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Paediatric Neurology


Short-term attachment


1 Year Diploma

Masters' Programme

DEPARTMENTAL STAFF

Professor and Head:
J Wilmshurst, MBBS London MRCP UK FCPaed SA MD Cape Town

Senior Lecturer Full-time:
A P Ndondo, MBChB Medunsa FCPaed CertPaedNeuro SA

Senior Lecturers Part-time:
G Riordan, MBChB Cape Town DCH MMed (Paed) FCPaed SA
V Kander, MTech (Neurophysiol) Bloemfontein

Contact:
Head of Department
Prof Jo Wilmshurst
E-mail: jo.wilmshurst@uct.ac.za

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

LOCATION:
Training in paediatric neurology is based at Red Cross War Memorial Childrens’ Hospital in the paediatric neurology department, neurophysiology, the outpatients department, the in-patient dedicated ward as well as the outlying wards where referred patients are based. Children are also assessed in the emergency ward and are accepted from, or management care is discussed with, referral centres local and further afield. The department is dedicated to paediatrics and cares for paediatric neurology conditions from primary to quaternary level needs. The unit is the largest such unit in Southern Africa.

AREA OF TRAINING:
The service is extremely busy caring for a wide range of neurological conditions inclusive of common conditions such as epilepsy and neuroinfections, and rarer disorders such as neuromuscular diseases and metabolic disorders. 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 optional, but daytime attendance (08.30-17.00) 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, 2 year and 1 year training period below).    

ADDITIONAL ACTIVITIES:
All trainees have access to the busy neurophysiology unit which has specific training modules that can be completed (see PG Diploma below).  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 in “basic EEG and management of children with epilepsy” and short-term observational attachments can be supported but these must have a specific and clear outcome in mind to be beneficial.  
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MASTERS PROGRAMME

MPHIL SUBSPECIALISATION IN PAEDIATRIC NEUROLOGY
Duration of training:
24 months
Convener: Prof J Wilmshurst (Department of Paediatrics & Child Health)

Admission requirements
FPG1.1
To be eligible for consideration for admission, a candidate shall
(a)     have an approved Bachelors 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;
(b)     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;
(c)     have proven proficiency in written and spoken English (this may be tested if necessary); and
(d)     have an acceptable level of computer literacy, and access to a computer and the internet.

FPG1.2 
Preference shall be given to candidates who are currently working in the field of paediatric neurology and have demonstrated a need for this training to the benefit of their home setting.

FPG1.3 
Applicants may be asked to attend an interview or to take part in a telephonic or Skype interview.

Duration of training
FMC51 Two years of clinical training and completion of the dissertation.

Curriculum outline
FMC52 The curriculum outline is as follows:

   NQFcredits  HEQSFlevel
PED7025W -    MPhil Paediatric Neurology Part 1  120  9
PED7019W -    Paediatric Neurology minor dissertation        60  9
                                                                                                  Total NQF credits:  180  

      
FPG4.1
Students are assessed continuously through course-related tasks and formal assessments– some conducted under examination conditions.

FPG4.2
Coursework assessment:
(i)    Graded course assignments (written and/or oral). Each course assignment is an opportunity for students to synthesise
       learning objectives and concepts covered in the individual courses. In-course assignments are weighted and contribute
       to the overall assessment per course.
(ii)   Ongoing assessment of performance through regular clinical supervision/tutorial sessions and an assignment.

