Family, Community and Emergency Care
Building inclusive communities of care together
Department of Family, Community and Emergency Care
Overview
The Department of Family, Community and Emergency Care (FaCE) was established by UCT under the leadership of the Faculty of Health Sciences’ deanery and formally approved by Senate in December 2021.
This new department brings five clinical generalist disciplines together, namely:
- Primary Health Care Directorate,
- Division of Family Medicine,
- Division of Interdisciplinary Palliative Care and Medicine,
- Division of Emergency Medicine,
- and Sports and Exercise Medicine.
As a newly formed department, FaCE is in the process of defining its collective Mission Statement and as a first step has agreed on its Massive Transformative Purpose to describe how we envisage moving forward together, as follows:
“Building Inclusive Communities of Care Together”.
The department aims to work alongside the faculty in translating transformation into action to ignite agency for a just and inclusive society built on health equity, and align with the University's Vision 2030 for unleashing human potential. As such social responsiveness, social accountability, diversity, inclusivity and serving the community underpin our vision by producing education and research that is fit for purpose. A bi-weekly online seminar series has been initiated to encourage debate and develop our footprint across the faculty, university, nationally and globally.
Divisions
The Department of Family, Community and Emergency Care includes five Divisions:
The vision of the Primary Health Care Directorate is a Health Science Faculty that promotes equity in health care, guided by the primary health care principles and approach. The Directorate aims to promote the primary health care approach in teaching, research, policy, health services and community engagement by the Faculty of Health Sciences (FHS). Its objectives are to integrate a primary health care approach into the Faculty’s undergraduate and postgraduate curricula by means of extending and developing the Faculty’s clinical teaching platform in rural and primary care sites; deepening community engagement within the health service and the Faculty’s curricula; enhancing the recruitment and support of students of rural origin in the Faculty; and increasing inter-disciplinary research in health sciences.
The Directorate is also pioneering the emerging field of Medical and Health Humanities and has developed humanities-related threads linked to social justice, and explorations of power, privilege and intersecting identities. In addition to incorporating critical reading, thinking, and writing skills into the FHS curricula, the threads also provide a basic introduction to gender, ‘race’, class, sexuality, systems of violence, globalisation, subjectivity, environmental concerns, witnessing, and patient-centred health narratives.
The growing inequities in South African society and the persistent negative effects of the social determinants of health, have been highlighted by the student protests and the call for decolonization of the university and society. As a unit charged with addressing these societal disparities within the FHS, the PHCD has sought to influence the teaching, research and service of each department using the principles of the Primary Health Care Philosophy. Themes of human rights, equity, a holistic approach, community participation, and health promotion have been inserted into a number of existing courses, particularly in the pre-clinical years, with varying degrees of success.
The Primary Health Care Directorate holds the following values as priorities:
- equity and dignity in health outcomes and health care
- environmental justice
- respect for reflexive positionality and diversity
- appreciation of context
- an aspiration towards health for all
Family Medicine has been an independent division at the University of Cape Town since 2001. Our division has a strong tradition of being rooted in multidisciplinary community-based learning with a focus on strengthening primary care. The academic discipline of family medicine and primary care aims to provide holistic care to the whole family unit. It aspires to integrate care both across different healthcare system levels, as well as the traditional boundaries of facility-based and community-based care.
As a division, our strategic goal is to contribute to the body of knowledge that improves individual and community health holistically, build the academic disciplines of primary and palliative care, and produce educational, clinical and research practitioners who are both locally and internationally recognised for their work.
We are extensively involved in learning and teaching across the undergraduate MBChB curriculum, both in the pre-clinical phases: 2nd and 3rd year (Becoming a Doctor, BaDr), as well as clinical phases: 4th and 6th year. At the postgraduate level, we have students enrolled for the Postgraduate Diploma, MMed (registrar) and PhD programmes in Family Medicine. We also provide support to our interns during their 6-month family medicine rotation in their second year of internship. In terms of research, we are committed to growing academic primary care and engaging with local, regional and international collaborators in all domains of primary care research.
