CMSA

T h e Co lle g e s o f Me d ic in e o f S o u th A f r ic a N P C
Nonprofit Company (Reg. No. 1955/000003/08) Nonprofit Organisation (Reg No 009-874 NPO)

27 Rhodes Ave, PARKTOWN WEST 2193 Private Bag X23, BRAAMFONTEIN 2017 Tel: +27 11 726-7037/8/9 Fax: +27 11 726-4036 General: admin@cmsa-jhb.co.za Academic Registrar: alv@cmsa-jhb.co.za www.collegemedsa.ac.za

JOHANNESBURG
ACADEMIC OFFICE

Website:

November 2012

FOR ADMISSION TO THE DIPLOMA IN ANAESTHETICS OF THE COLLEGE OF ANAESTHETISTS OF SOUTH AFRICA

DA ( SA )
1.0 1.1 1.2 SCOPE AND OBJECTIVES The purpose of the Diploma in Anaesthetics is to encourage postgraduate training and raise the standards of practise of anaesthetics in general practice The Diploma is not designed for the specialist anaesthetist. Importance is attached to the hospital training in anaesthetics and evidence of knowledge of modern developments in the field of anaesthetics will be sought by the examiners; but the candidates will be examined primarily with a view to deciding whether they are good, practical general practitioner anaesthetists ADMISSION TO THE EXAMINATION (to be read in conjunction with the Instructions) Qualification 2.1.1 The candidate must for six months have held a post-internship qualification to practise medicine which is registered or registrable with the Health Professions Council of South Africa. Community service doctors are eligible to write this examination during their y ear of community service The CMSA Senate, through its Examinations and Credentials Committee, will review all applications for admission to the examination, and may also review the professional and ethical standing of candidates Except in the case of certified supervised training at a teaching or CMSA-approved hospital, a completed logbook (obtainable from the CMSA) is required to substantiate training and/or credit points claimed, to the full value of 1000 points The number of candidates accepted for the DA(SA) examination is capped at 96. Please ensure that y our application is received timeously by the Johannesburg office to ensure y our place for this examination.

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2.2 Education and Training

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Within the three y ears preceding the examination, the candidate will have to accumulate 1000 credit points, in the following three categories: 2.2.1 Supervised training 2.2.1.1 Certified post-internship fulltime, or sessional supervised training in anaesthetics at a teaching or CMSA-approved hospital, at a rate of one credit point per hour to a maximum of 170 credit points per continuous month (six months fulltime is sufficient) 2.2.1.2 A minimum of 500 credit points must be gained by supervised training 2.2.1.3 If the candidate works at a non-CMSA approved hospital which is located more than 125km from a CMSA-approved or teaching hospital, and is thus unable to comply with 2.2.1.2 (providing all reasonable efforts have been made on the part of the candidate) the following provision may be applied for: The candidate must acquire 500 points in unsupervised training, claimed by affidavit in a logbook. The candidate must be prepared to submit him/herself for a standardised practical evaluation at the nearest teaching or CMSA-approved hospital by a minimum of 2 Diploma in Anaesthetics examiners for a period of 5 working day s. There should be two evaluators, both registered specialist Anaesthesiologists, one of whom should be a member of the Diploma in Anaesthetics examiners panel or an official Tutor (once tutors have been appointed). This will provide 250 points. A further 250 points will have to be obtained from 2.2.3. Should the candidate not qualify for 250 points from the practical assessment a recommendation will be made on an individual basis for further training. The Diploma in Anaesthetics committee reserves the right to adjudicate on all applications in this category . The evaluators should be resident practitioners at the institution. The practitioners being evaluated would be treated as supernumerary . All institutional rules and regulations (including liability ) apply ing to supernumeraries would apply to these doctors. This would obviously be subject to the approval of the medical superintendent and the Head of Department of Anaesthesia at the institution. Unsupervised experience 2.2.2.1 Fulltime general/primary care/non-specialist practice or experience in non-CMSA-approved hospitals which embrace anaesthetics, at the rate of 250 points per annum, or 20 points per continuous month. 2.2.2.2 Part-time general/primary care/non-specialist practice or experience in non-CMSA-approved hospitals which embrace anaesthetics, at the rate of 0.125 points per hour, provided that no credit will be granted for part-time practice of less than 45 hours per continuous month. 2.2.2.3 A maximum of 500 credit points may be awarded for unsupervised experience and must be claimed by affidavit in the logbook.

