International Orthopaedic Surgery Programme (as supernumerary)
Thank you for you interest in our training program.
At the University of Cape Town we strive to be the first choice Orthopaedic Surgical program with excellence in training and research. As you no doubt have realised, we provide a comprehensive program at a high level which results in an excellent success rate of our candidates in the national exit exams. This success is based both on our efforts and our registrar selection criteria.
With applicants from many different environments, it is difficult for us to assess your skill level remotely. Our South African trainees pass through medical officer posts which we control, allowing assessment prior to joining our registrar program.
Due to time restrictions imposed by the Health Professions Council and your study visa, this is not possible for supernumeraries. We therefore can only confirm skill level on arrival. Due to the environment you trained in this is often lower than our local trainees making the jump to Orthopaedic Registrar difficult.
We thus have developed a system to deal with this as we strive to maintain the quality of our product, i.e. the UCT trained Orthopaedic Specialist. This means that there is NO GUARANTEE that you will complete the training with us, as your progress is assessed on an ongoing basis. If it is realised that you will not achieve the standard required to pass the exit exam, your training may be discontinued completely or a 2 year Diploma option offered.
Our training is both academic and practical where trainees rotate through our units providing a clinical service. Thus there are limited positions available. We do not want to dilute the experience.
Please apply with you CV stating clearly whether you are looking for specific training or the full Orthopaedic Specialist training.
Indicate your General Surgery, ICU and Orthopaedic Surgery experience. Explain the Hospital environment and exposure you have had. Highlight appropriate courses you have attended and exam status.
You need to register with the HPCSA as a supernumerary prior to arrival.
The first step is to apply to Educational Commission for Foreign Medical Graduates (ECFMG) for certification and verification of your qualifications. This can take 6-12 months.
We will then provide a contract from Groote Schuur Hospital and a letter of acceptance from our Orthopaedic department for this.
Ms Mngaza can assist you with this process. She will then facilitate with an application to the Foreign Workforce Management Programme (FWMP) of the Department of Health (SA) for permission to work in South Africa. Once the HPCSA has registered the candidate and the FWMP has agreed to them working in South Africa you can apply to the Department of Home Affairs for an appropriate work permit, entry, or student permit.
You need to be proficient in English. Our teaching is in English and most of our patients can communicate in English although many speak local languages as their preferred language.
If your undergraduate degree was not conducted in English, you will need to provide evidence that you are able to communicate in English.
To qualify as a specialist you need to complete three College of medicine exams:
Primary 1A basic science, anatomy, pathology.
Intermediate 1B Principles of Orthopaedic Surgery
Care of the surgical patient (including ICU)
Exit exam 2 Orthopaedic Surgery at specialist level
Our South African trainees are only accepted once they have the 1B, so you can see the disadvantage you have. It would be preferable for you to write the primary before coming to SA but we realise that this is logistically difficult.
We expect you to pass the 1A within 6 months of starting with us.
The 1B requires 18 months of training time, 6 months General surgery (including 3 months ICU) and 12 months Orthopaedic Surgery. Prior General surgical training experience in your home country may be recognised for this which would be an advantage for you as it will allow more time to focus on Orthopaedic Surgery, remembering that the HPCSA will give you 5 years training time. We hope to extend this by 1 year as it takes 6 years to train a competent Orthopaedic Surgeon. Our local trainees spend at least 18 months at surrounding hospitals working as medical officers obtaining their 1A and 1B BEFORE starting our 4.5 year training program.
You require the ATLS to write the 1B and it would be useful for you to have it before you come, else you will need to do it here at your cost.
See the College of Medicine website for more information.
As we need to assess your level of skill and potential, our supernumeraries start at GSH in the Trauma Unit (C14) assessing patients, applying plasters / traction, interacting with our trauma team but not operating independently. Despite being registered as a registrar, this is essentially SHO / MO level work.
You will be interviewed on arrival with an oral at our undergraduate exit level to assess your knowledge level. Unfortunately we find occasional surgeons at such a low knowledge level that it is extremely difficult to train at post-graduate level.
During the first 6 months you will be expected to complete the following courses:
Surgical Basic skills course (in house - Dept of Surgery)
AO basic trauma course (AO local – own cost)
Joint surgical approaches course (in house - Dr Louw / Rowe
Reduction of joints course (Dr - Louw / Rowe)
External fixation course in house
ATLS (own cost)
After these 6 months a decision is made based on your knowledge level and progress of above as to the way forward.
If you are not chosen for the entire course (usually inadequate undergraduate knowledge), you will need to return home. If reasonable but assessed as not specialist potential within available time frame, we will offer 2 year training in Trauma and basic Orthopaedic Surgery and you write the Orthopaedic Diploma (not specialist level).
If satisfactory knowledge and progress you will continue on the full 5-6 year specialist training and write the Part 2 exit exam (specialist).
After the 6 month assessment, you will rotate through our peripheral hospitals under Dr Rowe and his consultants. These offer a General Orthopaedic Service but trauma predominated and include Victoria Hospital (VHW), New Somerset Hospital (NSH) and Mitchell’s Plain Hospital (MPH).
You will be allocated a 3 month slot in ICU to prepare you for your 1B exam.
You will spend 3 months at the Paediatric Hospital in Casualty which includes all trauma patients, not only Orthopaedics.
You will then be expected to pass your 1B exam, following which you will join what we regard as the senior rotation at Groote Schuur Hospital where you rotate through all the sub-discipline firms.
Research / MMed Dissertation
You will be expected to perform a research project and dissertation to be marked by the university as part of your examination. This is part of your MMed qualification requirements.
As a supernumerary you need to be fully self-funded. The duration is a minimum of 5 years but best to plan on 6 to become a fully competent and confident Orthopaedic Specialist.
Cape Town is an expensive city. You can budget on around R15 000 ($1000 US) per month to live and function. You will require a car to move between hospitals. You will require a mobile phone to be contactable. The university charges an annual registration fee of around R10 000 for the MMed course. The College exams are not insignificant.
Although you are not paid by us, by joining our program you are committing to working exactly the same as our local trainees. This is based on a 56 hour week (including calls). You will be allocated 1 months leave per year.