Undergraduate Teaching Programme

The Department of Medicine convenes courses for MBChB students in their 3^rd, 4^th, 5^th and 6^th years of study. Each class has approximately 200 - 220 students. The students spend the longest periods of time in the Department in 4^th year (12 weeks) and 6^th year (8 weeks). The teaching during these 4^th and 6^th rotations consists of in-person seminars, high quality video seminars and additional on-line material hosted on the UCT’s Vula platform, bedside consultant-led tutorials and ward rounds, and practical learning as junior members of a medical firm admitting patients to hospital and being involved in their ward management under clinical supervision. The students are assigned to be part of medical firms at Mitchells Plain Hospital, Victoria Hospital Wynberg, New Somerset Hospital, George Hospital or Groote Schuur Hospital. The 4^th and 6^th year students also each spend 2 weeks in the Ambucare Clinic in the Groote Schuur Hospital Medical Outpatients Department assessing ambulatory medicine patients and developing management plans under clinical supervision.  There is also a 2-week block run by the Division of Emergency Medicine in 4^th and 6^th years. Every division within the Department assists in the teaching, training, and assessment of the undergraduate students. Assessment is in the form of in-block continuous assessment, portfolios documenting clinical cases that are examined, multiple choice question exams and clinical exams.

Because we needed to adapt to an on-line learning platform during 2020 when students were away from campus during Level 5 Covid-19 restrictions, the Department of Medicine spent several weeks of intense preparation overhauling and enriching our existing on-line teaching content to develop a robust E-learning platform. This aligned with our long-term objectives to provide a substantial amount of the theoretical content for students on-line while focussing our in-person teaching around clinical experience and bedside teaching in the wards. Our E-learning platform, hosted on Vula, is now a comprehensive offering that is structured for easy navigation.

Introduction to Clinical Practice: Semester 6 (3^rd Year  MBChB)

This multidisciplinary semester is run by the Department of Medicine. It is designed to consolidate and expand the clinical skills developed in the earlier semesters of the MBChB curriculum. Students spend a series of five 3-week attachments rotating through the domains of Adult Health (attachments to the medical wards and Emergency Unit at Groote Schuur Hospital); Women's Health (introduction to gynaecological examination and assessment); Perinatal Health (introductory obstetrics and neonatology); Mental Health (introduction to psychiatric and geriatric assessment); Clinical Skills (intensive training in Basic Life Support); ENT and ophthalmoscopic examination, electrocardiography and technical skills such as phlebotomy and catheterisation.

Medicine: Semesters 7 - 8 (4^th Year MBChB)

4th year MBChB students spend 8 weeks on their Ward Care rotation in the Department of Medicine. They undertake their learning in one of our four teaching hospitals in Cape Town (Groote Schuur, Mitchells Plain, New Somerset, and Victoria). The first week of their rotation is in the form of an orientation ‘Bootcamp’ which takes place at Groote Schuur Hospital and is designed to impart the foundational knowledge and skills the students will need during their time on the clinical platform over the subsequent 7 weeks. More details of this initiative, introduced by the Department in 2021, are available at this link:

https://www.news.uct.ac.za/article/-2021-03-03-bootcamp-prepares-fourth-year-medical-students-for-clinical-practice

Students spend another 4 weeks during their Ambulatory Care block learning Medicine. This block is comprised of Ambucare (in the Groote Schuur Hospital Medical Outpatients Department) and Acute Care, during which students undertake practical learning in the Emergency Centres at our four major teaching hospitals.

The 4^th year teaching programme was extensively updated in 2020 to incorporate blended learning, with the UCT Vula website hosting more than 47 video seminars recorded by senior clinical staff in the Department across all the sub-specialities, supplementary academic content and self-assessments. Our teaching platform for these students also includes tutorials via video conferencing, high-quality clinical bedside teaching, and the opportunity for students to be mentored by all ranks of medical and nursing professionals in a clinical environment. We emphasise that learning during their Ward Care block should be within the context of belonging to a clinical team, focussing learning in four domains: clinical skills, clinical knowledge, professionalism, and effective teamwork.

Medicine: Semesters 9 - 10 (5^th Year MBChB)

In their fifth year, medical students spend time in the following specialised areas of internal medicine: Neurology, Dermatology, Pharmacology and Rheumatology.

Neurology

Primary undergraduate teaching of neurology occurs during a 4-week clinical neuroscience block, which is integrated with neurosurgery teaching. It involves consultant-led bedside tutorials, topic-specific seminars, attendance at outpatient clinics and online learning resources, as well as a 30-MCQ end-of-block examination. The aim of the course is to provide undergraduates with basic competencies in taking a neurological history, eliciting neurological signs and the principles of basic investigation and management of common neurological conditions such as stoke, epilepsy, movement disorders and neuromuscular conditions.

Dermatology

The 5^th year dermatology teaching course is shared with ENT as part of a 4-week block during the mixed specialities rotation. The learning objectives are to enable students to diagnose and manage common and emergency dermatological conditions. During this block students will be exposed to patients in the out-patient setting at Groote Schuur Hospital and Red Cross Hospital as well as the dermatology ward. The course makes use of a variety of teaching methods, including both interactive face to face tutorials, bedside tutorials, on-line large group tutorials as well as a web-based self-directed learning component. The assessment consists of an end of block MCQ exam and the production and presentation of a patient information tool.