Our division has a substantial service delivery and social responsiveness footprint via our joint appointee family physicians at the community learning sites. Our joint staff are enmeshed with the clinical governance activities at the substructure level and provide significant leadership input in the district health system. The academic and PASS staff are involved with social responsiveness activities, including a minor surgical outreach service to local primary care facilities. Hosting our annual General Practitioner Refresher course speaks to our desire to provide relevant lifelong learning opportunities to our primary care community.
Interdisciplinary Palliative Care and Medicine has been an independent division since 2021. IPCM ‘s vision is to strengthen academic and clinical palliative care aiming to ensure better access to sustainable, quality and appropriate palliative care for all ages when indicated, for South Africa and beyond. Since 2002 this division has developed a strong footprint in the undergraduate MBChB program. The division offers a post-graduate diploma in Palliative Care /Medicine and an M.Phil program. The division is proud of its research projects and collaboration with a global research unit aiming to strengthen the healthcare system and ensure distinct African palliative care is accessible to patients and families.
The division actively provides clinical care and works alongside the Department of Health to ensure palliative care is integrated into the South African health setting. Members of the division serve on the national and provincial Palliative Care task teams advocating for quality palliative care. The division is also a proud member of the African Palliative Care Association, assisting in developing the African palliative care community.
We hope to ensure that this division will grow alongside the development of international palliative care practices as an integrated but distinct element of care. It is our vision to grow the leaders of palliative care on the African continent in clinical care, research and as advocates in quality palliative care.
The Division of Emergency Medicine is the oldest academic emergency medicine unit on the continent, having enrolled its first students in 2003. EM graduates are now spread around South Africa and across the continent, leading and challenging the old thinking and providing effective, quality emergency care from the prehospital arena, through hospital Emergency Centres, and across health systems.
We contribute to MBBCh undergraduate training so that UCT medical doctors are able to manage the undifferentiated emergency, but our focus is on postgraduate training across our five programs: the flagship MMed 4 year specialist training program, MPhil which offers a distance coursework and research masters, MSc for a pure research masters, PG Dip is an online year-long introduction to the discipline, and a large PhD program, encouraging future academics and innovative research
The Division has fostered a new generation of researchers, with a focus on developing emergency care in LMIC settings. The change has been rapid from the hospital “casualty”, run by the most junior doctors, to the current specialist run emergency centres, with their role being not only prioritizing and managing emergencies, but also as the gateway to inpatient care, working synchronously with prehospital providers and in hospital teams to make every patient journey efficient, safe and effective.
From Tim Noakes’ early publication titled “The management of head and neck injuries in rugby players” following the death of Chris Burger in 1982, UCT Sports Medicine research has been at the forefront of sports and exercise related injury research.
The UCT Sports Medicine and Orthopaedic Surgery Clinical Research Practice is the largest provider of Sports & Exercise Medicine related clinical services on the African Continent and provides services to numerous international teams and federations which include: UAE Team Emirates (winner of the 2020 and 2021 Tour de France), Stormers Super Rugby, Springbok Sevens Rugby, Cape Town Spurs Football Club, Cape Town City Football Club, The Two Oceans Marathon and many others. The practice is an International Sports Medicine Federation Center of Collaboration (FIMS-CCSM) and hosts 10 leading sports physicians and 6 leading orthopaedic surgeons (the majority of whom are UCT academics). Provision of Sports & Exercise medicine clinical services to the broader public have been implemented through the first public sector sports injuries clinic in conjunction with the Division of Orthopaedic Surgery which is run through Groote Schuur Hospital out-patient department since 2016.
These clinical platforms and World leading clinical expertise provide a continuous platform for clinical research activities. Moreover, UCT HPALS researchers are recognized as international leaders in the genetics of soft-tissue, exercise-related injuries, as well as video analysis of rugby-related injuries. The latter work has resulted in changes in both national and international practice and rules changes.