Senior Staff Duties and Responsibilities
District level hospital guidelines applicable for interns and comm service doctors. Published in 2016
Consultants and Principal Medical Officers
Consultants and Principal Medical Officers
Consultants in Paediatrics are dual appointees with responsibilities to both the Gauteng Provincial Department and Wits University. Definition of exact day -to-day duties is not possible but broadly, their time is divided between Service, Teaching and Research duties as well as administrative responsibilities. In general, where competitive forces are present, patient needs, i.e. service delivery, takes precedence.
Service
Core-Time;
The official hours of work are from 8am – 4pm and should, in general, be adhered to. Service duties during this time include supervision of the day -to-day clinical problems. Consultants are responsible for ensuring the smooth running of their units and for conducting post-intake rounds and day four rounds. On the post-intake rounds all admitted cases should be assessed and the management should be modified where necessary. Clear instructions should be given where further “red flag” checks by other staff are required. Where necessary, the consultant should check sick patients later in the day. Day 4 rounds should be aimed at expediting discharge prior to intake, evaluating response to treatment, and using one or two patients, where appropriate, for teaching. However, different units structure these rounds differently and some of these activities may occur outside of the day 4 round.
After-Hours Duties;
For those Consultants and PMOs partaking in commuted overtime, duties consist of a system of night-time and weekend call duties including availability for telephone consultation throughout the overtime period, physical consultation where circumstances require and ICU and Post-Intake ward rounds (PIWRs) on weekends. In POPD overtime requirements are met with services provided in casualty in the evenings.
Teaching
Rahima Moosa Mother and Child Hospital’s Paediatric Department has a hard-earned, well -deserved reputation for undergraduate and postgraduate teaching.
GEMP I and II students attend the paediatric wards on Thursdays and Tuesdays respectively. They will be allocated to a unit and be expected to “shadow” the unit doctors from 8am to 11am. They are then expected to clerk a patient and attend a tutorial by the allocated registrar from 12am to 1pm.
GEMP III clinical teaching attempts to formally address the full spectrum of the paediatric curriculum and requires that the assigned tutor finds a suitable case at least 30 minutes before the session and notifies the student group in advance so that they may take a history and examine the case prior to the tutorial. A “Topics list” should be filled in by the students so that the consultants can find cases to “fill the gaps”. It is imperative that this list be kept up-to-date as to avoid duplication of tutorials. The part-time, honorary consultants add an important, often “first-world” perspective of paediatrics and are encouraged to address teaching at this level. It should be remembered that the emphasis should be on teaching hands-on, basic, clinical skills. In addition to clinical tutorials, students also have access to computer and internet facilities in Block B, 2nd Floor, as well as do presentations on specific Paediatric problems and themes.
GEMP IV training allows for a clinical clerkship with junior intern allocation rotating between the paediatric Units and Newborn Services. The students should be integrated fully as members of the “team” and are expected to involve themselves with the usual activities of the Unit e.g. Intakes, Procedures, Weekend Duties etc. and they should be given cases to clerk and care for under supervision. Registrars in the Unit are directly responsible for supervising the Junior Intern’s clinical work. Most of their teaching should be done during routine rounds. Daily all available GEMP IV students should be encouraged to attend a specific problem-based teaching round in the early afternoon (usually starts at 2pm) with a designated consultant.
Post-Graduate teaching should be integrated into all clinical settings especially utilising “interesting” cases on Day 4 rounds and at sub-specialty clinics. Registrar teaching is the responsibility of ALL consultants. A “mock FCPaed” teaching session is offered on Wednesday Mornings 8h00-8h30. The Community service and rotational Medical Officers are all encouraged to prepare themselves to write the DCH and special arrangements for tutorials can be arranged. Consultants are asked to assist with this. Alternatively, candidates can join FCPaed I teaching groups. The formal academic programme is discussed elsewhere.
Research
Improving the quantity and quality of academic research remains a priority. All research projects must have ethical clearance from the Human Research Ethics Committee (HREC) at the University of the Witwatersrand. Currently HIV/AIDS is the major area of investigation, however increasingly all other paediatric topics are being investigated. Contract research is a significant source of funding for the department.
Professor Coovadia and Empilweni Services and Research Unit (ESRU) are willing to assist anyone who is keen on conducting any research whether in HIV or
not. http://www.esru.co.za/Home/AboutUs.aspx
See section XI below on Research Approval Process (page 23)
RWOPS
Remunerative work outside the public sector is allowed only with approval of the Gauteng Health department and must comply with strict guidelines. ALL monies earned from other sources than the Province are subject to these controls. Applications must be renewed annually and submitted to the CEO by December of the year prior to the year one hopes to do RWOPS. All applications are first submitted to the HOD, the CEO and then the University RWOPS committee administered by the Wits Health Consortium. Only staff fully registered for unlimited private practice may apply. (I.e. excludes Interns, Community Service MO’s and many foreign graduates.)
Note : RWOPS at RMMCH is defined as ANY remuneration received for work done which is not part of one’s full-time post salary. This includes amongst other activities, marking examination papers, participating in clinical exams, marking theses, speaking engagements, research, consultations etc.
Financial Disclosures
All senior staff in the department are required to complete an annual financial disclosures form that has to be submitted to the hospital’s HR department.