RCGP International Volunteer Family Physician (Post CCT) Placement at Bwindi Community Hospital

Job Title: Family Physician

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 Out patient department (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 foundation 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 and qualified GPs. 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 Report.1,2

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 British general practitioner, 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 the current Executive Director Dr Birungi Mutahunga in 2010. All three Executive Directors have a Masters in Public Health with hospital services, placing a high status on primary care and preventative medicine activities. These are implemented via outreach activities, use of village health promoters, an outpatient department which delivers 90% of hospital consultations and 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 in 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 it is planned that three twelve-month posts will be available to general practice trainees as an out of programme experience (OOPE), and to qualified GPs.  

Aims

The RCGP and BCH 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 from working as a family physician.  The aim of the posts is to enable GPs to extend their training, enhance their knowledge and skills in areas that are difficult to achieve within the present 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 that 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 the 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 the 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

Clinical supervision while in post will be from the Head of Clinical Services at BCH. In addition there will be mentorship offered by previous RCGP GP volunteers via Skype. 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.  This will be specific to the work at Bwindi and is not a formal appraisal that will count toward revalidation. 

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 of 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 self-fund all travel. Candidates are responsible for processing paperwork relating to their visa, CRB/Disclosure Scotland, providing evidence of 
MBChB/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

The opportunity is available to qualified GPs. 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: A UK-based and UK-trained post CCT GP and a member of RCGP, in Good Standing with the GMC and RCGP. 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: A UK-based and UK-trained post CCT GP and a member of RCGP, in Good Standing with the GMC and RCGP. Broad-based clinical experience to date. Available to commit for one year.
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) http://www.aomrc.org.uk/about-us/news/item/academy-encourages-voluneteering- opportunities-in-global-health.html
  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) http://specialtytraining.hee.nhs.uk/the-gold-guide-fifth-edition-now- available/

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