2O11. University of Otago Faculty of Medicine. Bachelor of Medicine and Bachelor of Surgery (MB ChB) A guide to the Otago undergraduate medical degree

Transcription

1 2O11 University of Otago Faculty of Medicine Bachelor of Medicine and Bachelor of Surgery (MB ChB) A guide to the Otago undergraduate medical degree Te moemoeä: Whaia te iti kahurangi

2 Page 1 About the undergraduate medical degree course The purpose of the University of Otago undergraduate medical course (MB ChB) is to produce safe, knowledgeable, competent practitioners with the skills to move into clinical practice and continual learning. The curriculum takes into account national and international perspectives of medical training, and is externally evaluated and accredited by the Australian Medical Council. The University of Otago expects its medical graduates to have developed specific personal, interactive and disciplinary attributes as outlined in the Graduate Profile. The course is more specifically defined by learning outcomes, which students attain throughout their degree, at different levels appropriate to the stage of learning. Outcome Domains The outcomes are organised within six programme domains and eight practice domains, with the emphasis on programme domains because they comprise mainly generic skills and apply across all areas of practice, while practice domains focus on specialised areas of practice. The undergraduate curriculum database tracks the outcomes, where and how they are learned, and to which level, to develop a cohesive and comprehensive map of the Otago MB ChB. Programme Domains Research and Information Literacy Clinical Skills Medical Science Hauora Mäori Ethics/Professional Development Population Health Practice Domains Acute Care Cardiology/Lungs/Renal Digestion/Endocrine Musculoskeletal/Infection/Immunity Palliative Care/Continuing Care/Rehabilitation Systems Psychological Medicine Reproduction and Development The Senses Resources Graduate profile: Outcome Database: You will need a University username and password to gain access to this database. Contact: karin.warnaar@otago.ac.nz for assistance.

3 Page 2 How the course is organised The Otago course takes at least six years to complete if the student has no prior degree. First Year Health Sciences First Year Early Learning in Medicine (ELM) Year Two Year Three Otago School of Medical Sciences Faculty of Medicine Dunedin School of Medicine Graduate and Other Entry UOC DSM UOW Advanced Learning in Medicine (ALM) Year Four Year Five Year Six RMIP Most students spend their first year on the Dunedin campus taking the University of Otago s Health Sciences First Year programme to compete for entry into the medical degree programme. Years two and three of the medical degree, Early Learning in Medicine (ELM), are taught on the Dunedin campus by staff from the Otago School of Medical Sciences (OSMS), Dunedin School of Medicine (DSM), and Faculty of Medicine staff. At the end of third year, students are allocated to Dunedin School of Medicine, University of Otago, Christchurch (UOC) or University of Otago, Wellington (UOW) for the fourth, fifth and sixth years of the programme (Advanced Learning in Medicine or ALM), depending on their choices and availability of places at each campus. Up to 20 students each year are selected to spend their Year 5 within the Rural Medical Immersion Programme (RMIP), which has satellite centres in Balclutha, Queenstown, Greymouth, Blenheim, Masterton, and Dannevirke. Students spend most of their sixth or Trainee Intern (TI) year on clinical attachments, including time in rural and regional sites.

4 Page 3 First year and admission to medicine Otago medical students enter the course in a number of ways. Health Sciences First Year School leavers enrol at the University of Otago for the Health Sciences First Year (HSFY) course. In July students applying from HSFY also sit the Undergraduate Medicine and Health Sciences Admission Test (UMAT). HSFY Compulsory papers 70% minimum required Foundations of Biochemistry Cell and Molecular Biology The Chemical Basis of Biology and Human Health Human Body Systems 1 Human Body Systems 2 Foundations of Epidemiology Biological Physics Optional paper from approved list UMAT Logical Reasoning and Problem Solving Understanding People Non-verbal Reasoning Applicants results are used to derive a score comprising 2/3 Grade Point Average (using the best 7 papers) plus 1/3 Weighted UMAT score. Applicants with the highest scores are offered a place the number of places varies slightly from year to year Competitive Graduate entry Graduates in any discipline, from any New Zealand university, may apply within three years of completing their first degree. They are ranked on the basis of a score derived from the grades achieved in their first degree, must meet the UMAT threshold in the year of application and must pass the HSFY papers or their equivalents before taking a place in the second year of the course. Other entry A very small number of students (New Zealand Citizen or NZ Permanent Resident) are also accepted under the Other category, which considers applications from: Health Professionals For health professionals with not less than five years experience in their chosen profession, at least two years in New Zealand. Other Graduates Those who completed their first degree more than three years prior to application, completed a second or higher degree in New Zealand or completed a degree at an overseas university. Sub categories Prospective students may indicate that they wish to be considered under Mäori, New Zealand Resident Pacific Origins, Mental Health Professional, New Zealand Rural Origins. These special allocations reflect Government-identified areas of workforce need. International Some second year places are offered to students who are classified as International Students, who must apply in the HSFY or Competitive Graduates categories. International applicants must achieve a pre-determined level of academic attainment and complete all necessary prerequisites. Resources Admission website: Contacts: Associate Dean, Medical Admissions, Alison Belton, alison.belton@otago.ac.nz

