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FIT FOR PURPOSE M.B., Ch.B. admission, curriculum & outcome. Faculty of Health Sciences University of Cape Town. Parliamentary Portfolio Committee on Health 20 April 2011. what we stand for. mission and goals address South Africa’s health challenges promote quality and equity in health
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FIT FOR PURPOSEM.B., Ch.B. admission, curriculum & outcome Faculty of Health Sciences University of Cape Town Parliamentary Portfolio Committee on Health 20 April 2011
what we stand for mission and goals address South Africa’s health challenges promote quality and equity in health produce health practitioners responsive to need promote spirit of enquiry engage with need through research and the application of our academic resources values PHC approach health equity, social justice high ethical standards respect for human rights and human dignity
context / drivers National Health Act, 2003 unite elements of the NHS decentralised health system advance provision of appropriately trained staff to meet national need establish AHCs (training platform) at all levels to educate and train health care personnel Higher Education Act 101, 1997 restructure, transform programmes and institutions to respond better to the national HR, economic and development needs Redress past discrimination and ensure representivity and equal access provide optimal opportunities Promote values of human dignity, equality and freedom Pursue excellence, promote the full realisation of the potential of every student
our response • curriculum to meet requirements of health sector • admissions policy for redress • support to ensure success
purpose • to produce a generalist doctor • capable of providing health care in a decentralised health system • able to manage conditions responsible for the burden of disease • imbued with a spirit of enquiry • committed to equity & social justice: PHC approach
graduate attributes & capabilities • professional values, attitudes, behaviour and ethics • scientific foundation of medicine • communication skills • population and health systems • clinical skills • management of information • critical thinking and research
Curriculum structure (1) • Year 1: • Becoming a professional • Becoming a health professional • Introduction to cycle of life • Transitions in health • Year 2 / 3: • Integrated health sciences • Becoming a doctor • Intro to clinical practice • Special study module (research)
Curriculum structure (2) • Year 4 / 5: • Medical and surgical disciplines • Public health • Primary health care (and 4 week elective) • Family medicine • Forensic medicine • Year 6: • Student internships
Transversal skills • ethics • human rights • primary Health Care • HIV/AIDS • Languages • IT competencies • Educational strategies • Student centred • Problem based learning • Integrated, multi-disciplinary • Community based education • Self directed learning • IT assisted learning
content linked to disease priorities • BoD • common problems • core skills • needed to know and manage • need to recognise and refer • curriculum to follow
teaching & learning platform • community-based & community-engaged • NGOs, schools, CBOs • community health centres • secondary hospitals • tertiary (central) hospitals
Admissions legislation and policy - Pre 1986: no black African medical students at UCT Few admitted in successive years Under-preparedness for higher education - Mathematics and science - Critical reasoning Lack of resources to support higher education Our legacy
Goal • redress the imbalances of the past • expand access to university & medical education • Engagement with scholars in historically disadvantaged schools • Active recruitment from under-served areas • Admit through streamlined process • support the progression of students • ensure throughput in order to provide a cohort of “fit-for-purpose” medical graduates.
the policy • All students (minimum): symbols - Maths: E - Physical Science: E - Minimum points 39 • Admission possible: Points - Black (African) and Coloured students: 39 - White, Indian: 42 • Admission probable: points - Black students: 41, coloured:42; White and Indian students: 47
Race composition of 1st Year MBChB Class by number: 1986-2010
Race composition of 1st Year MBChB Class by proportion: 1986-2010
supporting progression to improve performance and ensure throughput • Intervention Programme • Student mentorship • Early Warning systems • Student Development and support
Intervention programme • Intervention Programme (IP) • 10 – 15% of first year class • most students succeed and some excel
MBChB class size and composition have changed significantly over the period: 1986 to 2010 outcome
Gender and Race profile of all MBChB students 2007 – 2011 62% are women