Selection policies for undergraduate medical programmes aimed at redress should be continued and further refined, along with the provision of support to ensure student success.

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ResearchGlobally, more than a billion people never consult a healthcare worker in their lives. Inequitable and ineffective healthcare systems are weakened by a scarcity and maldistribution of the healthcare workforce.[1] Together with other stakeholders, health professional schools can play a key role in reducing inequality and improving health equity. The Global Independent Commission on Education of Health Professionals for the 21st Century (2010) calls for transforming institutional and educational approaches to better meet changing health systems needs.[2] Furthermore, in late 2010, the Global Consensus for Social Accountability of Medical Schools (GCSA) urged schools to improve their response to current and future health-related needs and challenges in society and reorientate their activities accordingly.[3] From the above it follows that it is necessary for health professional schools to engage with the community as an essential strategy to achieve a diverse healthforce, increasing access to healthcare and eliminating health disparities.In South Africa (SA), as in the rest of the world, community engagement plays an important part in higher education. Reorientation of health professions education to an inclusive primary healthcare approach was called for in the White Paper on the Transformation of the Healthcare System in SA.[4] Some [5,6] argue that the educational programme for health care professionals should deliver graduates who are prepared for work in community settings, resulting from the move from fixed institutions, such as hospitals, to various settings in the community. Community-based education (CBE) and service learning (SL) as a means of achieving greater social responsibility have become more prominent in health professions education worldwide.CBE in a medical context can be defined as learning activities that take place within communities and take into consideration the main health problems of the country, but do not directly engage the community in the design, conduct and/or evaluation of these activities. [7,8] SL has been defined as 'an educational approach involving curriculum-based, credit-bearing learning experiences in which students (a) participate in contextualised, well-structured and organised service activities aimed at addressing identified service needs in a community, and (b) reflect on the service experiences in order to gain a deeper understanding of the linkage between curriculum content and community dynamics, as well as achieve personal growth and a sense of social responsibility. It requires a collaborative partnership context that enhances mutual, reciprocal teaching and learning among all members of the partnership.' [9] The Faculty of Health Sciences at the University of the Free State (UFS), Bloemfontein, SA recognises the tremendous potential of CBE and SL to enhance health professions education, as both allow students to apply the information they learn in the classroom to real-world settings and provide an important avenue for self-reflection. CBE and SL contrib...

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The strategic framework provides guidelines for the development and sustainable management of an SEM research programme. It will make a substantial contribution to the research, further development, and ultimately the status of SEM in South Africa.

Background: A growing ageing community puts additional demands on the public health system. This will contribute to ethical consequences for the health care sector. A public health ethics framework can contribute towards addressing the ethical challenges faced by the geriatric community.Aim: This article intends to contribute to a public health ethics framework for the geriatric community from a South African perspective.Setting: Twenty-two participants from six geriatric institutions, two each in the three provinces, participated in the research. The provinces are the Free State, Northern Cape and North West.Methods: Fifteen statements were rated using a five-point Likert scale questionnaire. The statements were grouped into three indexes, namely what is ethics, what is public health ethics and what is public health ethics for the geriatric community?Results: Ethical behaviour is observable not only from person to person but also through systems, processes and practices. The need is to understand how to apply ethical principles to the working environment. A public health ethic can be understood from applied, professional and social ethics.Conclusion: Public health ethics is the application of health care principles through a professional ethic resulting in care and relationship-building. The core of what public health is should be the basis to identify a public health ethic where the focus is on the community and improvement of the quality of health and well-being of the community.Contribution: No evidence of a public health ethics framework for the geriatric community could be identified in South Africa.

Background. With the new Mental Health Care Act in use, additional demands will be placed on general practitioners to provide adequate care for mental health patients. The College of Psychiatry of the Colleges of Medicine of South Africa awards a Postgraduate Diploma in Mental Health (PGDipMH) to medical doctors, but there is no standardised formal tuition or curriculum available to potential candidates. Objectives. A study was undertaken to design a postgraduate programme using a six-step process to assist medical practitioners in preparing for the PGDipMH. Methods. The Delphi research method, a nomi nal group technique for developing forecasts and trends based on the collective opinion of knowledgeable experts, was used. Data, obtained by means of closed items in a questionnaire, were analysed, and the opinions and ideas of the expert respondents were used to adapt the formulated set of criteria for each subsequent round of Delphi. This process was repeated until 80% consensus or stability had been reached. After the last round, a framework and final set of criteria were compiled. Results. The preferred mode of teaching was online distance learning utilising electronic learning and limited formal learning. The content of the curriculum was based on the findings of the Delphi study experts. The programme as a complete entity contains six steps. Conclusion. Using the recommendations and findings of the Delphi panel, a comprehensive programme was developed, which shows an appreciation for the interfaces between the different role-players (the patient/so-called mental healthcare user and the doctor as learner), outcomes-based education and distance learning.

SummaryAim:The purpose of this article is to present the results of a private cardiac surgical practice. This information could also serve as a hermeneutical text for new wisdom.Methods:A personal database of 1 750 consecutive patients who had had coronary artery bypass graft (CABG) surgery was statistically analysed. Mortality and major morbidity figures were compared with large registries. Risk factors for postoperative death were determined.Results:Over a period of 12 years, 1 344 (76.8%) males and 406 (23.2%) females were operated on. The observed mortality rate was 3.03% and the expected mortality rate (EuroSCORE) was 3.87%. After stepwise logistic regression, independent risk factors for death were urgency (intra-aortic balloon pump), renal impairment (chronic kidney disease, stage III), re-operation and an additional procedure. Apart from the 53 deaths, another 91 patients had major complications.Conclusion:Mortality and morbidity rates compared favourably with other international registries. Mortality was related to co-morbidities. This outcome contributes to a hermeneutical understanding focusing on new spiritual wisdom and meaning for the surgeon.