University of Cape Town (UCT)
UNIVERSITY OF CAPE TOWN
FACULTY OF HEALTH SCIENCES

RESPONSES TO QUESTIONS FROM THE PC ON HEALTH

1. 158 students graduated on 08 December 1998. (Black -20; Coloured - 25; Indian -20; White - 91).
2. Racial and gender breakdown: 1st year to 6th year of MBChB

3. Attrition rate for 1998: 2 (Black - 1male; Coloured - 1female).

4. The Faculty has for a number of years had a support programme for students from disadvantaged backgrounds. It is called the Academic Development Programme (ADP). ADP students are identified during the admissions process. For ADP students the first 3-years of study of the MBChB programme are spread over a 4-year period. During this 4-year period ADP students are assisted by means of additional small-group tutorials ("small-group" means never more than six students at a time) and one-on-one tutoring. The programme has been very successful; indeed its success is largely responsible for the Faculty’s low attrition rate.

5. Postgraduate registrations:

The postgraduate figures for 1999 are incomplete as new postgraduate students are permitted to register throughout the year and current students are still in the process of registration. Consequently, it is too early yet to draw a comparison between registration figures for 1998 and 1999.

6. Attached hereto is an outline of the MBChB programme as well as brief outlines of our postgraduate curricula.

• The MBChB programme is divided into a preclinical phase (1st to 3rd years of study) and a clinical phase (4th to 6th years of study). Students are prepared for the public health system from their first year when they do a subject called "Health and Society." Primary Health Care (PHC) is again taught in the 4th year where students are required to do fieldwork at off-campus teaching and community sites (core syllabi attached). In all fields the teaching is now significantly focused in the community (hospitals, clinics and other sites);
• The Faculty has a team of drivers and vehicles dedicated to transporting students, at all levels and in all disciplines, to the off-campus teaching and community sites to implement and foster the holistic teamwork approach;
• In addition, UCT has unique educational experience in support of primary health care; experience which is completely PHC based in that students take responsibility, together with needy communities, for determining the communities’ needs and providing appropriate PHC services. This organisation called " SHAWCO" has been in existence for more than 50 years.
• On 15 April 1999 the ENT Department and the Department of Logopaedics’ Deaf Child Centre will receive a "HARK" vehicle. These two departments applied for funding to the Commonwealth Society for the Deaf. This specialised vehicle which contains, inter alia, facilities for an ENT surgeon, apparatus for testing hearing, electricity generators and water purifying systems will be used to reach outlying communities where these facilities are not available. Enough funding was received from the Commonwealth Society for the Deaf to remunerate two audiologists for a 3-year period. The vehicle will enable these departments to give an important service to the community, to train students and to do essential research.

7. The Faculty’s programmes are constantly being assessed, both internally and externally. Examples of the different assessments are:
• The Health Professions Council of SA assessed the Faculty more or less 3 years ago. These HPCSA (previously SAMDC) assessments usually take place on a 3 to 5 year basis.
• The General Medical Council of the UK also assessed the Faculty some years ago. In agreement with this Faculty the GMC is informed of visits from its (GMC) prominent members to the Faculty. On their return to the UK these visitors are then questioned by the GMC on the Faculty’s standards and programme content. The GMC gives regular feedback to the Faculty, and where appropriate the necessary adjustments are considered and implemented;
• External examiners participate in all our examination cycles, at all levels and in all disciplines, and this participation includes reviews of the courses (subjects).
• For at least 35 years the Faculty had an undergraduate education committee which continuously assessed the MBChB curriculum against the health needs of the country. At times this committee dedicated blocks of time to studying the health situation and making the necessary changes to the curriculum in order to better prepare students to deal with the needs and requirements of the public health system;
• At the end of each year students are given the opportunity to evaluate each course (subject) and the relevant lecturers.
• The Faculty is currently involved in a programme of curriculum reform with the intention of introducing a new MBChB curriculum in 2001 which will fully encompass the primary health care approach. The curriculum reform process is a consultative process and experts in curriculum reform from as far afield as Tokyo, Liverpool and McGill are consulted on an ongoing basis.

8. UCT has a Schools’ Liaison department which visits schools in the university’s feeder area. Prospective students are introduced to all the programmes offered at UCT. In addition the Faculty of Health Sciences has introduced a "rural outreach" programme with the aim to introduce the Faculty’s programmes to pupils in far-off rural parts of the country. Students from the Faculty, in all the disciplines, go to these rural areas during university holidays and they talk to the pupils about the programmes in this Faculty and their own personal experiences as students at UCT.

9. Under question 6 we dealt with our students’ involvement in Primary Health Care and Community Health during their undergraduate studies. The first group of graduates have now started their compulsory year of community service. It is thus too early to come to any conclusions about the success or not of this programme of community service.

10. Government subsidy (based on estimated student numbers): R53,5M
Donor funding (external funding of academic posts): R18 430 306,00

11. The Faculty runs a comprehensive portfolio of programmes. An important new programme is the Master of Public Health (MPH) which was introduced in January 1999. Ten (10) students have already registered for this programme and more registrations are expected during the course of the year. All other programmes in the Faculty are under constant review. Increasingly all our undergraduate programmes are being managed along the principles of the primary health care approach. The postgraduate programmes, which are a particular strength of the University of Cape Town, are being rationalised and are being further strengthened.

12. The Faculty has several important initiatives which are either already in existence or which are in the process of being developed. These have relevance in the increasingly important public/private mix which has become a world-wide trend. Examples of these are:
• The UCT/MRC Bioenergetics of Exercise Research Unit. This Unit had grown out of a development which started in the early 1980’s; and which today plays an important role in SA in having significant influence on all the major sports codes, in sports development and in a wide range of health and rehabilitation programmes. The Exercise Research Unit is managed by a world-class team of experts. Apart from their contribution to our undergraduate programmes they have no less than 74 registered postgraduate students.
• The Cape Heart Centre, which is a grouping of strong teams who has a common interest in heart diseases. The results of their research is of direct application to the clinical services in SA;
• The UCT Lung Institute. This is a consortium which will research common respiratory diseases in SA, including occupational lung diseases such as silicosis and asbestosis; as well as allergic diseases including dermatology. The building for this Centre is currently under construction.

The Faculty of Health Sciences has significant strengths in research which makes an important contribution in solving the country’s health care problems, and also in developing capacity at an advanced level for health care workers and researchers. Examples of these are:
• The UCT Liver Centre; and
• Genetics research.

Currently under consideration are the establishment of an Institute for Molecular Health Sciences in Africa, and an Institute for Infectious Diseases and Immunology.

The Faculty of Health Sciences is proud of already being the most racially mixed Health Sciences Faculty in the country for undergraduate programmes. The transformation at postgraduate level is slower, but it is a priority with the Faculty.