SAQA All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.
SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED QUALIFICATION: 

Bachelor of Medicine and Bachelor of Surgery 
SAQA QUAL ID QUALIFICATION TITLE
112488  Bachelor of Medicine and Bachelor of Surgery 
ORIGINATOR
Nelson Mandela University 
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY NQF SUB-FRAMEWORK
-   HEQSF - Higher Education Qualifications Sub-framework 
QUALIFICATION TYPE FIELD SUBFIELD
National First Degree(Min 480)  Field 09 - Health Sciences and Social Services  Curative Health 
ABET BAND MINIMUM CREDITS PRE-2009 NQF LEVEL NQF LEVEL QUAL CLASS
Undefined  930  Not Applicable  NQF Level 08  Regular-Provider-ELOAC 
REGISTRATION STATUS SAQA DECISION NUMBER REGISTRATION START DATE REGISTRATION END DATE
Registered-data under construction  EXCO 0324/24  2024-07-01  2027-06-30 
LAST DATE FOR ENROLMENT LAST DATE FOR ACHIEVEMENT
2028-06-30   2034-06-30  

Registered-data under construction

The qualification content is currently being updated for the qualifications with the status “Registered-data under construction” or showing “DETAILS UNDER CONSTRUCTION” to ensure compliance with SAQA’S Policy and Criteria for the registration of qualifications and part-qualifications on the National Qualifications Framework (NQF) (As amended, 2022). These qualifications are re-registered until 30 June 2027 and can legitimately be offered by the institutions to which they are registered.

 

In all of the tables in this document, both the pre-2009 NQF Level and the NQF Level is shown. In the text (purpose statements, qualification rules, etc), any references to NQF Levels are to the pre-2009 levels unless specifically stated otherwise.  

PURPOSE AND RATIONALE OF THE QUALIFICATION 
Purpose:
The purpose of the Bachelor of Medicine and Bachelor of Surgery (MBChB) qualification will be to train caring, competent and committed medical doctors who will work as members of interprofessional teams, to practice primary health care is holistically, culturally sensitive and comprehensive.

The qualification will use decentralised and distributive training platforms that incorporate the elements of community-based, primary health care and district health care (urban and rural) to provide work-integrated learning, which will complement the academic qualification. Modules on the theory and practice of medicine will introduce learners to community-engaged healthcare, in which they will learn to care for patients through work-based and Inter-Professional Education (IPE) while attached to under-resourced communities, old age homes, rehabilitation facilities, places of safety, non-governmental organisations, a mobile clinic, school health, screening services, community clinics and community-based primary healthcare facilities.

Learners will also engage in work-based learning and service delivery in nearby community clinics and health centres, and the multilateral agreement (MLA) with other medical institutions in the province and the provincial Department of Health formalised the sharing of resources.

Rationale:
This qualification for primary health care practitioners aligns with the goals of the Human Resource Development Strategy for South Africa 2030, which continues to implement policies that have been in place for the past two decades, and with the World Health Organization's (WHO's) Global strategy on human resources for health: Workforce 2030 (WHO, 2016a). The qualification aims to achieve the goals of the National Health Act, the Department of Health Strategic Plan 2015-2021, the National Development Plan 2030, the proposal for National Health Insurance (NHI), and the Sustainable Development Goals set out by the United Nations (UN, 2015).

The qualification will focus on training learners to provide preventive, promotive, therapeutic and rehabilitative health services and will develop medical doctors who are able and willing to serve and improve the health of individuals, families and communities in urban, peri-urban and rural areas of the Province in particular, and South Africa as a whole.

South Africa has only one doctor per 4024 people of the population. The province has fewer: one doctor per 4280 (Britnell, 2015). The WHO calculated South Africa's doctor-patient ratio as 0.77, i.e. low, but within the parameters of middle-income countries. However, the reality is far different. Of the total of 27 641 doctors in South Africa, only 14 814 serve in the South African public health sector, or 0.36 per 1 000 population (Strachan et al, 2011). This is drastically below the WHO recommended doctor to population ratio of 1:1000 (Deo, 2016). Moreover, Deo (2016) argues that the trend towards developing medical specialists is creating an imbalance in the medical profession and that all countries need more primary health practitioners to treat the "avalanche of non-communicable disorders."

Therefore, the rationale for this qualification is to contribute to implementing the national plan to provide universal, equitable health care, using the public health infrastructure to train primary health care oriented practitioners. These practitioners will be able to practice preventive and holistic medicine in the public health system, with special emphasis on meeting the health care needs of the Province and the public at large. 

LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
Recognition of Prior Learning (RPL):
The following categories can be considered for entry into the qualification via RPL according to the entry admissions guide:
  • Learners without a completed Bachelor Degree.
  • Learners who have a first Bachelor Degree.
  • Learners who have obtained higher education qualifications other than Bachelor degrees.

    RPL for credits:
    Due to the integrated theoretical, clinical and practical nature of the curriculum of the programme for this qualification, accommodating entry into different levels of the qualification and providing credits towards previous formal or non-formal learning will not be possible.

    If the learner does not have minimum entry requirement but has completed a module(s) as part of their qualification that is credited as a substitute for the required school subject(s) and has achieved a final mark of higher than 60% for that module, the Health Sciences Medical Selection Committee may consider the application.

