As South Africa moves towards a Primary Health Care approach, the demand for doctors, especially in rural areas, has become a critical concern. 

To address this need, the UKZN’s Nelson R Mandela School of Medicine has responded to the clarion call by the provincial health department to increase its annual intake of medical students from 210 to 250 with the ultimate aim of doubling this number over a period of time. 

Although crucial, the MEPI programme of capacity building is not simply about increasing numbers alone. More importantly, the programme aims to equip its graduates with critical skills needed in addressing the challenges around treatment and care, especially of those affected by HIV and AIDS.  

Through its multi-pronged approach of improving capacity and developing competent doctors, MEPI programmes include the following:  

The traditional medical curriculum needed to be reviewed in order to ensure clinicians are fully prepared to deal with issues around HIV as current teachings were found to be inadequate in meeting this need.  UKZN therefore implemented a revised 6 year MBChB curriculum in 2011 which includes a shift in teachings in the three clinical years from a discipline-specific to a more patient-problem-centred model.  

UKZN graduates are required to show competence as communicators, collaborators, leaders, health advocates, scholars and professionals, and to combine these roles with biomedical knowledge and skill into the overarching role of the medical expert. Added to this is an eighth competency: that of South African health care provider, embracing comfort with proficiency in and commitment to working in all South African contexts, rural and urban, district and regional level, community and hospital.  These competencies formed the framework upon which the revision of the curriculum was based. 

 

Through the Department of Public Health  Medicine, students’ clinical education has been revised to ensure that appropriate emphasis is placed on HIV issues. Some of the revised changes include:

This module prepares students with basic knowledge and skills required for being an adult learner in an institute of higher education and provides the core foundational knowledge and principles of community, family, public and environmental health.

This programme endorses the key concepts of a Community Oriented Primary Health Care Approach (COPC) and were introduced into the MBChB curriculum from academic years 2 to 4.  

The attachment is run by teams from the Disciplines of Family Medicine, Public Health Medicine and Rural Health. 

The goal is to follow the COPC cycle which addresses the health needs of a defined population using a planned integration of public health with primary care practice. This is achieved by placing students in community sites for a series of experiential learning items.  The aim of the programme is to provide UKZN students with practical exposure within public health facilities across the province. The programme is extremely beneficial in providing students with practical skills in health care delivery whilst assisting UKZN with critical data collection to improve the experience of students in this setting. The programme also develops opportunities for the DOH to afford students placement opportunities after graduation.

 

A ‘dual track’ programme aimed at medical, nursing and pharmacy students is currently being piloted. This allows selected high-achieving students to pursue Masters degrees together with their undergraduate coursework. The primary aim of this programme is to address the paucity of clinician scientists in SA, through early intervention in the MBCHB curriculum and to retain these bright minds within the academic sector.