Medical Registrar's Information Pack

UNIVERSITY OF THE WITWATERSRAND FACULTY OF HEALTH SCIENCES DEPARTMENT OF PSYCHIATRY

INFORMATION FOR REGISTRARS

DEPARTMENT OF PSYCHIATRY ORGANOGRAM HEAD - PROFESSOR CP SZABO CHARLOTTE CHRIS HANI TARA HOSPITAL HELEN JOSEPH STERKFONTEIN COMMUNITY MENTAL WITRAND MAXEKE BARAGWANATH HOSPITAL HOSPITAL HEALTH SERVICES JOHANNESBURG ACADEMIC ACADEMIC HOSPITAL EKHURULENI DISTRICT SPECIALIST HOSPITAL HEAD OF CLINICAL HEAD OF CLINICAL DR. MAITIN DEPARTMENT HEAD OF CLINICAL HEAD OF CLINICAL UNIT HEAD OF CLINICAL HEAD OF CLINICAL DR. T MADIGOE UNIT DEPARTMENT Dr K MAAROGANYE DR. DEPARTMENT DEPARTMENT ASSOC. PROF B ADJ. PROF U SPECIALIST MODISANE PROF CP SZABO ADJ. PROF FY JEENAH SENIOR JANSE VAN SUBRAMANEY VACANT SPECIALISTS RENSBURG REGISTRAR (MEDICAL) HEAD OF CLINICALHONORARYHEAD OF CLINICAL DR. S FERNANDES HEAD OF CLINICAL 2 POSTS UNIT - Child and UNIT DR. P NAICKER SPECIALISTS UNIT MEDICAL OFFICERS Family Unit DR. W FRIEDLANDER DR C BRACKEN Dr J SEBEI DR. E PAK 4 POSTS Vacant DR K LAXTON VACANT SENIOR SPECIALIST SPECIALISTS JOHANNESBURG PRIVATE SENIOR DR. H CLARK (CHILD) DR. B MARAIS SENIOR SPECIALISTS METRO DISTRICT DR. M EWART- SPECIALISTS DR. R PRICE- PSYCHOLOGIST DR. T SCHUTTE HEAD CLINICAL UNIT SMITH DR. A PILLAY– SPECIALIST HUGHES MS. J KUHN DR. E ERASMUS ADJ PROF MYH MOOSA DR. M subspecialist DR. F JEENAH DR. N TEMA (5/8) DR. P MAHARAJ TALATALA (Neuropsychiatry) DR. L PARUK (CHILD) SPECIALIST ADJ. PROF R DR. V STANCHEVA – (Sessional) MEDICAL OFFICER PSYCHOLOGIST DR. B ARMSTRONG Dr. F Tarajia THOM Senior subspecialist DR. J BUCKLEY DR. A Vacant DR. R WDGMC (Child and MATCHOUGANSKA BRUMMERHOFF REGISTRAR DR. K adolescent MEDICAL OFFICER REGISTRARS 6 POSTS TRICORIDIS psychiatry) DR. S MEYER SENIOR 4 POSTS SPECIALIST MEDICAL OFFICERS PSYCHOLOGIST DR. C MARSAY 2 POSTS MEDICAL PRINCIPAL MR. J PERCALE MEDICAL OFFICER (Sessional) PRINCIPAL SPECIALIST PSYCHOLOGIST 1 post DR. F MAYNARD PSYCHOLOGIST DR. N ARIEFDIEN MS. J KOOVERJEE PSYCHOLOGIST DR. Y NEL MS. K JOHN Dr Z Tenea MS. B DR. Z EBRAHIM- PSYCHOLOGIST Dr N Vahed KARPELOWSKY RAHIMA MOOSA IQBAL (5/8s) 7 POSTS SENIOR MS. S ZWANE HOSPITAL DR. G GOVENDER PSYCHOLOGIST MS. A SCHMIDT- DR. T MELAPI SEDIBENG DISTRICT CHIEF MS. L NENE (CHILD) EHCKE SPECIALIST DR. K MANGREY HEAD OF CLINICAL PSYCHOLOGIST MS. J HALSTEAD- /SUBSPECIALIST DR. I CHETTY UNIT ADJ. PROF C SMITH PSYCHOLOGIST CLEAK Dr Paul Sussman Vacant (CHILD) MS. A VACCARI MR. Z MBELE (Child& Adolescent PRINCIPAL MS. L MARELETSE Dr. M JONES Psychiatry) PSYCHOLOGIST SPECIALISTS SENIOR (CHILD) MR. L GOWER DR. D HOFFMAN DR. L ROBERTSON PSYCHOLOGIST MS. G MAKOME MS. S FRASER Vacant Dr. Z RADEBE MS. N NOORBHAI PSYCHOLOGIST SENIOR REGISTRAR (MEDICAL) (Grade 2) MS. E JORDAAN PSYCHOLOGIST 4 POSTS MS. C DA SILVA MS. S MAHARAJ MS. MP MOGOTSI ALMEIDA (CHILD) REGISTRARS REGISTRARS MS. J KOURSARIS MS. M TSHABALALA WEST RAND DISTRICT 13 POSTS 9 POSTS MS. R BEEKARUN MS. C WALDECK SPECIALIST (Sessional) DR. A RAMA PSYCHOLOGIST MEDICAL OFFICERS MEDICAL MS. T GRAHAM PSYCHOLOGIST REGISTRAR (MEDICAL) MS. M NAIDOO 7 POSTS OFFICERS (Sessional) MS. L FERREIRA 2 POSTS MR. R PARRY 4 POSTS MS. T SMITH MEDICAL OFFICERS MS SKEAD 1 POST REGISTRARS REGISTRARS PSYCHOLOGIST REGISTRARS 1 POST 13 POSTS MS O. GERBER 5 POSTS MEDICAL MEDICAL OFFICERS OFFICERS 6 POSTS 2 POSTS

ADMINISTRATIVE SUPPORT : PATIENCE TABA (CMJAH) : CHANTAL LAMBERT (Department ) TRAINING FOR SPECIALIST QUALIFICATION

This comprises both clinical - on site - and Department based teaching, with service and academic components. All registrars are thus jointly appointed by Gauteng Health (specific pay point) and the University (Faculty of Health Sciences/School of Clinical Medicine/Department of Psychiatry) Training consists of a range of activities, including:

 Supervision by consultants – related to clinical service - during ward rounds and generally, case presentations and journal article presentations at the respective units.  Departmental meetings/seminars and lectures  Workshops and updates organised by the Department.

