DOCUMENT MSC A HEALTH PROFESSIONS COUNCIL OF SOUTH AFRICA MEDICAL AND DENTAL PROFESSIONS BOARD COMMITTEE FOR MEDICAL SCIENCE POLICY REGARDING AND TRAINING OF INTERN MEDICAL SCIENTISTS 1. INTRODUCTION There are three active Medical Scientist Registers: Medical Biological Scientists (MS), Medical Physicists (PH), and Genetic Counsellors (GC). Medical Biological Scientists may register in one, or at the most two, discipline(s) among the following: Anatomical Pathology, Cell Biology, Clinical Biochemistry, Genetics, Haematology, Immunology, Microbiology, Molecular Biology, Pharmacology, Physiology, Radiation Biology, Reproductive Biology or Virology. In order to become a professional medical scientist in the registration category Independent Practice in South Africa, i.e. registered with the HPCSA, the formal academic requirements, internship and Board approved assessment of competence have to be successfully completed. A Medical Scientist first has to register as an intern for 24 months, successfully complete a Board approved assessment and then apply for registration, according to the promulgated regulations: Regulations relating to the registration of interns in medical science (R. 578) (Government Gazette 22 May 2009) Regulations relating to the qualification for registration of medical scientists (R. 579) (Government Gazette 22 May 2009) Registration as a Medical Scientist in the category Student does not require internship training and implies that the Medical Scientist is studying towards a degree that may lead into the profession of Medical Science. Regulations relating to the registration of students in medical science (R. 580) (Government Gazette 22 May 2009) All individuals who plan to work within the Scope of the Profession of Medical Science must be registered with the HPCSA. Regulations defining the scope of the profession of medical science (R. 579) (Government Gazette 22 May 2009) Individuals doing health related research, but who do not work within the Scope of Medical Science do not need to be registered with the HPCSA. All relevant, up to date, registration forms and documents have been posted on the HPCSA website (http://www.hpcsa.co.za/). Look under Professional Boards, Medical and Dental (and Medical Science), and navigate among the list of categories on the right.
2 FULL CERTIFIED DOCUMENTATION IS ESSENTIAL FOR REGISTRATION. 1.1 Upon registration as an intern-medical scientist an applicant must comply with one of the criteria below: a) submit proof of having completed appropriate academic requirements b) submit proof of registration for an accredited MSc(Genetic Counselling) degree of at least 24 months duration, full time (applicable only to GC) Facilities accredited for internship training are obliged to provide candidates for internship training with details concerning registration since intern medical scientists are legally required to register with the HPCSA (Committee for Medical Science, Medical and Dental Board) within two months following the commencement of internship training. 1.2 The intern medical scientist, the coordinator of the Intern Training Programme and the accredited training facility are jointly responsible for ensuring that the registration of an intern medical scientist with the Board takes place within that period. 1.3 Registration as a professional medical scientist (Independent Practice) is possible only after a) the relevant academic requirements have been completed, b) the internship has been satisfactorily completed and the candidate has been successful in an examination as determined by the Board (definition of examination in this context means an assessment of competency conducted by an educational institution approved by the Board or examiners appointed by the Board), and the appropriate documentation has been submitted to confirm these facts. 1.4 Registration as a medical scientist will only be possible if a person holds a valid registration as an intern medical scientist. 1.5 Foreign applicants applying for registration must also submit official documentary evidence of meeting academic requirements or the academic requirements and the internship training in the category of medical science in which registration is required. Foreign applicants may be required to complete an internship or part thereof in South Africa in order to familiarise themselves with local circumstances. 2. ACADEMIC PREREQUISITES FOR INTERNSHIPS IN MEDICAL SCIENCE 2.1 The minimum academic requirements are: 2.1.1 four years full-time formal education (BSc(honours)) degree in the case of MS or PH, or equivalent (as determined by SAQA and in line with the recommendations of the SGB) 2.1.2 four years full-time formal education (BSc(honours)) and registration for an accredited MSc (Genetic Counselling) degree in the case of GC. Application for intern registration should be made in the first year of study and the intern will receive 12 months credit for two years of study towards an MSc in Genetic Counselling. One year full-time internship must follow the attainment of the academic qualification.
