Public private collaboration to train Maties med students

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The programme was initiated in 2014 with a pilot project at Mediclinic Durbanville in Cape Town's northern suburbs, in partnership with the SU Faculty of Medicine and Health Sciences (FMHS). Fourth and fifth year medical students can now complete their four-week long internal medicine rotations at the hospital, and receive clinical training from private sector doctors. The students accompany the doctors on their ward rounds and to their rooms and are given the opportunity to assist the doctors with the management of patients.

The project was the initiative of Professors Rafique Moosa, executive head of the department of medicine of the FMHS, Elvis Irusen, chairman of the undergraduate programme in general internal medicine of the FMHS and two specialist doctors with practices at Mediclinic Durbanville - a radiologist, Dr René Truter, and an internal medicine specialist, Dr Rust Theron.

"The pilot project was very carefully planned and we are very pleased that it has been received so positively. We have to give credit to all the stakeholders for being so brave to go on this journey with us. I would highlight two of the success factors as the wonderful support of Mediclinic Durbanville and the specialists coming on board," said Prof Moosa.

"It is the first time that such a programme for the formal training of undergraduate students in the private sector has been successfully implemented. We can now roll it out knowing that it is a winning project."

Prof Jimmy Volmink, dean of the FMHS, said, "The health care training platform is under tremendous pressure, as it responds to the urgent need to increase the number of doctors and other health workers in South Africa. Extending our partnership with the private sector is vital to realise the broader objective of universal access to health care."

Koert Pretorius, Chief Executive Officer: Mediclinic Southern Africa added, "The chronic shortage of healthcare professionals is not a problem unique to South Africa, and we face a set of challenges that requires the cooperation of all parties in order to achieve an equitable solution, particularly as they affect all stakeholders in the sector.

"Mediclinic Southern Africa has formed an enduring relationship with the University of Stellenbosch over the years, assisting various departments within the health sciences faculty. It therefore makes sense for us to join forces with them to provide additional learning experiences for medical students.

"By providing training in the private hospital context, we have the opportunity to expose future doctors to other facets of medical care that they would not necessarily experience in the public hospitals. We believe this more rounded approach will enable them to be better clinicians and, in the long term, we hope this will contribute towards the delivery of affordable and accessible quality health care to a greater cross-section of South Africa's people," he concluded.

Programme to extend

Based on the success of the pilot project, the FMHS and Mediclinic have agreed to expand the programme to three other hospitals in the group, namely Mediclinic Cape Gate, Mediclinic Louis Leipoldt and Mediclinic Panorama. The two parties are in the process of drawing up a Memorandum of Agreement that they hope to sign shortly.

Prof Ben van Heerden, director of the Centre for Health Professions Education and MB, ChB programme coordinator at the FMHS, also commented, "The faculty and the MB ChB programme committee are excited about this collaboration with the private sector. Not only does it offer the opportunity for our students to be exposed to another important component of the country's health system, but also exposure to a different patient and disease profile than what would ordinarily be encountered in the public sector."

Accreditation by university

The specialists at Mediclinic Durbanville received accreditation by the FMHS to be able to train students. All participating staff attended a short course to ensure they are equipped to transfer the appropriate skills and knowledge to the students.

According to Prof Marietjie de Villiers, deputy dean of education of the FMHS, the feedback from students and lecturers has been positive. "Even the patients welcome the initiative, because they say the student doctors are able to spend more time with them."

"The benefits to the students include that they see a full spectrum of patients and that they are given one-on-one tutoring, which is not something they would experience in public sector hospitals. The students and the physicians now hold regular meetings where cases are presented and discussed. The physicians, by the nature of their work, are able to provide the first rate teaching and the environment lends itself to good teaching material. As the students are in their fourth year, they are not complete novices, which means they can meaningfully engage with the physicians. The feedback from all parties has been positive," Prof Moosa said.

Provincial government support

Minister Botha, who has supported the initiative from the beginning, commented, "I welcome the agreement between both institutions - Mediclinic in its capacity as a private sector hospital and SU as a training institution - to promote the concept of health professions training.

"It is the objective of Western Cape Government to effect legislative changes to enable the private sector to become involved on a considerable scale in the training of doctors in South Africa. At present, it is not possible because medical training is public sector driven.

"It is not reasonable to expect the private sector to accept co-responsibility for health care, but prohibit them from participation in training. The private sector is involved in the training of nursing staff and I see no reason why this cannot be expanded to medical doctors.

"The issue of the shortage of doctors in South Africa is well-known, as well as the dire need to improve public health care. The relevant legislation needs to provide a framework where both the public and the private sector accept responsibility to take on the challenge that lies ahead," he conluded.