There are a number of specific requirements in fulfilment of training:

- Duration: 48 months (44 months of training/4 months vacation leave over 4 year period) - Research - Psychotherapy

It is expected that all requirements will be completed within the 48-month period of appointment as a registrar, specifically both registering for and entering the Part II exam.

I Specialist qualification /FCPsych

Whilst the FCPsych is the only qualification recognized for specialist registration with the Health Professionals Council of South Africa (HPCSA) all registrars will be required to register for and complete the MMed degree through the University. Such registration needs to be undertaken annually through the Faculty.

All registrars must successfully complete either the MMed I (only available until 2017)/FCPsych I (as of 2018) and the FCPsych II through the Colleges of Medicine of South Africa (CMSA) for the FC Psych. . There are certain requirements for entrance to the FCPsych Part I and Part II which are obtainable from the CMSA website www.collegemedsa.ac.za. Successful completion of the MMed part I permits entry to the FCPsych part II.

CMSA – FC PSYCH(SA) Summary of requirements: List of components/topics (and weighting) to cover during rotations - from the FC Psych(SA) blue printing schedule (https://www.cmsa.co.za/view_college.aspx?collegeid=20)

o Knowledge:

 Neuropsychiatry and D/O due to medical conditions (30%): Neuropsychiatry; Consultation-Liaison Psychiatry; Psychogeriatrics;  General Psychiatry (40%): Addiction Psychiatry; General psychiatry across the lifespan; Emergency psychiatry; Psychopharmacology; Intellectual disability  Special topics (30%): Forensic Psychiatry; Ethics; C&A Psychiatry; Public Mental Health and Community Psychiatry, Psychotherapy; ECT; Research; Management and Leadership; Culture and Spirituality

o Core competencies:

 Medical expert/clinical decision maker  Communicator  Collaborator  Manager  Health Advocate  Scholar  Professional  Per module: General psychiatry across the lifespan; neuropsychiatry; addiction psychiatry; Emergency Psychiatry; Consultation-Liaison Psychiatry; C&A Psychiatry; Intellectual Disability; Psychogeriatrics; Forensic Psychiatry; Public Mental Health and Community Psychiatry, Psychotherapy; ECT; Other neuro-technologies; Research; Management and Leadership; Culture and Spirituality

MMed degree

The degree consists of two parts:

 Course work and option for assessment thereof at the end of the course – Part I (last available in 2017 and confers eligibility for entry to the FCPsych II provided the FCPsych II is undertaken within 6 years of successful part I completion );  No Part II but FCPsych II recognized as equivalent.  A research report (Part III) in part fulfilment of the Masters’ degree.  If a registrar successfully completes the FC Psych Part I exams he/she will be credited for the MMed Part I and if a registrar successfully completes the FC Psych Part II exams he/she will be credited for the coursework component of the M Med (Part II) and has only to complete the research report, with a successful examination outcome, in order to obtain the MMed degree.

1. Coursework

This consists of:

 A program for the MMed Psych Part I course in the first year with lectures in Neuroanatomy, Neurophysiology, Neurochemistry and Psychology – available until end of 2017. 2018 will see a revised programme aligned with the FCPsych I requiremements  A program for the Part II course over the second, third and fourth years. The format will be seminars and workshops covering various topics as appropriate for the FCPsych II exams.

2. Research Report

WITS Department of Psychiatry (2016) - Information on: Research requirements for MMED in Psychiatry (MMC040) – requiring the registration of a Research Report (PSMH7009); and CMSA Regulations regarding the FC Psych (SA) Part II examination

According to the University of the Witwatersrand’s Faculty of Health Sciences’ Rules and Syllabuses 2012 (pp89-90), candidates registered for the degree Master of Medicine in Psychiatry (MMC040), have to register for a prescribed Research Report (PSMH7009) as one of the required academic units for fulfilment of the degree.

College of Psychiatry, CMSA

There is currently one exit exam through the SA College of Psychiatrists, for which candidates are required to have already submitted at least a draft of a research report, prior to being eligible to sit for the College Part II exams and from 2014, as per HPSCA specifications, a completed report before being eligible to register as a specialist with the HPCSA. The Dean of the Faculty will only sign the HPCSA document for specialist registration if the research report has been submitted for examination. The exit exams are usually scheduled in the first or third quarter of the fourth year of training.

