Q&A about LIM

What is the Rural Clinical School?
The FM&HS at Stellenbosch University has ventured on an exciting new educational project called the Ukwanda RCS, in 2011. Final year medical student interns (SI’s) now have the option to spend their final year at Worcester Hospital or one of the District Hospitals attached to Worcester Hospital. All the SI’s accepted at the RCS, do their rotations through the short rotations i.e. Anaesthetics, Urology, Ophthalmology and ENT at Tygerberg during the 1st block in the last semester of their 5th year. In the 6th year at the RCS SI’s offer two options, namely: District Hospitals: Longitudinal Integrated Model (LIM) Students spend most of the year at a district hospital under the primary mentorship of a family physician with regular input and visits from the various specialists from Worcester Hospital. Short rotations in some of the clinical disciplines will take place at Worcester Hospital. The rotations include Surgery, Orthopaedics, Paediatrics and Internal Medicine. The district hospitals in the RCS are Ceres, Robertson, Swellendam and Hermanus hospital.

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
  • becoming part of a health team and a valuable contributing member of that team engaging with a community and becoming part of a community
  • Who may apply?

  • All students can apply to do their final year at the RCS.
  • An online application is completed.
  • Academic history and interest in rural health is taken into consideration.
  • A motivation for your reason to attend the RCS needs to be added to application.
  • Students who are self-directed, self-motivated learners do better in the RCS.
  • 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 in managing uncategorized/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 portfolio 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 should LIM students learn in all the disciplines if they do not have fixed rotations?

    LIM students rotate through some of the clinical domains at Worcester Hospital which will assist them in:

  •     getting a good indication of what is required of them in terms of clinical learning.
  •     meeting the consultants and building a learning relationship for future consultations to assist with writing up patients
  •     setting priorities for interactions when the consultants do outreach to the district hospitals
  •     by preparing their patient portfolios with sufficient enthusiasm and consultation with doctors, allied health professionals and consultants.
  •     by taking initiative in consulting with clinicians and by finding the balance between clinical work and studying.
  • 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. The LIM 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 April July and October. They will participate in the same final exams in November as their counterparts in Worcester and TBH. If you have any further questions, please do not hesitate to contact one of the RCS team:

    If you have any further questions, please do not hesitate to contact one of the RCS team:

    Francois Coetzee

    Program Coordinator

    Tel: 023 346 7804

    Cell: 083 409 9240

    E-mail: franna@sun.ac.za


    Helta Jordaan

    Student administrator

    Tel: 023 346 7803

    Cell: 084 250 2824

    E-mail: helta@sun.ac.za