5 Page 4 Years 2-6 of the medical degree The Faculty currently accepts about 270 students into ELM each year; in future years this may increase to 300 as determined by government funding. Early Learning in Medicine (ELM) The ELM programme (years 2 and 3) continues the medical science learning which began in HSFY, while introducing students to patients, their communities, and their points of view. The learning emphasis in ELM is: active and collaborative, integrated, contextually and community based. The introduction to patients and patient context take place in a combination of the Healthcare in the Community (HIC), Integrated Cases and Clinical Skills Programme Modules. Within HIC, students visit patients in their own homes, work in a nursing home and interview volunteer patients from the Friends of the Medical School. Clinical Skills sessions provide opportunities to learn and practise clinical skills (consultation skills, physical examination and practical procedures), and to develop basic clinical reasoning. The Integrated Cases programme offers examples of the medical sciences in a context that emphasises their clinical relevance. All tutorials emphasise an active small group collaborative working environment. In ELM, students spend about 45% of their time in formal teaching situations (lectures, labs), about 15% in small groups (case tutorials, supervised patient contact), with the remaining 40% of non-contact time allocated to independent learning. Advanced Learning in Medicine (ALM) In Years 4 and 5, students rotate through specific context-based block modules and learn through clinical exposure to patients. Their clinical experience is gained in a number of situations including community, in-patient and out-patient in both urban and rural settings. This is supplemented by lectures and tutorials, including vertical module topics such as ethics, microbiology, and pathology. The Trainee Intern year is based on the apprenticeship model of learning, and largely spent in clinical situations on and off campus. It includes a 12-week elective undertaken away from campus which allows students to extend their experience in a particular area of interest. In ALM about 75% of the student s time will be spent in clinical situations and 25% in lectures and tutorials.

6 Page 5 Modules Learning opportunities within the medical degree are arranged in modules. The block modules are concentrated within a period of time; in ELM, they are mainly based on body systems (for instance cardiovascular, endocrine) and in ALM are based on a combination of body systems or on a context of care (such as general practice or paediatrics). Vertical modules typically are less context-dependent, and cover areas like ethics or pathology, which can be relevant to a wide range of medical problems and apply to many of the block modules. Schools arrange ALM modules to fit their specific circumstances. ELM overview Year 2 Year 3 Semester 1 Semester 2 Semester 3 Semester 4 Block Modules Integrated Cases Healthcare in the Community Units Clinical Skills Foundation Trauma Weeks 1 Being a Patient, Being a Consultation Skills Behavioural Health & Illness Behaviour Doctor Medicine HIV Musculoskeletal Painful Joints Headache and Fever 2 Disabilities and Carers History and Examination of the Musculoskeletal System Bruising Cardiovascular Fainting Palpitations Chest Pain Respiratory Shortness of Breath Cough Hauora Maori Immersion Week Gastrointestinal Abdominal Pain and Jaundice Colon Cancer Nervous System Metabolism and Nutrition Renal Endocrine Reproduction, Development and Ageing/ Regional Clinical Anatomy Traumatic Head Injury Developmental Delay Collapse Suicide and Depression Diabetes Obesity Haematuria Chronic Renal Failure Failure to Thrive Lethargy Lump in the Neck Infertility and Pregnancy Sexual Health and Cervical Cancer Lower Abdominal Pain 3 Culture and Health 4 Clinical Placement 5 Illness and Ageing 6 Addiction 7 Doctors in the Media (Delivered in streams) Units 3-7 continue after mid-semester break/immersion Week 1 Interprofessional Learning 2 - Humanities History and Examination of the Cardiovascular System History and Examination of the Respiratory System History and Examination of the Gastrointestinal System History and Examination of the Nervous System 3 Child Development Clinical Reasoning 4 Biomedicine and Complementary and Lifestyle Alternative Medicine (CAM) Dealing with Emotions in the 5 Health Promotion Consultation Techniques including 6 Domestic Violence Venepuncture, Blood Sugar Levels, Urine Dipstick 7 Primary Healthcare 8 Patient Safety 9 Community Contact Week 10 - Cure and Care 11 Year 4 Preparation Revision History and Examination of Obstetrics and Gynaecological Systems Vertical Modules Blood; Cancer; EBP; Ethics; Genetics; Hauora Maori; Infection and Immunity; Pathology; Professional Development; Pharmacology; Psychological Medicine; Public Health