Courses for MPhil subspecialisation in Paediatric Neurology:

PED7025W - MPHIL PAEDIATRIC NEUROLOGY PART 1
NQF credits: 120 at HEQSF level 9
Convener: Prof J Wilmshurst
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 specialist paediatricians to become subspecialists in paediatric neurology. Students follow the relevant curriculum of the College of Paediatricians of South Africa and, on successful completion of the Certificate in Paediatric Neurology examination of the College, are granted credit towards
PED7025W. This encompasses the study, assessment and management of a wide spectrum of neurological diseases from the new-born period to adolescence. General consensus accepts that it should include expertise in cerebral palsy, childhood epileptic syndromes, strokes, disorders of the spine, hydrocephalus, neuro-cutaneous disorders, neuromuscular disorders, children with movement disorders, CNS tumours, neuro-degenerative disorders, neuro-metabolic/inborn errors of metabolism disorders, mental retardation, language and communication (autism) disorders, ADHD and learning disorders, headaches, sleep disorders, neuronal migration disorders, disorders of the cerebellum, neuro-psychiatric disorders, and complimentary involvement in neurosurgical patients. Candidates learn key basic sciences and receive clinical training in a wide range of paediatric neurological conditions. Candidates also gain competence in a range of neurological emergencies and are taught a wide range of rehabilitative therapies. They develop specific clinical skills (e.g. developmental assessment, an understanding of the common psychometric tests, detailed neurological examination and interpretation of results of investigations), as well as teaching skills and research skills. For the detailed curriculum, see the regulations of the relevant College of Paediatricians at www.collegemedsa.ac.za.
DP requirements: 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 institution/programme in which he/she trained indicating satisfactory completion of all training requirements; submission of a satisfactorily completed portfolio; presentation or acceptance for presentation of a first-author research poster or paper at a local (i.e. PANDA SA meeting) 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 component of which the OSCE is part, and a 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.

PED7026W - PAEDIATRIC NEUROLOGY MINOR DISSERTATION 
NQF credits: 60 at HEQSF level 9
Convener: Prof J Wilmshurst
Course entry requirements: Qualification as specialist paediatrician (see FMD1; MPhil programmes in subspeciality disciplines).
Course outline: The minor dissertation, prepared under supervision, is a requirement for those senior registrars who wish to graduate with the MPhil degree. Those with a South African specialist paediatric qualification who are South African Citizens, who choose not to complete a dissertation, may register with the HPCSA as subspecialists after successful completion of the Certificate in Paediatric Neurology examination of the College of Paediatricians of South Africa. The dissertation may be submitted in “publication-ready format” including a publication-ready manuscript of not more than 3 000 words and a separate introduction, or it may be submitted as a standard monograph, usually must be between 15 000 and 20 000 words in length, and must be on a topic in paediatric neurology. It must be based, moreover, on a study the work for which was commenced while the candidate was registered as a postgraduate student. The findings of the dissertation should contribute to the scientific understanding of the topic. Students are trained in statistics, in research methods, in conducting literature reviews, in designing a research proposal, and in writing a dissertation. The candidate may also be required to present the work at a congress and submit the research for publication.
DP requirements: Approval of the research proposal by head of the relevant departmental research committee, the supervisor(s), the Health Science’s Human Research Ethics Committee, and the chair of the relevant master’s committee.
Assessment: External examination of the minor dissertation.
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ONE YEAR POSTGRADUATE DIPLOMA

POSTGRADUATE DIPLOMA IN CLINICAL PAEDIATRIC ELECTROPHYSIOLOGY AND EPILEPSY
[Qualification code: MG033. Plan code: MG033PED21]

Duration of training: 12 months
Convener: Prof J Wilmshurst (Department of Paediatrics & Child Health, Paediatric Neurology)

The key objective of the Diploma is to allow practising doctors to develop foundation skills in clinical electrophysiology and epilepsy to ensure safe practice. The qualification aims to produce graduates who are trained in the discipline to strengthen and deepen their knowledge in the field of paediatric EEG and epilepsy, 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 EEG and epilepsy, and allows these skilled workers to use the knowledge gained to lobby for improving child health.

