RCGP International Family Physician Trainee AiT - Bwindi Community Hospital (Church of Uganda)

Job Title:
Family Physician Trainee

Reports to:
Head of Clinical Services

Key relationships:
Other Medical Officers within the hospital
Ward in-charges on the adult-in-patients and paediatric wards
OPD in-charge and other staff in OPD
Communications / Fundraising Team

Introduction

The RCGP has formed a Partnership with Bwindi Community Hospital (BCH) in rural Uganda. The aim is to provide an innovative volunteer opportunity which incorporates elements of service provision, teaching, quality and improvement and research, but with its foundations in an African hospital which is well known for its focus on primary care. This is in recognition of the increasing awareness of the wide reaching benefits of working overseas and demand for such placements from GP trainees. Support for voluntary work and the development of international partnerships in healthcare is in accordance with the Academy of Royal Colleges statement and the Crisp Report1,2

Bwindi Community Hospital started as an outreach project under a tree in 2003 by Dr Scott Kellerman, an American family physician. Dr Paul Williams, a UK GP, replaced Dr Scott in 2006 and helped build the health centre into a 120 bedded fully functioning hospital serving over 100,000 people. Dr Paul handed over to current Executive Director Dr Birungi Mutahunga in 2010. All three Executive Directors have a Master’s in Public Health with hospital services placing high status on primary care and preventative medicine activities. These are implemented via outreach activities, use of village health promoters, outpatient department which delivers 90% of hospital consultations along with pan hospital screening for HIV, family planning and alcohol abuse. It has implemented a health insurance scheme covering 28,000 people and regularly consults with key community stakeholders. It has been voted the best hospital by the Uganda Protestant Medical Bureau for three consecutive years and in 2011 won the STARS impact award for delivering healthcare to disadvantaged children and for effective management practices.

In collaboration with Bwindi Community Hospital three twelve-month posts will be available to general practice trainees as part of an out of programme experience (OOPE), and to qualified GPs. GP trainees must have successfully completed their ST2 year in their specific training programmes. The family physician jobs will be competitively recruited to and offered eight months prior to starting as this is the lead-time required to plan and complete relevant documentation.

Aims

The RCGP and Bwindi Community Hospital see opportunities for working abroad as of great benefit to volunteers and the patients they will serve while on placement. The applicant will bring added value to their post due to competencies already gained in their GP training. The aim of the posts is to enable GP trainees to extend their training, enhance their knowledge and skills in areas that are difficult to achieve within the training programme and develop experience in international health development. For example, training and mentoring skills will be developed as candidates will be working at a senior level managing outpatient cases clinical officers find difficult. In addition skills in leadership, management and research will be strengthened through developing clinical guidelines, supporting the Ministry of Health perinatal death audit report plus family planning and alcohol services. It is hoped that the opportunities provided by these posts will equip these GP trainees to become future leaders within the profession.

Purpose of the job

The candidate will work as a family physician responsible for care of patients on adult in patient and paediatric wards and in Out-patients Department. Clinical work will comprise around 50% of the commitment. The other 50% of the candidate's time will be spent on teaching, mentoring, audits, research, and other projects aimed at quality improvement and achieving long-term sustainability The candidate’s activities will be adaptable to the needs of the hospital. However, from volunteers' past experience the anticipated duties are outlined as follows.

Main Responsibilities

Service Management

  • Manage medical patients in the adult in patient department – 30 beds for medical, mental health and surgical patients with support from Ugandan colleagues
  • Oversee the chronic disease management clinics – hypertension, diabetes, asthma, epilepsy, mental health, alcohol, and paediatric
  • General outpatient duties –supporting Clinical Officers to review all challenging patients
  • Manage acutely unwell patients in the emergency room when outpatient department is busy.

Staff Management

  • Liaise with ward in charges to ensure efficient running of the wards and engage in quality improvement activities
  • Mentor and teach Medical interns, Clinical Officers, nursing and support staff working within clinical departments.
  • Supervise medical students.

Teaching

  • Lead departmental teaching sessions for the outpatient and inpatient teams
  • Regularly lead teaching sessions as part of hospital Continuing Medical Education (CME)
  • Teach clinical staff on the job
  • Teach medical students – both Ugandan and international who are attached to the hospital

Staff training

  • Be involved in training of all levels of staff both formal and ‘on the job’ including nurses, nursing students, medical students, medical licentiate interns, clinical officers and clinical officer students.