7 Page 6 ALM overview Medicine 1 8 (Acute 4 ; Geriatrics 4, Ambulatory concurrent) Surgery 8 Urban General Practice & ENT 5 Public Health 3 Psychological Medicine - 8 Whole Class Week Medicine 2 & Ophthalmology 7 Musculoskeletal & Emergency Medicine 7 Child Health & Reproductive Medicine 7 Rural General Practice 7 Whole Class / Study Weeks 5 during year Year 4 DSM UOC UOW Clinical Orientation - 2 Advanced Clinical Skills - 3 Bioethics; Clinical Pharmacology; Clinical Skills; Communication Skills; Evidence-Based Medicine; Hauora Māori; Radiology; Microbiology; Pathology; Professional Development Year 5 DSM UOC UOW Advanced Medicine -4 General Medicine & Subspecialties 5 Bioethics; Clinical Pharmacology; Clinical Skills; Communication Skills; Evidence-Based Medicine; Hauora Māori; Radiology; Microbiology; Pathology; Professional Development Healthcare of the Elderly - 4 Cardio/Respiratory 4 Cardio Vascular, Plastics and Dermatology (CVPD) 4 Surgery/Gastroenterology - 4 Surgery/Oncology - 4 General Practice - 8 Ophthalmology, Otolaryngology, Addiction Medicine (OOA) 4 Whole Class Week Musculoskeletal Medicine - 4 Neurology/Neurosurgery - 4 Women s Health and Developmental Medicine - 8 Paediatrics - 4 Psychological Medicine - 4 Public Health - 4 Whole Class/Study Week Anatomic Pathology; Biochemistry; Clinical Skills; Ethics/Medico-legal; Hauora Māori; Microbiology; Pathology/Systems Integration; Pharmacology; Professional Development; Quality and Safety; Radiology Anatomic Pathology; Biochemistry; Clinical Skills; Ethics/Medico-legal; Hauora Māori; Microbiology; Pathology/Systems Integration; Pharmacology; Professional Development; Quality and Safety; Radiology Medicine & Clinical Skills 10 Surgical & Clinical Skills 10 General Practice & Public Health 10 Whole Class Week Musculoskeletal & Skin 5 Reproductive, Sexual & Women s Health 5 Child & Adolescent Health 10 Psychological Medicine - 5 Primary Health Care & General Practice 2 Whole Class/Study Week Addiction Medicine; ; Clinical Pharmacology; Clinical Reasoning; Hauora Māori; Medical Imaging; Pathology and Laboratory Medicine; Professional Skills, Attitudes and Ethics Addiction Medicine; ; Clinical Pharmacology; Clinical Reasoning; Hauora Māori; Medical Imaging; Pathology and Laboratory Medicine; Professional Skills, Attitudes and Ethics