Courses for Postgraduate Diploma in Clinical Paediatric Electrophysiology and Epilepsy:

PED4037W - CLINICAL MANAGEMENT OF CLINICAL PAEDIATRIC ELECTROPHYSIOLOGY AND EPILEPSY
NQF credits: 90 at HEQSF level 8
Conveners: Prof J Wilmshurst and Dr V Kander
Course entry requirements: None
Course outline: This course provides students with foundation skills in clinical electrophysiologyand epilepsy to ensure safe practice. Students are exposed to the field of paediatric EEG andepilepsy; they learn how to perform, interpret and use information attained from EEGs to improvetheir patient care. They learn basic principles of epilepsy management in children. The student will undertake a combination of dedicated clinical exposure with the paediatric neurology staff in the clinical service for children with epilepsy (the logbook will record the number of patients and the range of conditions and will be signed by the clinical supervisor). This will focus the appropriate criteria to request an EEG, how the EEG can assist in the patient diagnosis and management, and recognition of key epilepsy syndromes. The student should gain insight into the key recommended interventions and medications for children with epilepsy. The student should understand the associated co-morbidities of epilepsy and the various epilepsy syndromes. The student will be expected to read from the recommended reading list, to have insight into the key epilepsy conditions which can be recognised through EEG testing, and the logbook will document the number of studies successfully interpreted extending beyond the EEG findings to the clinical syndrome (signed by the clinical supervisor and the technologist).
DP requirements: Students need to attend a minimum of 70% of lectures. All assignments must be submitted. A subminimum of 45% for the coursework is required in order to be granted admission to the final examination. Each module has specific outcome goals which must be completed. Regular reviews with the supervisors will be required. Logbook completion requires students to document the required number of cases (minimum n=50 for EEG performed, n=100 for EEG interpretation, two formal complex clinical cases formally summarised and management challenges identified, and document n=50 clinical cases reviewed).
Assessment: End-of-training assessment will be a one-hour paper (written paper – based on illustrative EEG cases n=20) requiring interpretation of the EEG and the clinical relevance of the findings.

PED4032W - ESSAY: TRANSITION AND TRANSLATION OF KNOWLEDGE
NQF credits: 30 at HEQSF level 8
Conveners: Prof J Wilmshurst, Prof David Woods, Dr V Kander and Dr A Ndondo
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.

Admission requirements
FPG1.1
To be eligible for consideration for admission, a candidate shall
(a)     have an approved Bachelors 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;
(b)     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;
(c)     have proven proficiency in written and spoken English (this may be tested if necessary); and
(d)     have an acceptable level of computer literacy, and access to a computer and the internet.

FPG1.2 
Preference shall be given to candidates who are currently working in the field of paediatric epilepsy and have demonstrated a need for this training to the benefit of their home setting.

FPG1.3 
Applicants may be asked to attend an interview or to take part in a telephonic or Skype interview.

Duration and structure of the programme
FPG2 
The Diploma may be completed over one year full-time or two years part-time. It consists of blocks which total six months of contact time for the entire Diploma. Additional time should be set aside for self-study, practical work and the completion of assignments. Written examinations are scheduled for the end-of-year.

Curriculum
FPG3  The curriculum outline is as follows:

   NQF credits HSQSF level
PED4037W   -  Clinical Management of Paediatric Epilepsy     90  8
PED4032W   -  Essay: Transition and Translation Of Knowledge    30  8
                                                                                                                    Total NQF credits:  120  


FPG4.1
Students are assessed continuously through course-related tasks and formal assessments– some conducted under examination conditions.

FPG4.2
Coursework assessment:
(ii)    Graded course assignments (written and/or oral). Each course assignment is an opportunity for students to synthesise
        learning objectives and concepts covered in the individual courses. In-course assignments are weighted and contribute
        to the overall assessment per course.
(ii)    Ongoing assessment of performance through regular clinical supervision/tutorial sessions and an assignment.

Distinction
FPG5
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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SHORT-TERM ATTACHMENTS

Duration of training: 3-6 months
Convener: Prof J Wilmshurst

{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 metabolic service, or the neuromuscular service. 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 short attachments and as such observation only is possible.}