Research requirements according to the Regulations for the FC Psych (SA), (par 3.2.8) have been specified: “Research Experience as evidenced by a Head of Department and supervisor approved, at minimum, first draft of the research report – this must comprise data collection and analysis i.e. a results section, with preliminary content related to the introduction/ methods/ discussion and conclusion sections. Research may include case series (but not single case reports) as well as systematic reviews that conform to recognized methods of undertaking such reviews”.1

Blue printing for Part II Paper 3 (Special topics in Psychiatry) also includes potential research content in the written papers, specifying the following components/sub sections: Research Concepts; Principles of Epidemiology; Research Ethics; Study Design and Protocol Development; the Research Process; Biostatistics; Writing up Results; and Critical Appraisal (p19).2

Research competencies that must be acquired, were specified (p32), to include the abilities to:2 (1) be involved in constant critical review of scientific principles and clinical precedent (2) understand different research methodologies and study designs (3) be knowledgeable about the principles of scientific method in practice and the use of this knowledge to evaluate developments in psychiatric research

1 REGULATIONS for Admission to the Fellowship of the College of Psychiatrists of South Africa FC Psych(SA), http://www.collegemedsa.ac.za/view_exam.aspx?examid=41 2 APPENDIX G REGULATIONS FC PSYCH(SA) PART II - BLUE PRINTS (4) be able to undertake a research or evaluation study, use appropriate statistical methods of analysis, and critically appraise published research relevant to psychiatry (e.g. evidence from randomized controlled trials, systematic reviews, meta-analyses) (5) develop the ability to teach, assess and appraise (6) develop the habits of lifelong learning The Portfolio of Learning (PoL) is another requirement of the CMSA. This document also has a section to report on the candidate’s research activities during his/her academic training (http://www.collegemedsa.ac.za/view_exam.aspx?examid=41).

In order to fulfil these requirements in time, the following schedule is recommended:

 Appointment of a supervisor, preferably in the first quarter of the first year of study, by notifying the Department of Psychiatry’s Research Committee of the preparedness to commence with the project and by submitting a request to the Head of the Department of Psychiatry and the Postgraduate Assessors Group to appoint a nominated supervisor.

 Attendance of required training courses including: (1) A protocol development course e.g. the Research Methodology and Techniques Course presented by the Faculty of Health Sciences (FHS) Health Sciences Research Office (HSRO), in the first six months of the first year; (2) A course on data analysis and statistics e.g. the Applied Statistics Methods Course, presented by the HSRO, within the first 18 months of training; and (3) A scientific writing course during the first half of the third year of training.

 Development of protocol should be completed within the first 12 months of the first year, in order to present the proposed protocol for approval to the Department of Psychiatry Postgraduate Assessors Group in the first quarter of the second year.

 Plagiarism/Similarity index – A report on documents’ similarity indexes must be submitted for both the protocol document being submitted to the Assessors Group, as well as for the final Research Report document being submitted for examination, using identified software programs such as “Turnitin”.

 Submission of protocol for ethics clearance to Human Research Ethics Committee – Medical must be done with the granting of clearance within the first 12-18 months, prior to commencing with data collection.

 Data collection and analysis starts upon approval of protocol and granting of ethics clearance, to be completed within 24 months.

 Report writing with completed first draft of the report must be completed by the last quarter of the third year.

 Appointment of examiners on completion of the final draft of report within the first six months of the fourth year.

 Submission of completed report for examination to Faculty Postgraduate Office and revision of the Research Report according to corrections required by examiners during the second six months of the fourth year.

Template for candidates’ schedule to complete the Research Report (PSMH7009) requirement:

First six months Second six months FIRST YEAR Appointment of supervisor Protocol development Research methodology course Presentation to Assessor Group Protocol development Submission for ethics clearance SECOND YEAR Presentation to Assessor Group Data collection and analysis Submission for ethics clearance Applied statistics course Data collection and analysis THIRD YEAR Scientific writing course Report writing with completed first draft FOURTH YEAR Appointment of examiners Revision of Research Report Submission of final draft report according to examiners’ for examination recommendation and graduation

 Research supervisors

Contact with prospective supervisors who are available in the Department will be facilitated by the Departmental Research Committee (DRC) and approved by the Academic Head of the Department (HoD). The supervisor has research experience and will provide guidance. Supervisors are expected to attend relevant post graduate supervision workshops and training courses. The relationship between supervisor and postgraduate student is a specific one and depends on the understanding that a supervisor’s role is to give guidance, not to do the research or write a thesis for a candidate.

The DRC provides a list of eligible supervisors and their special areas of interest from which candidates may choose (Mrs. Chantal Lambert or Ass. Prof. Bernard van Rensburg). Supervisors will assist with protocol development; presentation for approval and the research process thereafter. Co-supervision by more than one supervisor will only be considered if an additional supervisor is required with particular additional expertise. Co-supervision must be motivated for and approved by the Head of the Department.

 Process and documentation required

(1) Protocol Assessment Nomination of supervisor; appointment of additional/replacement of supervisor; signed agreement supervisor/candidate; protocol application form submitted with copies of protocol to Assessor Group (Mrs Junia Mthombeni); plagiarism form signed by candidate; quarterly progress reports by supervisor to DRC; letter to HoD of confirmation of first draft report by supervisor two months prior to sitting for the FC Psych(SA) Part II examination;

(2) Research Report Examination Nomination of examiners by supervisor (approved by HoD); conflict of interest (examiners); submission for examination; resubmission of revisions according to examiners’ recommendations.

(3) Graduation Requirements for graduation; Final Submission of Thesis, Dissertation or Research Report/Project; Declaration by supervisor

Relevant information and forms can be obtained from the FHS HSRO website: - https://www.wits.ac.za/health/faculty-services/research-and-postgraduate- offices/postgraduate-studies/protocols--research/ - https://www.wits.ac.za/health/faculty-services/research-and-postgraduate- offices/postgraduate-studies/enrolment/

Post Graduate Information Booklet, Style guide, Funding: - https://www.wits.ac.za/health/research/communiques/

o https://www.wits.ac.za/media/wits-university/faculties-and-schools/health- sciences/research-entities/documents/Postgrad%202017-3%20(4).pdf

o https://www.wits.ac.za/media/wits-university/faculties-and-schools/health- sciences/research-entities/documents/FACULTY%20OF%20HEALTH %20SCIENCES%20STYLE%20GUIDE%20FOR%20THESES-DISSERTATIONS- AND-RESEARCH%20REPORTS-Updated%20Marh%202016.pdf

 Contents and format of research proposal Refer to Faculty guidelines for applicants for higher degrees: https://www.wits.ac.za/media/migration/files/cs-38933-fix/migrated-pdf/pdfs-4/guidelines %20on%20proposal%20development.pdf

 Protocol approval by Faculty Graduate Studies Committee  Assessors evaluate new protocols to determine whether there are any obvious shortcomings and if too little or perhaps too much work is proposed. Deadlines for submission are available through the Department’s administrator and departmental secretary (Mrs Junia Mthombeni). After submission candidates will be given an appointment to meet with the Department of Psychiatry Assessors Group together with the supervisor. A discussion will follow related to the recommendation of the assessors. They may suggest acceptance of the protocol as it is, or require minor or major changes. If the protocol requires major changes, a candidate may have to resubmit a revised protocol for re-evaluation. The assessors write a report on a standard form, which goes to the FGSC for a formal decision. The Chair of the Departmental Assessors Group also approves the nominated supervisor(s) on behalf of the FGSC.