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2.2.3

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Theoretical education/training 2.2.3.1 Credit points in sections 2.2.3.1 to 2.2.3.5 of this category will be awarded at the rate of five points per hour, only if recorded in the logbook available for this purpose from the CMSA, certified by either the presenter or the organiser of the ward round, course, conference, lecture, congress, sy mposium or other meeting or by the specialist consulted, and declared as correct by the candidate. 2.2.3.2 Teaching ward rounds, mortality /morbidity meetings, patient presentations and the like, in the relevant discipline at a teaching or CMSA-approved hospital. 2.2.3.3 Formal courses, congresses or conferences in the relevant discipline. 2.2.3.4 Formal lectures or sy mposia in the relevant discipline. 2.2.3.5 Formal consultations with a registered specialist in the relevant discipline. 2.2.3.6 Any other theoretical education offered will be evaluated for acceptability by the CMSA. Private study is not acceptable. 2.2.3.7 In section 2.2.3.8 credit may be awarded to the value of 10 points per case study to a maximum of 50 points; and in 2.2.3.9 credit may be awarded to the value of 50 points per acceptable publication; provided that a maximum of 100 points may be awarded for patient studies and publications together. The decision of the CMSA with regard to the acceptability of publications or case studies offered will be final. 2.2.3.8 Written patient case studies in the relevant discipline which have been subjected to scrutiny as part of a formal continuing education or training programme. 2.2.3.9 Relevant research publication in reputable journals. 2.2.3.10 A maximum of 100 credit Points may be claimed in the logbook for theoretical educational/training. The Advanced Cardiac Life Support (ACLS) certificate is recommended but not obligatory for candidates entering for the DA(SA).

2.2.4 3.0

SYLLABUS OF THE EXAMINATION See the guidelines to candidates - Appendix A

4.0 4.1

CONDUCT OF THE EXAMINATION Two written papers of three hours each consisting of, in each case 4.1.1 two essay /short answer questions (counts for 2 / 3 of each paper) 4.1.2 a multiple choice (MCQ) component (counts for 1 / 3 of each paper) 4.1.3 An overall passmark of 50% must be achieved for all 6 questions AND the candidate must get a minimum of 50% in at least 4 of the 6 written questions An oral examination

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A clinical examination which may include an objectively structured clinical examination (OSCE) 4.3.1 The CPR and Machine Check OSCE stations are mandatory . They will be regarded as pass/fail stations for the Diploma in Anaesthetics 4.3.1.1 Anaesthetic Machine Check : The anaesthetic machine check will be performed on a non-electronic anaesthetic machine. 4.3.1.2 Computation of the final mark : The sum of [Paper mark (overall) % + OSCE mark % + Oral mark (overall) %] divided by 3 = Final mark % 4.3.1.3 Candidates must pass all 3 components separately and achieve a final mark of 50% or more to pass the examination (ie a candidate who achieves a final mark of 50% or greater but fails the written papers, OSCE or oral examination shall fail the diploma examination) 4.3.1.4 To pass the written papers, the candidate must achieve a minimum score of 50% for at least 4 of the 6 questions and achieve a minimum overall paper average of 50%

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5.0 5.1 ADMISSION AS A DIPLOMATE

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The candidate having passed the examination and having been admitted as a Diplomate in Anaesthetics of the College of Anaesthetists of South Africa, will be asked to sign a declaration, as under: I, the undersigned, . do solemnly and sincerely declare that while a member of the CMSA I will at all times do all within my power to promote the objects of the CMSA and uphold the dignity of the CMSA and its members that I will observe the provisions of the Memorandum and Articles of Association, By -laws, Regulations and Code of Ethics of the CMSA as in force from time to time that I will obey every lawful summons issued by order of the Senate of the said CMSA, having no reasonable excuse to the contrary and I make this solemn declaration faithfully promising to adhere to its terms Signed at ...... this ........... day of .. 20 .. Signature Witness (who must be a Founder, Associate Founder, Fellow, Member, Diplomate or Commissioner of Oaths)

5.2 5.3 5.4 5.5

A two-thirds majority of members of the CMSA Senate present at the relevant meeting shall be necessary for the award to any candidate of a Diploma A Diplomate shall be entitled to the appropriate form of certificate under the seal of the CMSA In the event of a candidate not being awarded the Diploma (after having passed the examination) the examination fee shall be refunded in full The first annual subscription is due one y ear after registration (statements are rendered annually )

