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African Paediatric Fellowship Programme

Paediatric Nephrology


Short-term attachment


1 Year Diploma

Masters' Programme

DEPARTMENTAL STAFF

Head of Department:
P Gajjar, MBChB DCH FCP CertPaedNephrol

Senior Lecturer Full-time:
P Nourse, MBChB MMed Cape Town FCP SA CertPaedNephrol

Senior Lecturers Part-time:
Jonathan Buckley, MBChB  FCP SA CertPaedNephrol

Contact:
Head of Department
Dr P Gajjar
E-mail: priya.gajjar@uct.ac.za

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

LOCATION:
The Renal unit is situated in ward E2 at the Red Cross Children's Hospital. A 25 bedded sub-specialty paediatric ward of which 12 beds are allocated to renal (including up to 5 transplant patients). The unit includes dialysis facilities. There are, in addition seven beds at Tygerberg Hospital. The department admit between 30-40 patients per month (400/yr) and the ward also has six High-care beds and a well staffed day ward.

AREA OF TRAINING:
The department provides a renal support service to an active 26 bedded Intensive care Unit, including provision of acute peritoneal dialysis, acute Haemodialysis and CVVH (continuous veno-venous hemodialysis) .This service extends to all subspecialty services, esp. cardiothoracics, oncology, paediatric surgery. We have four haemodialysis machines (two able to do haemodiafiltration) and one CVVH machine. The two dialysis technicians are paediatric trained and highly committed to the programme. 40 to 50 patients managed with acute PD per year. Peritoneal dialysis equipment is available to dialyse small infants as light as 2kgs. We are able to offer plasmapheresis for children

ONSITE EXPECTATIONS:
Trainees participate in the nephrology ward helping to manage patients post transplant on acute and chronic dialysis as well as general nephrology OPD: helping to manage outpatients in general nephrology and transplant After hours: One weekend call a month as well one week call per week. This is always done with consultant as second on call. The aim of this is mainly for teaching because much of the nephrology work occurs after hours. 

ADDITIONAL ACTIVITIES:
The Fellow is expected to participate in research activities. Fellows are expected to assist in training of undergraduate as well as registrars in paediatric nephrology.

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. 

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MASTERS PROGRAMME

MPHIL SUBSPECIALISATION IN PAEDIATRIC NEPHROLOGY

Conveners: Dr P Gajjar and Dr P Nourse (Department of Paediatrics & Child Health)

Duration of training
FMC49
Two years of clinical training, one year of research and completion of the dissertation.

Curriculum outline
FMC50 The curriculum outline is as follows:

   NQFcredits  HEQSFlevel
PED7009W -  MPhil Paediatric Nephrology Part 1   120  9
PED7019W -  Paediatric Nephrology minor dissertation        60  9
                                                                                                  Total NQF credits:  180  







COURSES FOR MPHIL SUBSPECIALISATION IN PAEDIATRIC NEPHROLOGY:

PED7009W MPHIL PAEDIATRIC NEPHROLOGY PART 1
NQF credits: 120 at HEQSF level 9
Convener: Dr P Gajjar
Course entry requirements: FCPaeds or equivalent.
Course outline: This training programme forms part of the credentialling process of specialist paediatricians to become subspecialists in paediatric nephrology. 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 PED7009W. Students learn to deal specifically with paediatric renal conditions in a South African setting, both in inpatient and outpatient situations, but also acquire a sound knowledge of basic sciences (genetics, embryology of the kidneys and urinary tract; anatomy and histology, molecular biology etc.) as these relate to the subspeciality. Training covers specific paediatric renal problems, ranging from paediatric urinary tract infections, management of nephrotic syndrome and acute kidney injury; principles of imaging of the renal tract; diagnosis and management of a range of kidney diseases; renal support to other specialities e.g. paediatric cardiology, endocrinology and oncology; kidney disorders of adolescents; paediatric dialysis; knowledge of renal transplantation; to pharmacokinetic and practice principles in children with respect to normal and impaired renal function. Candidates receive training in specific clinical skills related to paediatric nephrology which includes urinalysis and interpretation of renal function tests; placement of acute dialysis catheters, principles of dialysis, renal biopsy and ultrasound. For the detailed curriculum, see the regulations of the relevant College of Paediatricians at www.collegemedsa.ac.za.
DP requirements: At least 18 months as a subspeciality trainee in an accredited subspeciality unit in a teaching hospital; a written report from the head of the institution/programme; a satisfactorily completed logbook; presentation or acceptance for presentation of an original first-author research poster or paper at a local or international congress or meeting, 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 component and an oral/OSCE/OSPE/clinical 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/OSCE/clinical) components of the examination.

