The Longitudinal Integrated Model

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The District model (longitudinal model) 

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. 

  • Students apply for site placement and are placed according to preferences as far as possible. 
  • Training is largely non-disciplinary in nature, but rather integrated and inter-disciplinary 
  • This model has mid-year and end of October assessments which generates a module mark for each of the clinical domains. 

How many students can go to each site? 

  • Hermanus          3 students 
  • Swellendam       2 students 
  • Robertson          3 students 
  • Ceres                   3 students 

What are the advantages of the LIM? 

The one-year RCS experience provides students with: 

  • 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 care team and having the opportunity become a valuable contributing member of that team engaging with a community and becoming part of a community. 

In our first year (2011) all 8 students passed and on 1 student on LIM at Ceres passed with distinction. The results of research 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 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 studies with sufficient enthusiasm and in 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.