The philosophy of the RCS is based on the following principles:
- Recruit students from rural areas to encourage future retention.
- “Teach where the patients are” to ensure relevant exposure to the burden of disease and practical experience.
- Enable continuity with patients for better learning.
- Enable continuity with the mentor for better guidance and supervision.
- Enable continuity with a specific community for better service orientation and contextualization of health problems.
- Enable longer exposure to the district health system so that service learning becomes a win win for all:
- The university and the Department of Health and the community)
- Catalyze research in a rural context as the research base is limited
- Support multi-professional learning to foster teamwork
- Make use of IT solutions to overcome geographic distances
- Promote a community orientated approach/community engagement/sense of social responsibility for a defined population
Ukwanda pursues an “immersion model” where students are exposed to the realities of working/caring in a resource-limited environment. Students work within the existing healthcare system and not alongside it, hoping to provide assistance and support to health care personnel while gaining valuable “real-life” experience at the same time. Currently 970 undergraduate students rotate to rural towns for periods of 2-6 weeks per year. Students are from the following disciplines:
- Human Nutrition
- Occupational therapy
- Speech, hearing and language therapy
- MB ChB
– First contact during first and second years
– First clinical rotation as 3rd years
– Rural rotation as part of middle clinical phase
– District hospital rotation in late clinical phase
Students are exposed to the full spectrum of health care services provided at these sites including primary healthcare platforms such as: community health centres, primary care clinics, mobile clinics and home visits, NGO encounters as well as private sector exposure. The extended plans include a 1-year clinical rotation for final year medical students and trainee specialists. It is envisaged that the Ukwanda RCS will provide for an additional intake of 15-30 medical students per year and 10 students from the Allied Health Sciences. On a postgraduate level the RCS will allow for additional registrars (medical specialists) to be trained in the rural environment, as well as provide opportunities for research for Masters’ and Doctoral students. The selection criteria for students will be expanded to include rural origin (this is not a prerequisite). Selected medical students will complete their final year in one of the five participating district hospitals (up to 3 students per hospital), or in the regional hospital in Worcester (up to 15 students). This integrated training at district and regional level is a new approach for undergraduate students and is modeled on the successful specialist training of Family Medicine. The curriculum has been adjusted and extensive logistic arrangements have been made to support this Continuous Longitudinal Integrated Clerkship (CLIC) model. At a postgraduate level, the speciality of Family Medicine has progressed well with 8 registrars currently in the Worcester Training Complex in 2010. Registrars in Obstetrics and Gynaecology, Paediatrics, Surgery, Anaesthetics and Internal Medicine can also complete one year of specialist training at Worcester Hospital. Nursing and therapist students are encouraged to pursue postgraduate training.