations

DP requirements:  Registration as a specialist in an approved discipline; certification of having completed at least 18 months as a subspeciality trainee in an accredited subspeciality unit in a teaching hospital, registered and approved by the Health Professions Council of South Africa; submission of a written report from the Head of the Department and programme in which he/she trained indicating satisfactory completion of all training requirements; and submission of a satisfactorily completed logbook.
Assessment: Candidates write the relevant examination of the College of Paediatricians of South Africa. The examination comprises a written component of which a paper OSCE is a part, and an oral/OSCE component. Each of the two components contributes 50% to the overall mark. A subminimum pass mark of 50% is expected for each of the two (written and the oral) components of the examination.

PED7028W - PAEDIATRIC CRITICAL CARE MINOR DISSERTATION 
NQF credits: 60 at HEQSF level 9
Convener:  Prof A Argent
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 Paediatricians Part 1 examination. The dissertation must be between 15 000 and 20 000 words in length, and must be on a topic in paediatric critical care. 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. The candidate may also be 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 CRITICAL CARE
[MG037PED05][SAQA ID: 94788]
Convener:  Prof A Argent (Department of Paediatrics and Child Health)

The key objective of the diploma is to allow practising doctors to develop skills in the management of children with a life threatening illness or injury, or following major elective surgery. The qualification aims to produce graduates who are trained in the recognition and management of critically ill children, thereby building capacity to improve child health in Africa. This enables and 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, practice and research methods in the area of paediatric critical care, and allows these skilled workers to use their knowledge gained to lobby for improving child health.

Admission requirements:
FPE1.1
To be eligible for consideration for admission, a candidate shall

  • have an approved Bachelor of Medicine and Bachelor of Surgery (MBChB) or equivalent qualification as a medical doctor, experience working in paediatrics, and be registerable with the Health Professions Council of South Africa;
  • have submitted a letter of support from his/her employer granting the applicant study leave for the weeks requiring block attendance, and undertaking to provide support to enable the applicant to complete assigned tasks and assignments within the work context;
  • have proven proficiency in written and spoken English (this may be tested if necessary);
  • have an acceptable level of computer literacy, and access to a computer and the internet.

FPE1.2
Preference shall be given to candidates who are currently working in the field of paediatric critical care and have demonstrated a need for this training to the benefit of their home setting.

FPE1.3
Applicants may be asked to attend an interview or to take part in a telephonic or Skype interview.

Curriculum
FPE4:  The curriculum outline is as follows:

   NQF credits HSQSF level
PED4041W   -  Clinical Management of Paediatric Critical Care    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 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.

FPE4.1
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.

FPE4.2
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.

FPE4.3
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.

FPE4.4
Unless otherwise indicated, students are expected to obtain a subminimum of 50% in the coursework and in the final written examination in each course in order to pass the course. FPE4.5 Where a supplementary examination is granted, the mark obtained in the supplementary examination constitutes the final mark for the course.

Distinction
FPE5
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 Critical Care:

PED4041W CLINICAL MANAGEMENT IN PAEDIATRIC CRITICAL CARE
NQF credits: 90 at HEQSF level 8
Convener:  Prof A Argent
Course entry requirements: None
Course outline:  The purpose of this course is to allow practicing doctors to develop foundation skills in the assessment and management of critically ill children. Training is designed as an apprenticeship, a close trainer-to-trainee ratio, and hands-on experience. It does not aim to train the candidate to become a critical care specialist, but rather to practice safely and effectively in resource-limited areas without the immediate supervision of a specialist. Content includes management of specific organ-related problems and support, including brain injury and brain protective strategies; respiratory problems and support; cardiovascular support; gastrointestinal issues in the PICU building; management of fluids and electrolytes in the PICU; renal failure and renal support therapy in the PICU; haematological problems and management; infection control and utilisation of antibiotic therapy in the PICU environment; musculoskeletal issues in the PICU; skin emergencies and dermatological support in the PICU; and other areas including toxin ingestion or exposure. Students are also expected to attend training on practical management of airway management, vascular access and patient monitoring. Some basic skills in the use of ultrasonography for rapid diagnosis in the PICU setting is taught.
DP requirements: Students need to attend a minimum of 70% of training sessions (including lectures, seminars and tutorials). All assignments must be submitted. A subminimum of 45% for the coursework is required in order to be granted admission to the final examination. The student will be assessed continuously during the coursework. Each module has specific outcome goals which must be completed. Regular reviews with the supervisors are required. Completion by the due date of a logbook is obligatory, documenting the required number of cases.
Assessment: End of training assessment will be a 3 hour paper (with short questions and multiple choice questions), together with an oral examination of 1 hour duration.


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. Trainees have gained from periods of observation when they are deciding how to structure a more formal training program (1 or 2 years). Other 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 observation however HPCSA registration can attained for short term attachments and candidates are advised to apply at least 18 months in advance.