3 2.2 In circumstances where academic studies are not as outlined in 2.1 above but are believed to be equivalent to the above formal requirements, an applicant may submit details to the Committee for Medical Science for consideration. 2.2.1 Certified documentation is always required and should be submitted with the application. 2.2.2 Applicants should note that qualifications obtained at foreign academic institutions, which frequently offer different curricula, are difficult for the Committee for Medical Science to evaluate and that, therefore, as much detail as possible of the exact course(s) for the year(s) in which the applicant studied at the foreign institution and as much further detail as possible should be submitted with the application. A SAQA equivalence evaluation may be requested. 2.2.3 If such an application is turned down, it is not advisable to apply to the Committee for Medical Science again unless entirely new information becomes available and is of such a nature which is likely to make a substantial difference to the view in which the original application was considered by the Committee for Medical Science. 2.2.4 If such an application is accepted by the Committee for Medical Science, it is the responsibility of the applicant to secure placement in an internship training programme in the relevant category (see below). 3. INTERNSHIPS 3.1 REGISTRATION 3.1.1 The intern is obliged to register with the HPCSA (Committee for Medical Science, Medical and Dental Board) within two months of commencement of intern training at an accredited facility. 3.1.2 When the registration fee is rendered, the exact date of commencing the internship must be clearly stated. It is the applicant s responsibility to ensure that the payment for registration is received by the HPCSA. Late registration and non-payment of registration fees will lead to disciplinary procedures. 3.1.3 All applications for internships must be accompanied by the following documents: a) A written undertaking from the coordinator of the accredited intern training programme stating that the appropriate facility is willing to supervise the intern and stating the period of internship involved; b) A written undertaking from the Head of the training facility accredited for internship training indicating that the intern will be accommodated for the full duration of the internship arranged, as well as the exact period of the internship; c) In the case of GC, a written undertaking from the Head of Department of the supervising University, stating that the University concerned will act as collaborating University in association with the internship setting, that the Department will ensure that the training is undertaken in accordance with the approved internship programme and the dates of the internship. In order to act as collaborating University the University must offer a recognised MSc (Genetic Counselling) degree. It is the joint responsibility of the coordinator of the training programme and the Head of Department of the University to ensure that progress
4 reports on the intern are written at least every 6 months during the internship period and are presented in the portfolio of evidence of training; d) It is recommended that a contract be drawn up between the intern and the training institution to confirm the above undertakings. 3.1.5 The coordinator of the intern training programme has to ensure that the training team includes supervising medical scientists or medical specialists who have recognised qualifications in medical science in a relevant discipline or recognised specialist qualification in an appropriate field and registration with the HPCSA; plus three years experience; and appropriate training and/or experience in supervision. 3.1.6 In cases where the internship is completed at more than one training institution, the duration of each placement should be clearly stated. 3.2 TIMING OF INTERNSHIP 3.2.1 The internship on a full-time basis may only commence after completing the prerequisite formal academic requirements; internship time which predates the formal academic requirements will, therefore, not be recognised as part of the internship. 3.2.2 The training to be undertaken by an intern medical scientist shall meet the following conditions: (a) (b) (c) (d) Internship training shall be for a period of twenty-four (24) months and where it is broken or interrupted it shall consist of periods which, when added together, are not less than twenty-four (24) months in total, including vacation leave not exceeding one month per annum and sick leave not exceeding two months per annum; no such break or interruption shall exceed a period of one year if the period of training prior to such break or interruption is to be recognized as part of completed internship training; the period of twenty-four (24) months of internship training contemplated in paragraph (a) must be completed within a period of four (4) years from the date of registration as an intern medical scientist; if an intern does not complete his or her internship training within a period of four (4) years, his or her registration in terms of the Act shall be cancelled, unless- (i) (ii) he or she provides the board with satisfactory reasons as to why his or her registration should not be cancelled ; and he or she complies with the conditions which the board may determine for completing his or her internship training in order for the board to recognise such training. 3.2.3 A scientist who has completed an MSc or PhD degree in an appropriate field and who wishes to do intern training to register in the category Independent Practice, may be considered for a shortened internship period, at the discretion of the Committee for Medical Science, should it deem the activities during the student years pertinent and appropriate in preparation for intern training. A minimum of 6 months intern training and an assessment of competence will be required before registration in the category Independent Practice.