 Ethics

The University has a strict policy of adhering to international ethical norms for research. The Human Research Ethics Committee (HREC) must approve all projects (Mr Rhulani Mkansi: [email protected]; Ms Zanele Ndlovu: [email protected] ). In order for a protocol to be evaluated in the month of submission it must reach the HREC offices before the 7th of that month. Forms and details of the requirements are available from the Department’s administrator (Mrs

Chantal Lambert).

A copy of the clearance certificate with reference number should be submitted to the Departmental Research Committee for record keeping.

 Faculty Postgraduate and Research Support

Information on the support that the WITS FHS provide to candidates, can be obtained from the HSRO website https://www.wits.ac.za/health/faculty-services/research-and- postgraduate-offices/.

The HSRO is headed by Professor Maria Papathanasopoulos (Assistant Dean: Research and Postgraduate Support) and provide services including: - Training workshops - Information on external funding sources - Research capacity building initiatives - Mentoring for postgraduate students and supervisors

* A FHS HSRO Post Graduate INFORMATION Booklet can be obtained from: https://www.wits.ac.za/media/wits-university/faculties-and-schools/health- sciences/student-documents/postgraduate/Faculty%20of%20Health%20Sciences %20postgraduate%20information%202016.pdf

 Research Courses In addition to the candidate’s supervisors’ inputs, a number of courses and other guidance are routinely offered by the FHS HSRO. Information on staff and postgraduate research and statistical support can be obtained from: http://www.wits.ac.za/health/hsro/research/staff-and-postgraduate-research-and- statistical-support/.

Time tables for courses/workshops/seminars/tutorials are developed annually, are available online from this website and are also regularly distributed by the Department of Psychiatry. For all bookings, contact the research courses administrator on [email protected] or 011 7172503.

Examples of these workshops include:

(1) Research Methodology Course, usually presented in March and August of each year. This course is a requirement preferably in the first six months of the first year. (2) Applied Statistics Methods Course. This course is a requirement preferably in the first 18 months of training. (3) Scientific Writing Course: MMed Report. This course is a requirement preferably in the first half of the third year of training. (4) Data analysis workshop (5) Qualitative research methods course (6) REDCap workshops - Introductory and Intermediate (7) Advanced statistics with STATA  Dyads Dyads (candidate and supervisor) can be arranged annually by the Department to facilitate the progress of candidates in the various stages of completion of their Research Report project, including for: protocol development, report writing and data analysis. Such dyads could typically be scheduled in February, May, August and September.

 Library Information on the services provided by the WITS FHS Library can be obtained from the website: https://www.wits.ac.za/health/faculty-services/health-sciences-library/; and on available Library resources: - https://www.wits.ac.za/health/faculty-services/health-sciences-library/hot-links- essential-resources/ - https://www.wits.ac.za/health/faculty-services/health-sciences-library/cool-links- interesting-sites/

Wits Institutional Repository on DSpace (WIReDSpace) - Is the institutional repository and research archive of WITS University which showcases WITS research on the global stage via an Open Access Platform.

 Email and Internet access All staff and postgraduate students must register as users with WITS Computing and Networking Services (CNS). Once registered, students will have e-mail and internet access and many more facilities at their disposal. Any computer connected to the WITS online network may be used connecting through a modem or WiFi. Through the WITS Intranet candidates also e.g. have access to information for their research such as the WITS FHS Library and HSRO sites.

 Statistical analysis It is recommended by the HSRO that all postgraduate students requiring assistance with biostatistics must undertake a basic statistics course before assistance will be provided. The statistics consultants will provide guidance and offer advice regarding data entry, cleaning and coding, study methodology and data analysis using statistical packages such as STATA, STATISTICA and EPI INFO. Also see: http://www.wits.ac.za/health/hsro/research/staff-and-postgraduate-research-and- statistical-support/statistical-consultations-/.

(1) Medical School - Biostatistics room, Room 336, 3rd Floor, Phillip V. Tobias Health Sciences Building, 29 Princess of Wales Street, Parktown: Monday to Thursday 13h00-17h00. These are walk in consultations and no prior booking is required. Candidates are encouraged to bring their own data or protocol with them. The consultations in the Biostatistics room are conducted by student tutors who are either studying for an MSc or a PhD in Epidemiology and Biostatistics. For further assistance after consultation in the Biostatistics room, the tutors will refer you for one-on-one sessions with a senior biostatistician. (Note that you can only be referred to a senior biostatistician once you have seen a consultant in the Biostatistics room) (2) Chris Hani Baragwanath Academic Hospital- Requires an advance booking and consultations are available only on Thursdays. For bookings, contact Lukhanyo Nyati- [email protected]

(3) For general consultation enquiries, contact the HSRO: [email protected]; 011-717-2503

 Plagiarism Detection – “Turnitin” Turnitin (https://cle.wits.ac.za/home/index) is the world’s most widely recognized plagiarism detection system developed by iParadigms, LLC and is made available by the WITS eLearning Support and Innovation Unit (eLSI). For assistance, the contact for eLSI is: 011-717-7161; [email protected]

 Research Electronic Data Capture (REDCap) REDCap is a tool that allows for the creating of research databases, capture and manage data and export it directly to a statistics program of choice It is web-based, so no need for software installation, and it can be accessed from anywhere with an internet connection (including being mobile device friendly). Data is secured by a password protected account and site encryption, and data servers have various levels of back up in place. Contact Wits REDCap administrator [email protected] with queries, or to make an appointment. REDCap accounts are free of charge for any staff or students of the Wits FHS.