8 Page 7 Year 6 (Trainee Intern) DSM UOC UOW Ward Management: Medicine 6 Medicine 8 Medicine 1 (Internal Medicine) 6 Ward Management: Surgery 6 Specialty Management: Obstetrics & Gynaecology 4 Professional Development Critical Care (Anaesthesia, Intensive Care, Emergency Medicine) 4 Surgery 6 Professional Development; Hauora Māori Medicine 2 (Specialty Medicine) 4 Surgery 6 Professional Skills. Attitudes and Ethics Specialty Management: Paediatrics 4 Specialty Management: Psychological Medicine 4 Community Management: Clinics - 2 Community Management: General Practice - 4 Community Management: EM/Project - 6 Obstetrics & Gynaecology 4 Paediatrics 6 Psychological Medicine 4 General Practice 4 Emergency Medicine 2 Obstetrics & Gynaecology 6 Paediatrics 4 Psychological Medicine 4 General Practice 4 Elective 12 Elective 12 Elective 12

9 Page 8 How students learn at Otago The approaches taken in the course relate to learning, patient care, and professionalism. Students learn: In context Students learn scientific principles in a clinical context to improve recall during clinical encounters. Where patients are not present, clinical examples are used wherever possible, and patient scenarios emphasise both biomedical principles and the patient s point of view. In different situations Students learn in hospital and community settings as well as in urban and rural environments; the ELM course provides students with opportunities to visit patients in their homes and in community facilities. In teams and independently Doctors practise in teams and independently. Small group work is encouraged to facilitate collaborative learning and interpersonal, cognitive, and skill development. Through small group sessions and assigned individual work, students are required to work increasingly independently of teaching staff as the course progresses. Through enquiry Students need to develop skills to deal with problems they have yet to face, or that may not yet even exist. Enquiry based learning is encouraged through small groups in ELM and with teamwork and clinical situations in ALM. The acknowledgement of uncertainty within medicine is also emphasised. The approach to patient care The course emphasises a patient-centred approach to care: students are expected to put the patient at the centre of their care and to understand the illness and its impact from the patient s point of view. Students are also expected to demonstrate empathy and compassion. Professionalism in training The course also emphasises the development of the student as a health professional. Orientation to second year begins with the Student Code of Conduct which defines expectations of students on the behaviour appropriate to being a doctor. Students are required to treat peers and patients appropriately throughout the course, with components of the Code used to measure progress within small group tutorials. Student Code of Conduct

10 Page 9 Assessment The purpose of assessment Assessment ensures standards, monitors progress and provides feedback. At the end of the degree, graduating students must have reached the standard of knowledge, skills and attitudes required of qualified doctors. To achieve this, all students are tested to the same standard at key points during the degree. Terms During the course all students are expected to meet specified conditions or Terms before they are permitted to sit end-ofyear examinations (years 2, 3 and 5), progress to the next year, or graduate (from year 6). Meeting Terms requires satisfactorily completing all work assigned within each module; this varies from module to module and may take the form of essays, tests, observation of performance, case presentations and so forth. Students must also demonstrate acceptable professional behaviour (including punctuality and attendance) and contribute adequately to group projects and discussions. End of year assessments At the end of Years 2, 3, and 5, students undergo summative assessments to determine whether they have reached the standard required to progress to the next year. In year 2 and 3 these comprise Short Answer Questions papers (SAQ), an Objective Structured Practical Examination (OSPE), and an Objective Structured Clinical Examination (OSCE). In year 5 there is an extended matching items Multi-choice Question paper, an SAQ paper and an OSCE. Medical Student Assessment Procedures Guide Chair, Faculty Assessment Committee Tim Wilkinson Tim.Wilkinson@cdhb.govt.nz Chair, ELM Assessment Committee Helen Nicholson helen.nicholson@otago.ac.nz Assessment Coordinator MB ChB Sarah Jutel sarah.jutel@otago.ac.nz