Pharmacology

The objective of training in pharmacology and therapeutics is to enable students to develop the skills required to prescribe essential medicines rationally in the management of common conditions. The course builds on the foundation of Pharmacology and Applied Therapeutics learnt in 4th year. The course focuses on applying understanding of pharmacokinetics and pharmacodynamics to the management of common conditions. It aims to equip students with the skills for critically appraising evidence and judging the risk-benefit profiles of available treatment options and promotes rational drug prescribing to ensure optimal patient care.

Rheumatology

Rheumatology is a two-week rotation at Groote Schuur Hospital. During this time students are exposed to a series of patient encounters in the outpatient’s department and medical or orthopaedic wards. Clinical teaching sessions are based on patients specifically brought in to teach students about their arthritis. These encounters cover the broad scope of common musculoskeletal conditions such as rheumatoid arthritis, gout, fibromyalgia, and osteoarthritis. Students are expected to acquire skills in the examination of the musculoskeletal system, knowledge of common musculoskeletal conditions, formulate a differential diagnosis for a patient with musculoskeletal complaints and choose and interpret appropriate laboratory and radiological investigations for these problems.

Medicine: Semesters 11 - 12 (6^th Year MBChB)

Our final year MBChB curriculum includes 8 weeks of Medicine. The Medicine block is divided into 4 weeks of Ward Care, and 4 weeks of Ambulatory Care of which 2 weeks is spent in Ambucare and 2 weeks in Acute Care.

During the 4 weeks of Ward Care, students learn as part of the clinical teams across our 4 teaching hospitals in Cape Town (Groote Schuur, Mitchells Plain, Victoria, and New Somerset Hospital). They are involved in the day-to-day care and management of patients, they join post-intake and follow-up ward rounds, participate in calls and are expected to function as student interns. As part of their assessment, they are expected to present and discuss patients with their registrars and consultants and keep a portfolio of patients for presentation at the end of their block.

Ambucare is done in the MOPD / Rapid Access Clinic at Groote Schuur Hospital’s Outpatient building. The objective for these students is to gain confidence and make independent, but supervised, decisions after making their own clinical assessment of patients in the outpatient clinic setting. They assess patients that are follow-ups from either the ward or emergency unit, or new patients that are referred in for specialist investigation and management.

During Acute Care, students spend time in the Emergency Units at our teaching hospitals evaluating patients with undifferentiated clinical complaints in an emergency setting. The objective of this rotation is to ensure students gain confidence in dealing with common medical emergencies and prepare them for dealing with typical emergencies that they will encounter during their internship.

The 6^th year MBChB students also have access to a comprehensive online learning platform which comprises of voiced-over seminars, podcasts, case-based approaches to common medical complaints, clinical guidelines, selected journal articles and other supplementary learning material.

As a part of this 6^th year programme, a sub-group of students in the class spend the year at George Provincial Hospital where they undertake a rotation that mirrors the rotation undertaken by students based in Cape Town. Colleagues in the Department of Medicine at George Hospital undertake the Medicine teaching for those students.

Intercalated MBChB students

Our intercalated students are MBChB students, who take a gap year from their medical studies between 3^rd and 4^th year to complete an BSc (Med) Honours. During this time, research is their primary focus. However, to ensure that their clinical skills and knowledge are retained, the Department of Medicine concurrently runs a clinical rotation for these students. This rotation consists of weekly bedside tutorials, with the teaching shared by Medicine, Women’s Health and Perinatal Health.

Specialist Training

The Department of Medicine trains a large number of specialists in internal medicine and its associated subspecialties. Our trainees are appointed as registrars and follow a 4-year training programme following which they present themselves for the fellowship examinations set by the College of Physicians of South Africa. If successful, they are awarded the FCP(SA) qualification and are eligible for registration as specialists with the Health Professions Council of South Africa. During their training, our registrars are placed on a rotation during which they are attached for 3 months at a time to a specific Department, Unit or Division. Approximately half this time is spent in general medicine at Groote Schuur Hospital, our district hospitals and the Brooklyn Chest Hospital. Here they gain experience in a wide cross section of medicine at both secondary and tertiary levels. The remainder of the time is spent attached to various Divisions with a subspecialist focus, including Cardiology, Geriatric Medicine, Gastroenterology, Hepatology, Infectious Diseases, Nephrology, Neurology, Respiratory Medicine, and Rheumatology. Some of this time may also be spent in the Emergency Unit, the Coronary Care Unit or the Respiratory Intensive Care Unit at Groote Schuur Hospital. The Divisions of Dermatology, Neurology and Clinical Pharmacology train their own registrars towards their Fellowships in Dermatology, Neurology or Clinical Pharmacology and subsequent registration as specialists.

Subspecialty training is provided in most divisions. Senior Registrars are selected for sub-specialist training. To be eligible the candidate must have already qualified as a specialist and wish to train further in a specific subspeciality. At the completion of training and after meeting requirements and successfully completing examinations, this leads to formal certification through the Colleges of Medicine and registration with the HPCSA as a subspecialist.

Masters Degrees

Our registrars, training as specialists within the clinical disciplines, are registered for the MMed (Master of Medicine) degree. This is a two-part degree awarded on satisfactory completion of their clinical examinations, and the submission of a dissertation based on original scientific investigation. Within the basic sciences, we also have post-graduate students undertaking the MSc degree. We also have post-graduate students registered for the MPhil degree in various fields, including bioethics and epidemiology.