Funding Information on the availability of Faculty funding can be obtained from the HSRO (Mr Moraba Meela). Also see https://www.wits.ac.za/health/research/communiques/; e.g.: - https://www.wits.ac.za/media/wits-university/faculties-and-schools/health-sciences/research- entities/images/Funding%20Information%20Book_May%20to%20July%202017%20deadline %20dates.pdf -

 Research report writing

A comprehensive style manual is available at nominal cost from the desk in the Witwatersrand Health Services Library. All research reports must comply. o https://www.wits.ac.za/media/wits-university/faculties-and-schools/health-sciences/research- entities/documents/FACULTY%20OF%20HEALTH%20SCIENCES%20STYLE%20GUIDE %20FOR%20THESES-DISSERTATIONS-AND-RESEARCH%20REPORTS-Updated %20Marh%202016.pdf

Before submission of the final work for examination, the HoD and supervisor will submit names of nominated examiners to the FGSC for approval. Internal examiners are from within WITS and may not be a candidate's supervisor. External examiners are generally from outside WITS, certainly from outside the Faculty. For research reports at a masters degree level there is at least one internal plus one external examiner.

No research report dissertation or thesis will be accepted into the Postgraduate office for examination without proof of ethical approval of research or written confirmation from the relevant ethical committee that no approval is required. Reports are submitted to the Faculty Postgraduate Office (Ms Palesa Khumalo) together with a copy of the TURNITIN report (to confirm that content has not been plagiarized).

 Contact persons

- Department of Psychiatry Mrs Chantal Lambert: 011-717-2149; [email protected]

- Department of Psychiatry Research Committee Chair – Assoc Prof Bernard J van Rensburg: 011-489-0620/082-807-8103 [email protected]

- Department of Psychiatry Assessor Group Ms Junia Mthombeni: 011-717 2774; [email protected]

- Private statistician Dr Petra Gaylard; 011 486 4836; Fax 086 671 9895; [email protected]

- Faculty of Health Sciences Library: 011-717-2277

- WITS Computing and Networking Services (CNS): 011-717-1717

- Faculty Postgraduate Office Ms Palesa Khumalo: 011-717-2125; [email protected] Mr Owen Naicker: 011- 717 2108; [email protected]

- WITS Human Research Ethics Committee (Medical) 2nd Floor, Phillip Tobias Building, Parktown, Cnr York Road and Carse O’ Gowrie; Administrative Officers: (1) Ms Zanele Ndlovu (Administrative Officer) 011-7171252/2700, [email protected]; (2) Mr Rhulani Mkanzi 011-717 1234/2656; [email protected]; Administrative Assistant - Mr Lebo Moeng 011-717-1234/2656

- HSRO http://www.wits.ac.za/health/hsro/contact-us/

Prof Maria Papathanasopoulos Assistant Dean: Research and Postgraduate Support Ph: 011 717 2103; Email: [email protected] Ms Shae Lazarus Research Administrator (Research course bookings and Postgraduate Hubs) Tel: 011 717 2503; Email: [email protected] Mr Xolani Tembu Research Office Administrative Secretary Ph: 011 717 2530; Email: [email protected] Mrs Modie Maumela Senior Faculty Officer Clinical Disciplines Tel: 011 717 2075; Email: [email protected] - - Associate Professor Tobias Chirwa - Faculty Biostatistician Ph: 011 717 2547; Email: [email protected] - Associate Professor Elena Libhaber - - Research Co-ordinator: Faculty and School of Clinical Medicine Ph: 011 717 2102; Email: [email protected] - Mr Moraba Meela - Research Projects Officer Ph: 011 717 2023; Email: [email protected] or [email protected] - Mr Ncamile Moss - Research Courses Administrator Ph: 011 717 2503; Email: [email protected] or [email protected] - Ms Irma Mare - Biomedical Informatics Officer & REDCap Administrator Ph: 011 717 2503; Email: [email protected] or [email protected]

3 Psychotherapy

This is a requirement in fulfilment of training. Registrars are to consult the CMSA portfolio of learning in which there is a logbook to document the training that they undertake in psychotherapy in order to provide examiners of the College of Psychiatrists (FC Psych Part II) with evidence of a registrar’s practical proficiency in psychotherapy. This logbook must be signed by the supervisor and presented to the Head of Department prior to registering for the Part II examinations, having been signed off by the Department’s Psychotherapy co coordinator (chair of Psychotherapy Committee).

Psychiatry registrars are required to obtain a minimum of 50 hours of supervised psychotherapy by a clinical psychologist or a consultant psychiatrist recognized as a psychotherapy supervisor by the Department of Psychiatry. 3 cases (1 long, 2 short) must be written up according to guidelines set by the Psychotherapy Supervisors’ Committee, which is in keeping with the CMSA guidelines. The long case will be examined, and candidates need to ensure that such content is handed in well in advance of an intended Part II examination date. The long case (report + taped transcript) should be handed in by the 15th March of the year in which exams are to be written in the 2nd half of the year and by 15th October where exams are to be written in the 1st half of the following year.

Psychotherapy supervisors will be allocated to you at the beginning of your training – based on your site of training. You need to contact the Department’s administrator (Mrs Chantal Lambert) if a supervisor has not been allocated to you, for discussion with the Committee’s chair (Currently- Adj Prof Ugash Subramaney).