PED7019W PAEDIATRIC NEPHROLOGY MINOR DISSERTATION
NQF credits:
60 at HEQSF level 9
Convener: Dr P Gajjar
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 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 nephrology. 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 NEPHROLOGY
[Qualification code: MG040. Plan code: MG040PED08. Subject to accreditation by the HEQC.]
Convener: Dr P Gajjar (Department of Paediatrics and Child Health: Paediatric Nephrology)

The aim is to train suitable candidates to practice clinical paediatric nephrology in order to enable them to manage basic and complex paediatric nephrology in children, including those from vulnerable populations affected by diseases of poverty.

Admission requirements
FPK1
Bachelor of Medicine and Bachelor of Surgery (MBChB) or equivalent qualification as a medical doctor, with work experience in the field of paediatrics. Successful applicants must be registered with the Health Professions Council of South Africa by the time they
start their training.

Selection criteria
FPK2.1
Interested applicants from outside of South Africa will be screened through the African Paediatric Fellowship Programme. They must meet the inclusion and exclusion criteria set out by the APFP: (See http://www.scah.uct.ac.za/apfp/.) Applicants must
(a)   be supported by a tertiary African centre allied to the APFP;
(b)   have a letter of support from their employers granting them study leave where applicable;
(c)   submit proof of funding by the APFP and the referring centre;
(d)   provide proof that they will return to the home institution to a post in the government/public sector to fulfil a healthcare need;
(e)   have proven proficiency in written and spoken English (this may be tested if necessary); and
(f)    have an acceptable level of computer literacy, and access to a computer and the internet.

FPK2.2
South African trained doctors must submit proof of the need to gain the skills provided by the Diploma programme, with the aim to facilitate better care of tertiary renal conditions at a secondary level institution. 

FPK2.3
All applicants may be asked to attend a telephonic or Skype interview.

Structure and duration of Diploma
FPK3
The training is based at the Red Cross Children’s War Memorial Hospital. It is a one year full-time or two-year part-time programme.

Curriculum
FPK4   The curriculum outline is as follows:

   NQFcredits  HEQSFlevel
PED4044W  -  Clinical Management in Paediatric Nephrology    90  8
PED4032W  -  Essay: Transition and Translation of Knowledge    30  8
                                                                                                  Total NQF credits:  120  




 


Courses for Postgraduate Diploma in Clinical Paediatric 

PED4044W - CLINICAL MANAGEMENT IN PAEDIATRIC NEPHROLOGY
NQF credits:
90 at HEQSF level 8
Convener: Dr P Gajjar
Course entry requirements: None
Course outline: The aim is to train suitable candidates to practice clinical paediatric nephrology in order to enable them to manage basic and complex paediatric nephrology in children, including those from vulnerable populations affected by diseases of poverty. At the end of the course, the student will have knowledge in:
(i) clinical paediatric nephrology disease clinical markers;
(ii) procedures relevant to patients with nephrology disease;
(iii) interpretation of results and early initiation of acute interventions; and
(iv) management of nephrology disorders.
DP requirements: Completion of a logbook including management of cases and procedures. Students are required to attend at least 70% of group supervision sessions if attending full-time, and at least 50% of attendance is expected if attending part-time.
Assessment: Formative assessment comprises regular assessments of level of competency achieved throughout the course and are undertaken at four-monthly intervals (40%); Students’ range of experience as documented in their assessment and logbooks (20%.) Summative assessment comprise a final oral examination (40%). 

PED4032W - ESSAY: TRANSITION AND TRANSLATION OF KNOWLEDGE
NQF credits:
30 at HEQSF level 8
Conveners: Dr P Gajjar
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. 

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SHORT-TERM ATTACHMENTS

Duration of training: 3-6 months
Convener: Dr P Gajjar

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}.