5 3.3 INTERNSHIP TRAINING ARRANGEMENTS 3.3.1 The term internship refers to the prescribed minimum period of 24 months of full time experiential training (see above) OR a shortened internship at the discretion of the committee, in the case of applicants who have an appropriate MSc or PhD degree. 3.3.2 An internship usually comprises full time employment as an intern medical scientist at a facility accredited for training intern medical scientists (a list of accredited training facilities is available on the HPCSA website) by the Committee for Medical Science and following an accredited programme of training. 3.3.3 Should an intern require vacation leave in excess of one month per annum or sick leave in excess of the two months per annum, it is the responsibility of the coordinator of the training programme at the training facility to extend the period of intern training in order to comply with the above requirements. 3.3.4 All requirements relating to the internship in medical science must be completed within a four-year period. 3.4 INTERNSHIP TRAINING PROGRAMMES 3.4.1 Internship training programmes must be compiled by the coordinator of the training programme in situ at the various sites where the training is to proceed. Training is only permitted at facilities accredited for this purpose by the Committee for Medical Science. The dates of proposed commencement and completion of internship training must be clearly communicated. 3.4.2 The application for intern training must be submitted by the candidate together with a written undertaking from the coordinator of the training programme who will ensure that appropriate supervision is provided by a suitable and competent team of trainers. 3.4.3 The information as requested in form 26 MSIN/PHIN/GCIN must be submitted with the application to the Committee for Medical Science for approval of the internship. 3.4.4 In cases where a shortened internship is requested, details of the abbreviated programme, the specific medical science tests and/or skills which will be developed, techniques in which training is to be provided must be submitted by the coordinator of the accredited intern training programme. 3.4.5 The coordinator of the intern training program and some members of the training team must be registered in the same or appropriate professional discipline as the intern medical scientist. 3.5 COMPLETION OF INTERNSHIP 3.5.1 An internship must be completed within four years from date of first registration as an intern medical scientist. 3.5.2 Separate intern duty certificates (FORM 36 MS/PH/GC) (available on the website) must be submitted to the Committee for Medical Science by the relevant coordinator or coordinators of the intern training programme for each training placement, if there is more than one. These certificates should be handed to the intern by the coordinator for
6 submission to the Committee for Medical Science together with the application for professional registration as a medical scientist (Form 24 MS/PH/GC). 3.5.3 Training facilities are obliged to ensure that intern medical scientists are evaluated regularly, at least every six months, according to the criteria for intern training in the relevant category. The intern must be kept informed of his/her progress on the basis of this evaluation and copies of the progress reports/assessments must be retained for submission in the portfolio of evidence of training. The intern must keep a detailed portfolio of all aspects of the training for final assessment of competency. 3.5.4 Extension of internships: Internship training may be extended beyond the 48-month training period should the coordinator of the intern training programme deem this necessary in order to attain competence, and the training facility agree to support such extension. An intern medical scientist may not perform any professional acts unless it is under appropriate supervision and forms part of the formal internship period. 3.5.5 The intern will need to demonstrate successful completion of an assessment of competence (described as an examination in the legislation) as determined by the Board. A detailed portfolio, as described below, must be handed in for Board approved assessment within 8 months prior to final completion or on completing the internship. Assessments are only done twice a year and therefore there may be cases where portfolios need to be submitted up to 8 months prior to completion of the internship. If this is the case it should be clearly stated in the portfolio and the coordinator of the training program should indicate which aspects of the training program still need to be completed by the intern. The full 24-month internship must be within 2 months of final completion by the intern before submission of the forms, together with proof of successful evaluation of the portfolio, to the board for registration. 4. UNSATISFACTORY PERFORMANCE OF THE INTERN 4.1 In the event of unsatisfactory performance of an intern, a written report should be produced by the training institution and should be submitted to the Committee for Medical Science with recommendations for either a) the termination of the internship at a given date; or b) the extension of the internship with clearly specified objectives; such an application for an extension to be submitted not later than following the third progress report or the 18th month of the internship, preferably earlier if possible. 4.2 Should an intern become mentally or physically incompetent to perform medical science acts as required professionally, the matter should be reported to the Health Committee of the Board. The Health Committee will investigate the circumstances and will provide guidance on the treatment and rehabilitation of the intern medical scientist or deal with the matter as circumstances dictate.