4. Portfolio of learning

Completion of a ‘Portfolio of learning’ is a requirement for entry to the FCPsych II exam and is available from the CMSA/College of Psychiatrists website https://www.cmsa.co.za/view_exam.aspx?examid=41. It is strongly recommended that the Portfolio (PoL) is updated with completion of each requirement or clinical rotation. The PoL typically includes the following components: Candidate Details; P urpose of the Portfolio Of Learning; Clinical Rotations; Psychotherapy ; Research; Discipline-Specific Certificates ; Post-

graduate Lectures, Meetings, Workshops, Seminars, Symposia, Congresses and Modules ; and Declaration on Completion of Training (to be printed, signed by Head of Department and submitted with electronic portfolio)

The Clinical Rotations section includes: Learning objectives for each clinical rotation; Case summary and formulation; Record of learning activities; Certificate of practical training and proficiency; ECT and Record of Electroconvulsive Therapy Treatments. An example of a learning objective for a clinical rotation may be: “To achieve the knowledge and core competency outcomes for registrars in their different years of training in an acute adult assessment unit providing inpatient and outpatient care in a general hospital setting, as well as emergency and routine interdepartmental consultation- liaison services and outreach services in a defined drainage area”

The Psychotherapy section includes: Psychotherapy syllabus for the FC Psych(SA); CMSA Guidelines; Training Requirements; Psychotherapy Reading List; Psychotherapy Core Competencies; Methods to acquire Competence; Methods to assess Competence; Psychotherapy Supervision Log; Supervision Session Record

The Research section includes: (signature page to be printed, signed by head of department and submitted with electronic portfolio); Reading

II Clinical service delivery

Service delivery during registrar training in psychiatry involves care of inpatients, outpatients, consultation-liaison psychiatry, emergency service at casualties and case management.

Registrars will follow the guidelines provided and will have further duties explained to them when they join the unit /rotation.

The list of duties covers, inter alia:  Hospital/unit allocation  Unit/academic ward rounds/presentations  Clinics - outpatient  Journal presentations  ECT roster (site dependent)  Call list duties (night calls)  Leave and academic leave period (including unpaid leave)  Time off site

1. Rotation through the Department of Psychiatry’s circuit:

 Registrars will rotate through the Department of Psychiatry, University of the Witwatersrand’s Psychiatry registrar circuit.  The rotation will be through the Adult and the Child and Family Psychiatric units at Chris Hani Baragwanath (CHB), Johannesburg (CMJAH), Helen Joseph (HJH), Rahima Moosa (RM), Tara and Sterkfontein (SFH) hospitals as well as Community Mental Health services.  The registrar circuit is of four years duration, comprising rotations, each of six months duration i.e. January to June and July to December.

 All registrars will spend at least six months in Community Psychiatry, six months in a child and/or Adolescent Unit, three months in Neurology currently (will be revised as of 2018 with the introduction of reduced Neurology rotation and commencement of Neuropsychiatry) and six months at Sterkfontein (especially for Forensic Psychiatry exposure).  The timetable for this rotation is drawn up on a six monthly basis by a staff placement committee. It is the responsibility of each registrar to complete the registrar allocation form (a copy attached to this document). Not every registrar will be able to be accommodated with their first choice at every stage of their rotation.  Should a registrar obtain his/her final examinations before the completion of this time, they will be required to fulfil the statutory four-year time before being eligible to register as a psychiatrist or possibly take up a junior consultant post.  In the event of a registrar being unable to pass the specialist examination in the abovementioned four years, they may apply to the Head of Department for a six- month extension of their time. Support for an extension will in part depend on the registrar's performance in the previous years, including completion of requirements within the 4 years, and is at the discretion of the Head of Department, in consultation with the Department’s Executive Committee, and whether posts are available. Final approval is the prerogative of the registrar’s paypoint.  If a registrar is contemplating resignation then it would be expected that they complete their current six-month rotation, extenuating circumstances aside. One month’s notice prior for resignation is required.

2. Overtime:

 Registrars are expected to fulfil their overtime duties for the entire duration of their registrar time.  The details of the overtime duties will vary depending on your rotation and will be according to a roster.  Failure to be contactable or to arrive when called constitutes professional negligence and is viewed by the Department in a very serious light. Disciplinary measures will be taken against such behavior.  There is always a Consultant on call to back up the Registrar on call.

3. Remunerative Work Outside the Public Sector (RWOPS):

RWOPS is any work done outside of the public sector for which remuneration is received. Neither the University nor Gauteng Health permits Registrars to perform RWOPS.

III Mentoring

Mentoring is available and serves to provide guidance and support. You are free to choose your own mentor (a consultant in the Department – preferably with 3 or more years of experience post specialist registration). See attached content.

IV Leave

 Annual leave is 22/30 working days (depending on duration of service within the public sector). Leave cannot be carried over, and half the leave must be taken during each six- month period (11/15 days).  There is a limit to the number of registrars able to take leave at the same time, and leave will be given subject to discussion at the placement for that six months. For this reason leave forms must be completed as soon as possible within a six-month block and submitted to the head of unit to which the registrar is attached.  Leave during the first 2 weeks and the last 2 weeks of any 6 month rotation is not permissible, however an application can be made to the Chair of the Department’s Executive Committee to request such leave to be considered. This must reach the Chair for discussion at an Executive Committee Meeting before the 6/12 rotation in question and at least 2 months before the next rotation commences.

 Any registrar found taking leave not agreed to will be deemed absent without leave and subject to disciplinary measures.  Study leave is made available to registrars writing the specialist exams once proof of registration is provided. Guarantee of study leave can only be given with the first attempt at the exams.  In the case of pregnancy, please inform the Department timeously about maternity leave in order to facilitate proper planning of rotations.  Maternity leave – HPCSA Regulations in terms of maternity leave requires that such leave will have to be made up in additional education and training time i.e. added to the 48 months. Extended periods of sick leave may likewise be added to the training time.

