While it’s been a demanding few years for the Family Medicine Sub-Component of MEPI, significant in-roads have been made towards achieving its goals. These include developing the undergraduate curriculum and teaching sites for the Decentralised Teaching Programme in collaboration with the Department of Rural Health and developing and implementing a Family Medicine Emergency Medicine Updates Programme.

Revised Curriculum

In response to suggestions by the local Ministry of Health, UKZN, with MEPI support, has embarked on restructuring of the Family Medicine curriculum. The new curriculum, implemented in 2014, satisfies the recommendations of the Health Professions Council of South Africa (HPCSA) and is centred on the  Decentralised Teaching Programme.

Fourth Year MBChB

Our new programme places greater emphasis on Family Medicine and a completely new clinical attachment, Integrated Primary Care (IPC) 1 – comprising Family Medicine, ENT, Urology and General Surgery – was implemented in January 2014.

Fifth Year MBChB

This content has revised and introduced to fifth year medical students in 2015.  It includes approaches to Palliative care,, practise management, sexual health and the ESMOE training programme has been integrated into this attachment. 

Sixth Year MBChB

An innovative, new rural attachment, IPC 3 was introduced to final year medical students in January 2015 whereby every student is placed in a remote MEPI Learning Center (MLC) in a non-urban setting. Students are required to provide comprehensive care in relatively resource-constrained settings for 6 weeks, with a strong emphasis on the community as well as the hospital and patient. This is the first phase of a Decentralized Teaching Platform with plans to expand annually across KZN and is coordinated at present by the Department of Rural health together with Family Medicine.  

The post-rotation analyses have shown that the rural health block holds promise for producing the next generation of medical doctors who have the appropriate skills, mettle and psyche to practice primary care medicine that is responsive to patients, their families and communities within the context of a rural district health system.

Postgraduate Programme

The Family Medicine  Postgraduate Registrar training Programme has been decentralised since 2012, with registrars being placed in decentralised sites under locally and MEPI-appointed Family Medicine physicians. Bethesda Hospital is one such district hospital – funded by MEPI – which is now an accredited satellite teaching and training site. It boasts two Family Medicine specialists and a Family Medicine Registrar.

Family Medicine Emergency Medicine Update Programme

These workshops have been developed by Family Medicine to build capacity among healthcare workers in Accident and Emergency Units and contribute to health system strengthening.  Emergency Medicine outreach began in Family Medicine in 2004 but ceased in 2010 due to a lack of funding. It was revived in 2011 through MEPI support with a revision of the content focusing on common emergencies, including HIV emergencies, within primary emergency care.  This program is run jointly by Family Medicine, Emergency Medicine, Paediatrics and Surgery.

Eight EMUs were held across the 11 health districts in KZN with an average of 270 doctors and nurses being trained. Participants have been extremely satisfied with the training, with 87.5% reporting it to be excellent. The knowledge and skills gained in various aspect of Emergency Medicine was very significant and all trainees were confident in the skills gained to manage emergencies.

Family Medicine Emergency Medicine Updates  

This is a new Family Medicine MEPI objective with approval from the NIH.  The aim is to increase capacity, improve the quality of health care and strengthen the health system by increasing the number of health care workers trained in Emergency Medicine practical skills.  

The course has been designed as a two  day Emergency Medicine Workshop focusing on core competencies and targeted at nurses and doctors working in Public Sector Accident and Emergency Units and treating primary care emergencies at Community Health Centres and District Hospitals in the province of KwaZulu-Natal.  

Around 40 - 60 participants per workshop are in attendance, which incorporates  one 45 minute lecture and the remaining time dedicated to demonstrating and teaching technical skills and running of fire drills. 

Thanks to the support from the Departments of Health and Emergency Medicine the programme has proven to be extremely successful and is on-going.

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