11 Page 10 Governance of the curriculum The medical curriculum is overseen by the Faculty of Medicine s Faculty Curriculum Committee (FCC), which reports to the Faculty Board, and has reporting linkages to the Faculty Executive and Committee. Operational University Council Academic School Faculty Division University Vice-Chancellor Deputy Vice-Chancellor (Academic) Pro-Vice-Chancellor Health Sciences Dean Faculty of Medicine Faculty Executive Faculty Committee Dean Dean Dean Dean HoDs HoDs HoDs HoDs UOW UOC DSM OSMS Board of Examinations 2/3 ELM Exec Board of Examinations 4/5 ELM MEC ELM OC MEG MEG MEG 4/5/6 4/5/6 4/5/6 DSM UOC UOW Board of Examinations 6 Senate BUGS Board of Undergraduate Studies Divisional Board FACULTY BOARD Faculty Curriculum Committee MEC4/5 MEC 6 HSFY Board Medical Admissions RMIP HSFY is overseen by a Board within the Division of Health Sciences. Medical Education Committees (MECs) oversee the delivery of the curriculum: Early Learning in Medicine: ~ Year 2/3 MEC Advanced Learning in Medicine: ~ Year 4/5 MEC ~ Year 6 MEC Medical Education Groups (MEGs) are responsible for the implementation and evaluation of the curriculum on each campus; the ELM Operations Sub-Committee (ELM OC) has this role for years 2 and 3. As well as the MECs, the FCC uses a number of task-based sub-committees to which it refers specific aspects for consideration and recommendation. Assessment Clinical Skills Education Research and Quality Improvement elearning and ICT (Information and Communications Technology) Hauora Mäori Committee Chairs Chair, Faculty Curriculum Committee Tim Wilkinson Tim.Wilkinson@cdhb.govt.nz Chair, MEC 2/3 David Perez David.Perez@southerndhb.govt.nz Chair MEC 4/5 Jim Reid jim.reid@otago.ac.nz Chair, MEC 6 Ted Shipton ted.shipton@cdhb.govt.nz

12 Page 11 Ensuring improvements to the course The programme is consistently reviewed to ensure that it keeps up with national health care needs and research-informed educational approaches as part of ongoing continuous quality assurance and improvement. Health care needs Module convenors and Faculty ensure that the key health care needs and issues within New Zealand inform curriculum planning. At a disciplinary level, convenors adapt outcomes to meet changing needs; more centrally, FCC advice on national and international trends and directions is incorporated into overarching course planning. Educational research The Faculty uses institutional, national and international educational research, both qualitative and quantitative, to inform learning delivery within the course. Continuous quality improvement of course Components of the course (modules) are monitored at least once every three years. Modes of monitoring are dictated by the specific area monitored, for example, learning outcomes achieved during the course, student satisfaction, the learning environment. Programme evaluation is also undertaken looking across the totality of a year or course rather than discrete blocks (modules). Contacts for Faculty Education Unit / Medical Education Units Director, Faculty Education Unit Joy Rudland joy.rudland@otago.ac.nz Medical Education Adviser, ELM Tony Barrett tony.barrett@otago.ac.nz Medical Education Adviser, DSM David Tordoff david.tordoff@otago.ac.nz Medical Education Adviser, UOC Anthony Ali anthony.ali@otago.ac.nz Medical Education Adviser, UOW Peter Gallagher peter.gallagher@otago.ac.nz Clinical Education Adviser, DSM Geoff Cutfield geoff.cutfield@otago.ac.nz Clinical Education Adviser, UOC Maggie Meeks Maggie.Meeks@cdhb.govt.nz Clinical Education Adviser, UOW Sean Hanna sean.hanna@oratoa.co.nz Clinical Education Adviser, UOW Helen Winter helen.winter@midcentraldhb.govt.nz Clinical Education Adviser, UOW Joy Percy joy.percy@midcentraldhb.govt.nz

13 Page 12 Location map Main teaching centres RMIP Regional sites Hastings Palmerston North Dannevirke Nelson Lower Hutt Blenheim Masterton Wellington (ALM) Greymouth Christchurch (ALM) Timaru Ashburton Queenstown Dunedin (ELM and ALM) Invercargill Balclutha Regional contacts Associate Dean, Medical Education, ELM David Perez Associate Dean, Medical Education, OSMS Mike Legge Associate Dean, Undergraduate Education, DSM John Dockerty Associate Dean, Medical Education, UOC Tim Wilkinson Associate Dean, Medical Education, UOW Mike Tweed Director, Rural Medical Immersion Programme Branko Sijnja Associate Deans: Regional sites Invercargill Gordon Veale Nelson Don Wilson Hutt Tim Petterson Palmerston North Anna Ranta Hawke s Bay Carol McAllum Carol.McAllum@hawkesbaydhb.govt.nz

14 University of Otago Faculty of Medicine Bachelor of Medicine and Bachelor of Surgery (MB ChB) A guide to the Otago undergraduate medical degree Te moemoeä: Whaia te iti kahurangi