V Performance evaluation

 The performance of each registrar will be evaluated at the end of each three-month period at the site of current rotation (Department/Gauteng Health)  These assessments are discussed with the registrars. (A copy of the format of the assessment is attached to this document).  The assessment reviews performance and progress in training on a quarterly basis; it serves to inform the decision as to whether a registrar should continue the training program.  Unsatisfactory progress or performance may result in disciplinary measures at the site of rotation in question as well as the registrar being excluded from training.

VI Disciplinary procedures

The intentions of this process are corrective rather than punitive. The final disciplinary action lies with either the Provincial Government or the University. The principles of these guidelines are in the spirit of the Labour Relations Act. Should any item of the disciplinary code be violated (including unsatisfactory work performance), the staff member in question will receive a verbal, written, or final written warning. Depending on the nature of the offence, the respective supervisor may deem it appropriate to resort to a problem-solving session only. The warnings will be recorded and submitted to the Head of Department’s office, where they will be kept on file. If the disciplinary measures outlined below become exhausted, the particular dispute may be referred to an arbitrator. This assumes that both parties have adhered to procedural and substantive fairness.

A person shall be deemed guilty of misconduct and thereby liable to disciplinary action if he or she:  wilfully does, allows or causes anything detrimental to be done which reflects badly on the Department of Psychiatry and/or  disobeys, or disregards, or makes wilful default in carrying out a lawful order given to him/her by a person having authority to give such an order, or by conduct displays insubordination; and/or  is negligent in the discharge of his/her duties; and/or  conducts himself/herself in a disrespectful, improper, unbecoming or dishonest manner; and/or  absents himself/herself from his/her duties without valid permission and proper arrangements.

Disciplinary proceedings will be instituted at the site of misconduct. This will be done in conjunction with the HR Department where the registrar is employed.

VII Registrar associations

WITS PSYCHIATRIC REGISTRAR ASSOCIATION

The Department has a Registrar Association that comprises elected members from each year of training. These members are elected at an A.G.M. that is usually held early in the year. The function of the Association is to act as a link between the Department and registrars and to discuss matters that are common to both.

It is usually the function of the second year registrar representative to appoint a committee, which would assist him/her in co-ordinating and hosting the Department’s Research Day, which is held in June of each year.

The most senior representative is usually the Chairperson of the Association and represents the registrars in Department meetings, being involved in matters such as staff placement, inter- hospital issues, disciplinary matters etc. The representative is a member of the Department’s Executive Committee.

Meetings are also held between the Association and the Head of the Department as required.

The Psychiatric Registrar Association also has representation in:

1. Wits Registrar Association 2. South African Registrar Association 3. South African Society of Psychiatrists Gauteng sub-branch National executive

UNIVERSITY OF THE WITWATERSRAND SCHOOL OF CLINICAL MEDICINE DEPARTMENT OF PSYCHIATRY

QUARTERLY ASSESSMENT (BASED ON CORE COMPETENCY) REGISTRAR AND MEDICAL OFFICER

DATE / QUARTER: NAME: CONSULTANT/S: ROTATION CENTRE: PAYPOINT (PMDS forms):

PSYCHIATRY EXPERIENCE (circle): MO 6 12 18 24 Registrar year 1st 2nd 3rd 4th Months 6 12 18 24 30 36 42 48 Extended 6 12 18 24

REGISTRAR ACADEMIC PROGRESS (circle and date): Psychotherapy no Short case Long case completed …………………… ………………… …………………. . …. Research no Protocol Draft completed …………………. ………………… …………………… …. . Exams Part I writing completed Part II writing completed …………………… …………………. …………………. ………………… . … ….

Note: All assessments are made according to level of experience. This is because point 3 of the scale represents satisfactory performance for completion of that phase of training (year 1 or year 4), so a doctor having only recently entered that phase might be making perfectly satisfactory progress, yet only obtain ratings of 3. Therefore this rating according to level of experience was introduced to prevent trainees becoming despondent at receiving only low ratings, and to give a measure of ongoing progress.

Ratings of 1 and 2 require a separate attached letter with recommendations. Please motivate for ratings of 4 and 5 on the form. Mark appropriate block, Poor* Areas for Satisfactory Good Excellent *Attach letter for ratings less than satisfactory for improvement* level of training 1. Patient care 1* 2* 3 4 5

Provide a good standard of practice and care, appropriate, respectful and effective patient care. Patient formulation, develop and carry out management plans, record keeping and discharge summaries, assessment of patients with severe/enduring mental illness. Use results of clinical assessment to ensure effective patient management. Assessment and management of psychiatric emergencies. Counselling and educating families and patients, work effectively and constructively as part of a team. Comments… …………………………………………………………………………………………………………………………………………………… …………………………………………………………… …………………………………………………………………………………………………………………………………………………… ………………………………………………………….. …………………………………………………………………………………………………………………………………………………… ……………………………………………………………. …………………………………………………………………………………………………………………………………………………… …………………………………………………………..

2. Patient interviewing 1* 2* 3 4 5 and evaluation skills

Undertake clinical assessment, history taking, mental status examination and physical examination. Ability to make clinical judgements and management plans appropriate for level of experience. Comments… …………..……………………………………………………………………………………………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………………………………………… ……………………………………………………………. …………………………………………………………………………………………………………………………………………………… ………………………………………………………….. …………………………………………………………………………………………………………………………………………………… …………………………………………………………….

3. Medical knowledge 1* 2* 3 4 5

Knowledge and application of basic sciences, investigatory and analytic approach to clinical situations, application of scientific knowledge, knowledge of legislation concerning patient care. Comments… …………………………………………………………………………………………………………………………………………………… …………………………………………………………….. …………………………………………………………………………………………………………………………………………………… …………………………………………………………….. …………………………………………………………………………………………………………………………………………………… ………………………………………………………………. …………………………………………………………………………………………………………………………………………………… ……………………………………………………………….

