The state of South African internships: A national survey against HPCSA guidelines

Bola, Sumrit; Trollip, Eudiet; Parkinson, Fran

doi:10.7196/samjnew.7923

Cited by 40 publications

(61 citation statements)

References 5 publications

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“…1 This is considered a 'bridging' period for newly qualified doctors between acquired knowledge and required skills. 2 In South Africa, qualified doctors registered with the Health Professions Council of South Africa (HPCSA) are now required to complete a two-year supervised medical internship period at an accredited hospital. Interns are exposed to various aspects of basic clinical procedures, which are achieved by rotating through the required medical domains.…”

Section: Introductionmentioning

confidence: 99%

Self-perceived readiness of medical interns in performing basic medical procedures at the Universitas Academic Health Complex in Bloemfontein

Yiga

Botes

Joubert

et al. 2016

South African Family Practice

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Background: Medical internship in South Africa is a two-year period after completing the basic medical degree. Interns rotate through six different domains, where they are exposed to various clinical procedures. These skills are often not up to standard, and interns feel unprepared for future challenges. This study evaluated the self-perceived readiness of interns rotating through the Universitas Academic Health Complex in performing basic medical procedures, and the frequency of performing these procedures. Methods:This was a descriptive quantitative study. Consenting participants completed an anonymous questionnaire regarding four pre-selected medical procedures per department. Results: The majority of the 61 participants were second-year interns (52.5%), female (54.0%), with a median age of 25 years. Interns felt ready to perform the majority of procedures, but more than 50% reported not being ready to perform circumcisions, episiotomy and perineal repair, assisted delivery and appendectomies. Some procedures in Family Medicine, Internal Medicine, Obstetrics and Gynaecology, General Surgery and Psychiatry were rarely performed by at least half of the participants. Conclusions: Exposure of medical students during their clinical years to practical training is inadequate. The focus in the MBChB curriculum should be increased to a more specific practical approach during both the pre-clinical and clinical years.

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Section: Introductionmentioning

confidence: 99%

Self-perceived readiness of medical interns in performing basic medical procedures at the Universitas Academic Health Complex in Bloemfontein

Yiga

Botes

Joubert

et al. 2016

South African Family Practice

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“…[6,7] There is an increasing number of reports of overburdened and inadequately experienced supervisors, which also influences the quality of internship training across institutions in SA. [8,9] The concurrent impact of inadequate supervision within poor working conditions has raised concerns about the quality of assessments of interns in this context. [5,8] The Health Professionals Council of SA (HPCSA) is the regulatory body responsible for the accreditation of institutions, supervisors, curricula and intern-assessment practice.…”

Section: Researchmentioning

confidence: 99%

“…[8,9] The concurrent impact of inadequate supervision within poor working conditions has raised concerns about the quality of assessments of interns in this context. [5,8] The Health Professionals Council of SA (HPCSA) is the regulatory body responsible for the accreditation of institutions, supervisors, curricula and intern-assessment practice. [1] The HPCSA undertakes biannual accreditation visits to each institution to evaluate and ensure adherence to the mandated requirements for adequate training.…”

Section: Researchmentioning

confidence: 99%

“…The lack of multiple directly observed tools of assessment for interns in SA reflects the current status of assessment, the challenges and the shortage of sufficiently experienced supervisors. [7,8] Various factors were documented in the literature to indicate the challenges faced by internship training in SA and other LMICs. This context is noted for having high workloads, resource limitations and inadequate supervisor support and training.…”

Section: Researchmentioning

confidence: 99%

“…[36] In SA hospitals, there is a lack of emphasis on assessing interns on practices that ensure patient safety, despite identification of the fact that their excessive workload and long work hours compromise patient care. [8,37] Despite the challenges involved, proven innovations and developments in assessment processes from high-income countries need to be adapted and explored within the context of SA and LMICs to optimise the training of interns.…”

Section: Researchmentioning

confidence: 99%

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Comparing international and South African work-based assessment of medical interns’ practice

Naidoo

Wyk

Adhikari

2018

AJHPE

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Background. Resource constraints and a high disease burden impact on the work-based assessment (WBA) of medical interns in South Africa (SA). Objectives. To review the use of workplace-based assessment frameworks in intern practice in SA and to compare these with international practices. Methods. A systematic review using a thematic analysis was performed to analyse 97 articles selected from an initial scoping of 360 sources of evidence on WBA in internship between 2000 and 2017. This process informed a synthesis of descriptive and analytic themes related to competency-based assessment practices relevant to internship in SA.Results. There was an overall dearth of studies on assessment of medical interns in lower-middle-income countries (LMICs). The context in which the assessment of interns in SA occurs has many challenges related to resources, workload and supervision. SA intern assessment is largely focused on core clinical competency, and this occurs without using competency-based frameworks. This focus was reflected in the finding that most studies in SA have dealt with the assessment of core procedural skills related to acute clinical care, while the assessment of non-clinical competencies and non-procedural skills was poorly addressed. Self-assessment by interns was the predominant strategy used in the SA context. The review revealed limitations in the use of multiple assessment strategies and direct observation in the local context, in contrast to practices in most high-income countries. Conclusions. A shift in focus to assess both procedural and non-procedural skills within a competency-based framework is advocated for SA internship, together with the use of multiple assessment tools and strategies that rely on direct observation of performance. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. Afr J Health Professions Educ

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Not ready in the ways that count– a qualitative exploration of junior doctor’s perceived preparedness for practice using Legitimation Code Theory

Pattinson,

Savelberg,

Atherley

2024

Adv in Health Sci Educ

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Despite demonstrating the required competencies to graduate, many newly qualified doctors find the transition to internship difficult. There is a concern over whether their preparation is aligned with the expectations of the role. This study aimed to gain a better understanding of the competencies needed for legitimate practice as junior doctors and explores their perceived preparedness for practice. A qualitative, descriptive study using focus groups was undertaken with first year internship doctors. Thirty-two junior doctors in their first year of internship took part in five focus groups. The data were analysed using a reflective thematic analysis approach with a subsequent analysis using the Legitimation Code Theory (LCT) specialisation dimension coding framework to aid interpretation. Personal attributes including adaptability, organisation and proactivity form the basis of achievement in internship. While graduates felt ready in some ways, it was not in the ways that counted. Participants felt well prepared in terms of their clinical knowledge and skills, but legitimacy came from being able to take responsibility, communicate effectively and apply knowledge confidently and efficiently to all aspects of patient care, something that they did not feel ready to do. Using LCT has revealed a shift in the basis of achievement between medical school, where individual academic performance is rewarded, and internship, where personal and social competencies are legitimised. There is a clash between what graduates feel well prepared for and the expectations and demands of the internship role, resulting in a difficult and stressful transition from student to doctor.

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The state of South African internships: A national survey against HPCSA guidelines

Cited by 40 publications

References 5 publications

Self-perceived readiness of medical interns in performing basic medical procedures at the Universitas Academic Health Complex in Bloemfontein

Self-perceived readiness of medical interns in performing basic medical procedures at the Universitas Academic Health Complex in Bloemfontein

Comparing international and South African work-based assessment of medical interns’ practice

Not ready in the ways that count– a qualitative exploration of junior doctor’s perceived preparedness for practice using Legitimation Code Theory

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