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APPENDIX A
GUIDELINES TO CANDIDATES FOR THE DA(SA) SYLLABUS FOR THE EXAMINATION: 1.0 1.1 Human Anatomy and Physiology Human anatomy considered in relation to anaesthetics with special reference to airway management, insertion of invasive lines, regional anaesthesia and pain management. Human phy siology considered in relation to anaesthesia including cardiovascular, respiratory , neuro, renal, hepatic, endocrine, paediatric, maternal and fetal phy siology . Clinical Pharmacology Pharmacology of drugs for anaesthesia including inhalational agents, nonvolatile anaesthetic agents including opioids and other analgesics, muscle relaxants, cholinesterase inhibitors, anticholinergic drugs, and local anaesthetics and their interactions with commonly prescribed drugs. Pharmacology of drugs used in association with anaesthesia including adrenergic agonists and antagonists, hy potensive agents, cardiac and anti-hy pertensive agents and other adjuncts to anaesthesia including premedicants. Pharmacology related to interactions between anaesthesia drugs and drugs used in the treatment of disease. Elementary Physics Application to anaesthetic practice. Anaesthetic Equipment and Monitors Understanding of the design and function of the anaesthetic machine, breathing sy stems, medical gas sy stems, and safety in the operating room. The indications, contraindications, techniques and complications, considerations relevant to the most widely used anaesthetic monitors. Practise of Anaesthesia Preoperative evaluation, resuscitation, interpretation premedication in preparation for anaesthesia. of investigations and and clinical

1.2

2.0 2.1

2.2

2.3 3.0 3.1 4.0 4.1 4.2 5.0 5.1 5.2

The application of both general and regional anaesthesia to surgical procedures including obstetrics, trauma, orthopaedics, paediatrics, ophthalmology , otorhinolary ngologic, genitourinary , dental and outpatient anaesthesia. Anaesthesia in its relationship to disease including cardiovascular, respiratory , renal, endocrine, and liver disease. Management of patients with fluid and electroly te disturbances, acid-base disturbance, and immune compromise. Complications of anaesthesia both intra and postoperative. Management of critically ill patients postoperatively with cardiovascular, respiratory and renal compromise.

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6.0 6.1 6.2 6.3 6.4 7.0

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Cardiopulmonary resuscitation according to the Resuscitation Council of South Africa guidelines Basic cardiopulmonary resuscitation. Differences in basic cardiopulmonary resuscitation for children and adults Obstructed airway in adults, children and infants. The universal Advanced Life Support algorithim. RECOMMENDED READING LIST Morgan GE, Mikhail MS. Clinical Anesthesiology. 3 r d ed. Appleton and Lange

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APPENDIX B
CMSA-RECOGNISED HOSPITALS FOR DA(SA) TRAINING Candidates are informed that anaesthetic training in fulfilment of the DA(SA) examination regulations may be undertaken in: 1.0 Anaesthetic training posts under the supervision of university departments in teaching hospital complexes, as well as in teaching hospital equivalents or in university satellite departments of non-teaching hospitals. (Information relating to these posts is available from the heads of university departments of anaesthesiology) OR 2.0 Postinternship anaesthetic training posts at the following hospitals:
Be th le h e m H o s p ita l Bo itu me lo H o s p ita l Ce c ilia Ma k iw a n e H o s p ita l Co n r a d ie H o s p ita l E d e n d a le H o s p ita l E r n e s t O p p e n h e ime r H o s p ita l F a r E a s t Ra n d H o s p ita l F r e r e H o s p ita l G e o r g e H o s p ita l G o ld f ie ld s H o s p ita l/W e lk o m P r o v in c ia l G r e y s H o s p ita l K a r l Br e me r H o s p ita l L a d ys mith P r o v in c ia l H o s p ita l L e r a to n g H o s p ita l N a ta ls p r u it H o s p ita l N e w c a s tle /Ma d a d e n i H o s p ita l N g w e le z a n a H o s p ita l O liv e r T a mb o Me mo r ia l H o s p ita l P a a r l H o s p ita l P h o lo s o n g H o s p ita l P o r t S h e p s to n e H o s p ita l P o tc h e f s tr o o m H o s p ita l Ro b F e r r e ir a H o s p ita l Ru s te n b u r g P r o v in c ia l H o s p ita l S e b o k e n g H o s p ita l S o u th Ra n d H o s p ita l T e mb is a H o s p ita l T s h e p o n g H o s p ita l U mta ta G e n e r a l H o s p ita l V ic to r ia H o s p ita l W e s te r n D e e p L e v e ls H o s p ita l

Mafikeng Provincial Hospital

AND CURRENTLY 3.0 Post-internship anaesthetic posts in the following hospitals in Zimbabwe: Harare Group of Hospitals Mpilo Hospital; Bulaway o Enquiries concerning acceptability of posts should be addressed to: The Academic Registrar CMSA Private Bag X23 BRAAMFONTEIN 2017

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