fit for purpose m.b., ch.b. admission, curriculum & outcome

Click to edit Master subtitle style

4/21/11

FIT FOR PURPOSEM.B., Ch.B.

admission, curriculum & outcome Parliamentary Portfolio Committee on Health

20 April 2011

Faculty of Health SciencesUniversity of Cape Town

Click to edit the outline text format Second Outline

Level Third Outline

Level Fourth Outline

Level Fifth

Outline Level

Sixth Outline Level

Seventh Outline Level

Eighth Outline Level

• Ninth Outline LevelClick to edit Master text styles

– Second level

• Third level

– Fourth level

» Fifth level

4/21/11

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

4/21/11

our challenge

producing graduates fit for purpose

Click to edit the outline text format Second Outline

Level Third Outline

Level Fourth Outline

Level Fifth

Outline Level

Sixth Outline Level

Seventh Outline Level

Eighth Outline Level

• Ninth Outline LevelClick to edit Master text styles

– Second level

• Third level

– Fourth level

» Fifth level

4/21/11

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

4/21/11

our response

• curriculum to meet requirements of health sector

• admissions policy for redress

• support to ensure success

4/21/11

curriculum

4/21/11

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

4/21/11

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

4/21/11

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)

4/21/11

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

4/21/11

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

4/21/11

content linked to disease priorities

• BoD

• common problems

• core skills – needed to know and manage

– need to recognise and refer

• curriculum to follow

4/21/11

teaching & learning platform

• community-based & community-engaged

• NGOs, schools, CBOs

• community health centres

• secondary hospitals

• tertiary (central) hospitals

Click to edit Master subtitle style

4/21/11

admissions policy

Click to edit the outline text format Second Outline

Level Third Outline

Level Fourth Outline

Level Fifth

Outline Level

Sixth Outline Level

Seventh Outline Level

Eighth Outline Level

• Ninth Outline LevelClick to edit Master text styles

– Second level

• Third level

– Fourth level

» Fifth level

4/21/11

• 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

4/21/11

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.

4/21/11

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

4/21/11

outcome of admissions policy

Click to edit Master subtitle style

4/21/11

Race composition of 1st Year MBChB Class by number:

1986-2010 0

50

100

150

200

250

'86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10

Intake Year

Nu

mb

er

of

Stu

de

nts

I

C

C

B

B

W

W

4/21/11

Profile of students admitted 2006 – 2010

Year African Coloured Indian White Total

2006 65 (32%) 38 (19%) 26 (13%) 63 (31%) 203

2007 69 (34%) 39 (19%) 20 (10%) 64 (32%) 203

2008 65 (32%) 45 (22%) 23 (11%) 62 (31%) 203

2009 97 (46%) 44 (21%) 20 (10%) 45 (21%) 210

2010 91 (44%) 36 (18%) 24 (12%) 47 (23%) 205

2011 107 (51%) 32 (15%) 28 (13%) 35 (17%) 209

4/21/11

Race composition of 1st Year MBChB Class by proportion: 1986-

2010

0

0.2

0.4

0.6

0.8

1

1.2

Intake Year

Pe

rce

nta

ge

of

Cla

ss

I

I

C

C

B

B

W

W

4/21/11

Profile of all MBChB students 2007 - 2011

4/21/11

beyond admissions and curriculum: support for success

4/21/11

supporting progression to improve performance and ensure throughput

• Intervention Programme

• Student mentorship

• Early Warning systems

• Student Development and support

4/21/11

Intervention programme• Intervention Programme (IP)

• 10 – 15% of first year class

• most students succeed and some excel

Year 03/04 04/05 05/06 06/07 07/08 08/09

IP1 16 32 14 21 20 16

IP2 23 36 23 37 24 26

4/21/11

4/21/11

MBChB class size and composition have changed significantly over the period:

1986 to 2010

outcome

4/21/11

Class of 2010

4/21/11

4/21/11

Profile of all MBChB students 2007 – 2011

Year African Coloured Indian White Int/Unknown Total

2007 407 (35.5%) 203 (17.7%) 167 (14.6%) 359 (31.3%) 11 (1%) 1147

2008 419 (35.9%) 213 (18.3%) 170 (14.6%) 353 (30.3%) 11 (0,9%) 1166

2009 453 (38%) 221 (18.5%) 158 (13.3%) 347 (29.1%) 13 (1.1%) 1192

2010 468 (38.9%) 230 (19.1%) 156 (13%) 331 (27.5%) 15 (1.2%) 1202

2011 500 (41.9%) 218 (18.3%) 158 (13.2%) 300 (25.1%) 13 1.1%) 1193

4/21/11

Gender and Race profile of all MBChB students 2007 – 2011

Year African Coloured Indian White Total

Gender

F M F M F M F M F M

2007 254(22%) 153(13%) 148(13%) 55(5%) 94(8%) 73(6%) 216(19%) 143(12%) 721(63%) 426(37%)

2008 256(22%) 163(14%) 149(13%) 64(5%) 91(8%) 79(7%) 212(18%) 141(12%) 718(62%) 448(38%)

2009 284(24%) 169(14%) 149(13%) 72(6%) 82(7%) 76(6%) 210(17%) 137(11%) 735(62%) 457(38%)

2010 293(24%) 175(15%) 154(13%) 76(6%) 82(7%) 74(6%) 201(17%) 130(11%) 743(62%) 459(38%)

2011 324(27%) 176(15%) 141(12%) 77(6%) 85(7%) 73(6%) 184(15%) 116(10%) 745(62%) 448(38%)

62% are women

4/21/11

Gender and race profile of students : 2007-2011

4/21/11

Profile of graduates