Academic Year
There are four attachments in year 5, Psychiatry and Anaesthesia; Accident and Emergency (Medicine, Surgery, ENT, Dermatology and Ophthalmology); Maternal, Child and Urban Health (Obstetrics and Gynaecology, Paediatrics, Urban Clinics) and Rural Health. Each attachment is of 9 weeks duration and there is a 4 week elective (elective 5) at the end of the year. The elective period can be used, where required, for remediation prior to supplementary assessment.
Written and/or clinical assessments are held in the last 2-3 days of each attachment, however there is a major component of progressive "on-the-job" assessment during the Accident and Emergency and Maternal, Child and urban health attachments. Certification requirements must also be met, in full, to achieve a satisfactory result in the clinical attachments.
With the change in the academic year for 2003, year 5 students will have a reduced number of patient and community problems; a number of the P&C problems previously covered in year 4 will move to year 5 in 2004. There are seven P&C problems in Psychiatry and Anaesthesia, six in Maternal, Child and Urban Health, and five in Accident and Emergency. This should allow students to optimise their clinical involvement and experience.
The Attachments
Psychiatry/Anaesthesia
Students spend 4 weeks in each of the specialties, with a number of shared activities in the last week, prior to assessment. In Anaesthesia, students rotate between the main PMGH operating theatres, the Obstetrics and Gynaecology operating theatre and Intensive Care. You should spend as much time as possible in the theatres and ICU and gain experience in a broad range of procedures. In Psychiatry, students gain clinical experience in Ward 6, the Psychiatry clinics, Laloki Hospital and the rehabilitation clinic. Students are also encouraged to become involved with Psychiatry consultations in the general wards.
Accident and Emergency
This attachment provides experience as a member of the Accident and Emergency Department team, as well as opportunities to consolidate and extend clinical skills and learning in the previously encountered clinical disciplines of Medicine, Surgery and ENT/Dermatology/Ophthalmology. Students involvement in the Accident and Emergency Department extends through the attachment and provides a base for the 3-week rotations in the specific specialist areas.
Maternal, Child and Urban Health
There are three, three-week rotations through Obstetrics and Gynaecology, Child Health, and Urban health facilities. The hospital-based rotations should broaden and strengthen students’ learning and skills in these specialist areas. The Urban Health rotation provides experience in three urban clinics and in two private hospitals. This attachment assists students to gain an understanding of the range of health care options in the community and the important roles played by other health professionals.
Rural Health
After introductory work in week 1, a total of seven weeks is spent in a rural Health Centre and Aid Post; the final week is allocated to preparation and presentation of projects and topics and to written assessments. This attachment gives students insight into the health needs of people in rural areas the services provided and the effectiveness of care. It will allow students to experience the reality of caring for patients in an isolated community and to work as part of a health team.
Students are responsible, on a daily basis, to the local Health Extension Officer. Visiting faculty also provide supervision and assistance. Assessment includes written papers (essay and short answer questions), a viva, logbook and a report and presentation on group and individual projects and topics. Peer assessment of performance and participation is also obtained.
Both the urban clinic and rural health attachments offer experience and learning in a clinical setting beyond the teaching hospital environment. The majority of health care is delivered in urban and rural communities and, whatever the site and nature of their ultimate professional practice, students need to understand the nature of practice in these different settings and the problems faced in the broader community.
General Comments
The hospital-based rotations are, in effect, a pre-internship experience. Students are expected to take more clinical responsibility than previously and to develop basic organisational and time-management skills. A major component of their learning takes place in the clinical setting and students are encouraged to spend as much time as possible in the wards, clinics, operating theatres and A&E Department. The hospital-based attachments include night and weekend shift work, bringing further opportunities to admit and care for patients and to gain experience with procedures. There are substantial certification requirements and it is the student’s responsibility to obtain the required verification. Signatures should be obtained from their supervisors at the conclusion of the activity; if this is not possible, for any reason, the signature must be obtained later on the same day. Supervisors will not sign a student’s form retrospectively. If illness, personal problems or family difficulties prevent a student’s attendance, he/she must submit appropriate documentation. Medical certificates must be signed by a senior Registrar, Consultant or community-based, registered Medical Practitioner.
Failure to complete the specified certification activities and/or late submission of certification booklets will result in a requirement for repeating some components of the attachment. Any time penalties carried through from year 4 will contribute to the accumulated total. Accumulated time penalties, which exceed the 4-week elective period, will be transferred to the 2004 academic year, delaying the student’s completion of the course and his/her graduation. Forgery of signatures will result in expulsion for a minimum of one year and a requirement to repeat the entire year if and when readmitted to the course.