Fundraising

  • Be part of the fundraising team of the hospital
  • Activities include giving tours of the hospital to foreign visitors, representing the hospital at local tourist lodges, helping update website for responsible clinical departments and personal fundraising is also appreciated.

Self-Development

  • Attend and participate at clinical and mortality meetings.
  • Adapt skills to a resource limited environment and in a different culture
  • Keep a record of reflective learning as part of continuous professional development

Educational Supervision and Assessment

Clinical supervision while in post will be from the Head of Clinical Services at BCH. In addition, there will be mentorship offered remotely by previous GP volunteers via the internet. Regular informal meetings will ensure well-being and address issues raised. An informal appraisal will occur halfway through the post which will involve a one-to-one meeting with the Head of Clinical Services. The GPSTR will be encouraged to maintain links with their UK GP training throughout their time in Bwindi. This can be organised online through contact with the Training Programme Director and other trainees from their training programme as well as RCGP e learning packages.

The GPSTR will be encouraged to complete their WPBA e portfolio and will be assessed on line at six monthly intervals, by a UK based educational supervisor. Whilst this post will not be formally recognised towards training for a CCT, trainees should still provide evidence of maintaining WPBA.

Terms and Conditions of Service

Contracts will be held at the hospital. Hours of work and leave entitlement will reflect good employment practice directed by local Health District guidelines. This will include 30 days for annual leave for candidates volunteering for one year. The candidate will receive free housing plus free tea break, lunch and dinner 6 days a week. In addition, volunteers also receive a monthly stipend of £125 paid in the local currency.

This job description is not comprehensive. The post holder may be asked by the Executive Director to perform reasonable duties relating to these positions that are not specifically laid out in this document.

Liability

The hospital requires candidates to independently register for health insurance, repatriation, medical indemnity, and all travel. Candidates are responsible for processing paperwork relating to their visa, CRB/Disclosure Scotland, providing evidence of MBChB plus other relevant qualifications and a copy of their passport. There may be other documents required; the candidate should check the requirements with the hospital as soon as the placement is offered. The hospital will then help to apply for registration for a work permit.

Eligibility

This OOPE is available to trainees between ST2/3. Trainees must be able to demonstrate acceptable progression in their training, and therefore they must have their ST2/3 year approved by an Annual Review of Competence Progression. It is noted that the Gold Guide makes note of the valuable role UK health workers make in providing health to developing countries and this should be facilitated where possible by educators, employers and regulators.3

Person Specification

Eligibility, education, qualifications
Essential: Current GP trainee, in good standing with RCGP and GMC. For trainees satisfactory progression through ARCP panels. Broad-based clinical experience to date. Available to commit for one year.
Desirable: Prizes or distinctions. Rotations in Emergency Medicine, Paediatrics. Diploma in Tropical Medicine and Hygiene or similar.
When evaluated: application form

Knowledge and skills
Essential: Effective organisational, planning and administrative skills. A demonstrable understanding of International Health Development. Competence and experience of audit and working within guidelines.
Desirable: Evidence of International Health Experience. Evidence of Leadership activities. Evidence of learning and teaching activity.
When evaluated: application form and interview

Personal attributes
Essential: Tolerant and empathic – ability to remain positive when dealing with problems. Good sense of humour. Interest in forming friendships and mentoring colleagues. Effective written and oral communication skills. Able to work well individually and in a team as member or as its leader. Good problem-solving skills – having a nature of ‘identifying and owning problems’ until they are fixed.
Desirable: Evidence of leadership skills. Experience of a change process. Interest in social activities such as football, volleyball, walking, hosting movie nights, choir etc.
When evaluated: Application form and interview.

All Applications to be forwarded to: International@rcgp.org.uk

References

  1. Academy Statement on Volunteering: Health Professional Volunteers and Global Health Development. Academy of Royal Colleges; July 2013; (accessed 10/9/13 via internet)
  2. Turning the world upside down: the search for global health in the 21st Century. Crisp, N. (2010); Royal Society of Medicine Press Ltd.
  3. A Reference Guide for Postgraduate Speciality Training in the UK – The Gold Guide 5th Edition. May 2014. Modernising Medical Careers National Health Service (accessed 27/8/14 via internet)

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