MBChB VI Program


What is the goal of the Worcester Rural Clinical School?

To train final-year students continuously for a year on a secondary and/or primary health service platform in a rural environment. To motivate students to practice in rural areas on completion of their studies.
Which models of MBChB training does the Worcester Rural Clinical School (RCS) offer?
2.1 The Worcester model: This model follows the “traditional curriculum” as in TBH, i.e. discipline- orientated In addition students spend one afternoon per week in a primary care setting at the Avian Park learning centre, 18 students can be accommodated for one year (their SI year) at Worcester Hospital.

2.2 The District model (Longitudinal Integrated Model) Learning is done in an integrated way throughout the year. Students will receive training support from the specialists at Worcester Hospital. Students reach the same outcomes  and more than the Tygerberg and Worcester students.  The students experience continuity with patients and tutors while learning to manage undifferentiated patients and are quickly incorporated into the clinical teams.

Which hospitals are involved?

Regional hospitals: Worcester and Upington Hospital District hospitals: Ceres, Robertson, Hermanus and Swellendam

How are students selected for the Rural Clinical School?

The following selection criteria are used for student placement:

Proviso: Only students who apply as volunteers will be considered

Application: Students have to complete an online application form that is distributed to fifth year medical students at the beginning of the year. This application form contains a number of questions of which the answers are used for a scoring rubric. For the students applying for placement at Worcester, the 18 students with the highest rubric scores are selected. The same process is applied for the longitudinal student applications.

How many medical students have been trained at the RCS?

  • In 2011 there were 8 students on the platform: 6 at Worcester and 2 at Ceres.
  • In 2012 20 students were trained at the RCS: 16 at Worcester, 2 at Robertson and 2 at Swellendam.
  • In 2013 21 students were trained at the RCS: 16 at Worcester, 3 at Ceres, 3 at Robertson and 1 at Swellendam.
  • 20 students were placed on the rural platform for 2014: 16 at Worcester, 2 at Ceres and 2 at Hermanus
  • 22 students were placed on the rural platform for 2015: 18 at Worcester, 2 at Ceres and 2 at Hermanus
  • 23 students have been placed on the rural platform for 2016: 18 at Worcester, 3 at Ceres and 2 at Hermanus
  • In 2017 26 students have been placed on the platform: 18 at Worcester, 3 in Ceres, 3 in Hermanus and 2 in Robertson.

What are the advantages of coming to the RCS?

  • The one year RCS experience provides students with: one-on one mentorship and teaching, more opportunities to learn procedural skills, patients present undifferentiated, not already in a “specialist” box, continuity of care with patients over a year not just once off encounters with patients and becoming part of a health team and a valuable contributing member of that team engaging with a community and becoming part of a community.
  • Students have recognized the value of this new model of teaching especially the value of one-on–one mentoring and the enhanced opportunity to learn clinical and procedural skills. International publications have documented that academically students in rural clinical schools do as well and better than their fellow students at the teaching hospital. This was certainly our experience at the RCS. In our first year (2011) all 8 students passed and on 1 student on LIM at Ceres passed with distinction. The results of research just completed comparing the academic results of the students at the RCS with the students at Tygerberg show that the RCS students do as well as the Tygerberg students and better in some disciplines.

How many students can go to each site?

  • Worcester 18 students
  • Hermanus 3 students
  • Swellendam 2 students
  • Robertson 2 students
  • Ceres 3 students
  • Upington 6 students

What learning opportunities does the RCS offer students?

Clinical tutoring: All of the departments (except Psychiatry) have three consultants and they oversee ward rounds and tutor students along with the other clinicians working in the department. LIM students work closely with the doctors at the district hospitals learn a lot of practical skils in managing undifferentiated patients during calls. Patient consultations and presenting to consultants and doctors: You will have ample opportunities to see either referred patients or undifferentiated patients and to follow their progress after admission. Making notes of the practical aspects of managing patients: You are encouraged to take notes in the clinical environment; documenting the practical knowledge and exam tips provided by consultants and doctors and also to make notes of topics you need to read up on. Weekly tutorials: Students in the RCS including the students from the district hospitals meet one afternoon a week at Worcester for tutorials by specialist from disciplines involved. This an excellent opportunity to present your patients that you are busy writing up. Working on a portfolio of patients: Each student has to collect a number of patients that they saw as the primary contact and then write up the patient in terms of the clinical reasoning behind the assessment of the patient, the differential diagnoses considered, the workup (investigations) done and the management of the patient. Students are to engage with consultants and other doctors in writing up their patients to ensure correct clinical reasoning and to fill the gaps of the write up.

Are RCS students disadvantaged by not having input from the Tygerberg consultants?

No, the consultants at Worcester participate in the Tygerberg exams in April and in November at Tygerberg Hospital and are well informed of the required outcomes for students in the clinical domains. Students at the RCS also have access to video podcasts of the clinical tutorials that were presented at Tygerberg.
.How are RCS students assessed?

  • Each clinical discipline has a number ways of assessing students (MCQ’s, clinical cases, OSCE’s, OSPE’s, ward mark and short cases), and the combination of these evaluations vary amongst departments similar to the departments at Tygerberg Hospital. The end of rotation assessments have been adapted for the RCS students with the introduction of a portfolio of patients as part of the assessment instead of a ward mark. The Worcester students at the RCS do the same final examinations (April and November) as the SI’s at Tygerberg.  All the RCS students do the final examinations for Anaesthetics, Urology, Ophthalmology and ENT at Tygerberg in November of their 5th year. LIM students do not do end of the block assessments but have assessments in May and October.

How do students get to know more about accommodation and other logistics?

  • Students that were accepted to the program meet the RCS team in September of their fifth year and the program as well as the logistics are discussed during a question and answer session. During the first week of January on day one, students are orientated about the logistics and the roles of the members in the support team. The academic program and the responsibilities of students are also discussed and on a separate day the portfolio of patients and assessments are explained in detail.

For any further questions contact our RCS team

Lindsay-Michelle Meyer Ukwanda Centre for Rural Health

Tel: 021 938 9873 E-mail lindsaym@sun.ac.za

Francois Coetzee RCS Program Coordinator

Tel: 023 346 7804 Cell: 083 409 9240 E-mail: franna@sun.ac.za

Ruben Geweldt Student administrator

Tel: 023 348 9873 Cell: 083 391 5250 Email: rgeweldt@sun.ac.za