4. Interpersonal and 1* 2* 3 4 5 communication skills Creation of therapeutic relationship with patients, effective communication and limit setting, listening and therapeutic skills, work effectively with others as a team. Develop and practice self awareness, work with colleagues and maintain awareness of the quality of care provided. Dealing with interpersonal and communication problems in clinical practice Comments… …………………………………………………………………………………………………………………………………………………… ……………………………………………………….. …………………………………………………………………………………………………………………………………………………… …………………………………………………………. …………………………………………………………………………………………………………………………………………………… …………………………………………………………. …………………………………………………………………………………………………………………………………………………… ………………………………………………………..

5. Professionalism 1* 2* 3 4 5

Attendance, punctuality and commitment. Commitment to ongoing professional development, commitment to ethically sound practice (respecting confidentiality, obtaining consent), good communication, maintaining trust, sensitive to cultural, age, gender and disability issues. Comments… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………… …………………………………………………………………………………………………………………………………………………… ……………………………………………………………………

6. Practice based 1* 2* 3 4 5 learning and improvement.

Facilitate own learning (attendance, participation and presentation in case presentations, journal clubs and formal lectures/teaching). Maintain and use systems to update knowledge (use of internet literature searches, application of evidence from scientific studies into clinical practice) and its application to any aspect of professional practice, keeping up with clinical advances. Facilitate learning of students and other health care professionals. Comments… …………………………………………………………………………………………………………………………………………………… …………………………………………………………………… …………………………………………………………………………………………………………………………………………………… ………………………………………………………………..

7. Research, 1* 2* 3 4 5 psychotherapy and systems based practice

Formulate research protocol and conduct research if applicable (not applicable for MO and 1st year registrars), practice cost effective medicine, advocate for patients within health care system. Training psychotherapy write up. Comments… ……………………………………………………………………………………………………………………………………………………… ………………………………………………………………… ……………………………………………………………………………………………………………………………………………………… ……………………………………………………………….. - CMSA portfolio of learning signed: YES, NO - PMDS forms done: YES, NO - Psychotherapy progress: (page 1) ……………………………………………………… - Observed clinical case clerking: page attached (circle): YES, NO - Feedback given: (attach a letter with suggestions for ratings of 1 or 2) YES, NO Additional comments by Supervisor: ______

Signature Consultant ______Date______

Comments by Registrar/Medical Officer: ______

Signature Registrar/MO ______Date ______ROTATION OF REGISTRARS

NAME HOME TEL

E-MAIL ADDRESS CELL NO

DATE OF APPOINTMENT APPOINTED AT: PERSAL NO REGISTRAR NO

PREVIOUS PLACEMENT Chris Hani Johannesburg Tara Sterkfontein Helen Joseph Community Child & Adoles Neurology Psychotherapy

MEDICAL OFFICER

REGISTRAR 1ST YEAR

REGISTRAR 2ND YEAR

REGISTRAR 3RD YEAR

REGISTRAR 4TH YEAR

PREFERENCES FOR THE NEXT ROTATION

Indicate 1st, 2nd or 3rd Chris Hani Johannesburg Tara Sterkfontein Helen Joseph Community Child & Adoles Neurology Psychotherapy preferences

DMH MMED I FCPSYCH I MMED II FCPSYCH II EXAMINATIONS

Date to be Written

Date Completed

RESEARCH DETAILS:

Title Supervisor:

Progress: Please indicate with Protocol development Submission to Faculty Data collection Data analysis Report writing Final submission for a tick postgraduate marking UNIVERSITY OF THE WITWATERSRAND

FACULTY OF HEALTH SCIENCES

DEPARTMENT OF PSYCHIATRY

CONTRACT

Mentor – Department

I, ………………………………………………. agree to act as a mentor, in the Department of Psychiatry as per the Department of Psychiatry policy/guidelines attached hereto.

Signatures Mentor ………………………………………………….

Head of Department ………………………………………. UNIVERSITY OF THE WITWATERSRAND

CONTRACT

Mentor – Mentee

I, ………………………………………agree to mentor ………………………………….. (mentee) as per the Department of Psychiatry policy/guidelines attached hereto

Signatures Mentor ………………………………………………………..

Mentee ………………………………………………………..

Head of Department …………………………………………….. UNIVERSITY OF THE WITWATERSRAND

CONTRACT

Department – Ombudsman

The Department of Psychiatry, in accordance with Departmental policy/guidelines, hereby accept decisions made by ……………………………………….. (the designated ombudsman)

Signatures Head of Department ……………………………………………..

Ombudsman …………………………………………………. January 2004/revised November 2013

GUIDELINES FOR MENTORS

The mentor should be guide and provide support to the junior consultant, registrar or medical officer. Acting in an advisory capacity.

Some areas of specific support could be:-

Monitoring of academic progress. The idea would be to identify any problems early to enable early and effective intervention.

Emotional support. This is not meant to be in the form of psychotherapy, but to provide a supportive work environment.

Evaluating service circumstances. If the registrar has a problem, the mentor would help in providing a fair and unbiased assessment of the problem and mediate towards a solution, especially if the situation involves another consultant.

Helping with time allocation and management. This would include general principles of stress management, free time management as well as study methods, if needed.

It is important that all communication between mentor and medical officer/registrar/junior consultant be kept completely confidential unless it is decided by mutual agreement to take matters further, e.g. to the Head of Department. Trust is going to be a vital component of this system.

Another issue is that of professional boundaries which need to be clearly observed in this relationship. It is clearly not a friendship between equals on a professional level. The consultant needs to keep a professional distance and maintain discretion at all times. It would be completely wrong to disclose personal issues or discuss Departmental issues with a junior colleague, especially with regards to other consultants or units.