7 5. TRAINING AND SUPERVISION OF INTERNS 5.1 Supervision of interns requires that the supervising team comprising medical scientists and/or appropriate medical specialists and another appropriately qualified and registered person or persons are accessible and available for personal contact on a day-to-day basis. 5.2 There are specific supervisory and training stipulations required for training in each registration category. The content as stipulated in the approved curricula (soon to be posted on the HPCSA website) by the Committee for Medical Science should be included in the intern training programme. 5.3 The number of interns that each accredited training facility may supervise will be determined when the facility is accredited and will depend on the size of the team that provides the training and the full-time or part-time involvement of the supervisors. 5.4 If an intern medical scientist fails to comply with the requirements set by the Committee for Medical Science, or the training institution fails to deliver the content of the approved training programme, such training will not be recognised by the Committee. 5.5 Professional Registration categories: An intern may only register in the discipline in which he or she has trained. In rare circumstances migration between related disciplines may be appropriate, but should be done according to the guidelines in the curricula and in consultation with the Committee for Medical Science. 5.6 An internship setting must provide suitable and adequate exposure in the relevant category as stipulated in the accredited training programme. 5.8 The registration number of the intern medical scientist must be reflected in all correspondence. ---o0o--- GUIDELINES FOR THE PORTFOLIO The portfolio is the product which will demonstrate the elements of training that have been completed by the intern and the competence that has been achieved. The portfolio will be submitted to the HPCSA for Board approved assessment of competence at a national level prior to registration as a medical scientist. Submission may be made up to 8 (eight) months prior to completion of the 24-month internship to accommodate the biannual assessment of portfolios. If this is the case it should be clearly stated in the portfolio and the coordinator of the training program should indicate what aspects of the training program still need to be completed by the intern. Up to 22 months of the full 24-month internship must be completed before submission of the forms to the board for regsistration. The portfolio should include 8 sections as outlined below. Each portfolio must have a table of contents to enable the assessor to easily find relevant information. 1. Summary page 2. Intern Program 3. Description of activities 4. Scientific/medical knowledge 5. Assignments 6. Assessments 7. Research experience 8. Final assessment by training facility including a list of competencies achieved
8 1. Summary page (suggested content amend as appropriate) Activities (Section 3) Scientific knowledge (Section 4) Assignments (Section 5) Assessments (Section 6) Research experience (Section 7) Summary of activities recorded in logbook (each activity does not have to be submitted) Journal club Seminars Conferences/workshops attended Patient/case discussions Case studies/scenarios Tests and examinations Presentations Literature reviews/essays Coursework Lectures Trainer assessments Supervisor assessment Performance reports Project proposal or post-graduate protocol Official/applied research methodology courses Approved ethics application (where applicable) Write up or preliminary results and interpretations Examiner s report Publications Presentations at a national or international conference Section 2. Intern Program The intern should include a copy of the approved training program. 3. Description of Activities (can be listed) The type and number of activities that are needed to efficiently perform the procedure or method with/without supervision should be determined by the trainer/supervisor at the commencement of training. A list of actions or description of a specific activity with reference to standard operative procedures should be part of the logbook, including: the date when the activity is performed together with a description of the activity, signature/comment by the trainer, as well as signature by a dedicated supervisor. The log book does not need to be included with the portfolio, but reference to its content should be documented and it should be available on request. The supervisor or head of the training facility should review the procedural list with the intern and trainer at regular intervals to discuss difficulties and possible amendments. 4. Scientific/medical knowledge Attendance at lectures, seminars, conferences and participation in workshops/training/methodology courses should be listed. Documented proof of attendance should be retained and be available for review.
9 5. Assignments Subject specific assignments such as case studies, open book and formal tests, presentations, literature reviews, essays and course work should be categorized, marked by the trainer and signed by the supervisor as moderator of the assignments (or an appointed in-house moderator). 6. Ongoing Assessments Self-assessments together with the supervisor s appraisals should be performed at specific intervals. Remarks regarding observations, suggestions, amendments and progress according to the timeschedule should form part of the performance report. 7. Research experience A peer-reviewed project proposal, i.e. mini-projects and/or formal post-graduate protocol, together with approved ethics (if appropriate) and academic body application for the project, progress or examiners reports could form part of the research portfolio. Possible publications (i.e. peer-reviewed article and/or abstract submissions for an oral or poster presentations at national/international conferences), awards obtained for the research, and official/applied research methodology courses completed should be noted. 8. Final assessment by training facility including a list of competencies achieved This section will include the final assessment or provisional final assessment (if the portfolio is submitted prior to completion of the assessment) by the training facility and will also summarise the competencies achieved by the intern. It should be signed and dated.