    Admissions Criteria and Application Procedures that pertain to RPL:
    Learners without a completed Bachelor Degree:
  • The learner's academic performance will be evaluated based on the academic average mark for the duration of the studies.
  • To achieve comparability, learners applying from different disciplines/degrees will be considered and scored within those discrete groups.
  • The learner must obtain a minimum academic average mark of at least 65% for the previously completed year(s) of the current degree for which they are registered.
  • If the learner is in an extended programme, the learner can only apply after the completion of the second academic year of the qualification.
  • The learner must have registered for the full course load for the specific qualification.
  • If conditionally selected learners do not maintain an academic average of at least 65%, learners forfeit conditional placement offer.

    Applicants who have a first bachelor degree:
  • Preference will be given to those with a degree from the Health Sciences or Science faculties and to those who completed the qualification within the minimum time.
  • Learners must submit the full academic record.
  • Up to Honours level: learner's academic performance will be scored on academic average mark obtained from the last two years of the most recent degree. The learner must have obtained an academic average of at least 65%.
  • Masters or a higher level: Applications will be considered on a case-by-case basis.
  • Learners applying from different disciplines/degrees will be considered and evaluated within those discrete groups.

    Learners who have obtained higher education qualifications other than Bachelor degrees:
  • Preference will be given to those who completed the qualification within the minimum time and those with a qualification from the Health Sciences or Sciences.
  • Learners must have completed a qualification at NQF Level 7 and have achieved a minimum academic average of 75% of the last two years.

    Entry Requirements:
    The minimum entry requirement for this qualification is:
  • National Senior Certificate, NQF Level 4 granting access to admission to Bachelor's studies with Mathematics, Life Science and Physical Sciences.
    Or
  • Senior Certificate, NQF Level 4 with endorsement together with Mathematics, Biology and Physical Science. 
    		•

    RECOGNISE PREVIOUS LEARNING? 
    Y 

    QUALIFICATION RULES 
    This qualification consists of the following compulsory modules at NQF Levels 7 and 8 totalling 930 Credits.

    Compulsory Modules, Level 5, 20 Credits:
  • Academic Literacy and Reasoning, 20 Credits.

    Compulsory Modules, Level 6, 110 Credits:
  • Basic Medical Science (Chemistry, Biochemistry, Physics, Cell Biology), 70 Credits.
  • Theory and Practice of Medicine I, 40 Credits.

    Compulsory Modules, Level 7, 300 Credits:
  • Structure, functioning and development of the body (Anatomy, Physiology), 100 Credits.
  • Basic Principles of Pharmacology, 10 Credits.
  • Theory and Practice of Medicine II, 30 Credits.
  • Integrated Microbiology and Pathology, 110 Credits.
  • Medical Pharmacology, 20 Credits.
  • Clinical Reasoning and Methods, 30 Credits.

    Compulsory Modules, Level 8, 500 Credits:
  • Integrated Learning I, 10 Credits.
  • Paediatrics, 40 Credits.
  • Obstetrics and Gynaecology, 40 Credits.
  • Internal Medicine, 40 Credits.
  • General Surgery and Urology, 40 Credits.
  • Integrated learning II, 10 Credits.
  • Family Medicine and Primary Care, 40 Credits.
  • Psychiatry, 40 Credits.
  • Additional Clinical Specialities I (Anaesthetics, Emergency Medicine, Radiology), 40 Credits.
  • Additional Clinical Specialities II (Orthopaedics, ENT, Ophthalmology), 40 Credits.
  • Longitudinal District Hospital Clinical Placement, 80 Credits.
  • Specialist rotations, 80 Credits. 
    		•

    EXIT LEVEL OUTCOMES 
    1. Integrate all of the graduate attribute roles, applying profession-specific knowledge, clinical skills and professional attitudes in their provision of patient/client-centred care.
    2. Effectively facilitate the carer-patient/carer-client relationship and the dynamic exchanges that occur before, during and after interventions.
    3. Work effectively within a team to achieve optimal patient/client care.
    4. Participate in healthcare organisations, organising sustainable practices, making decisions about allocating resources, and contributing to the effectiveness of the healthcare system.
    5. Responsibly use their expertise and influence to advance the health and well-being of individuals, communities and populations.
    6. Demonstrate a lifelong commitment to reflective learning as well as the creation, dissemination, application and translation of knowledge.
    7. Demonstrate commitment to ensure the health and well-being of individuals and communities through ethical practice, profession-led self-regulation and high personal standards of behaviour. 

    ASSOCIATED ASSESSMENT CRITERIA 
    Assessment Associated Criteria for Exit Level Outcome 1:
  • Function effectively as entry-level healthcare practitioners, optimally integrating all ethical, comprehensive and patient/client-centred care in a plurality of health and social contexts.
  • Acquire and maintain knowledge, skills, attitudes and character appropriate to their practice.
  • Perform comprehensive assessments of patients/clients.
  • Use preventive, promotive, therapeutic and rehabilitative interventions effectively.
  • Demonstrate efficient and appropriate use of procedural skills, both diagnostic and therapeutic.
  • Seek appropriate consultation from other healthcare professionals, recognising the limits of their own and others' expertise.

    Assessment Associated Criteria for Exit Level Outcome 2:
  • Develop rapport, trust and ethical therapeutic relationships with patients/clients, families and communities from different cultural backgrounds.
  • Accurately elicit and synthesise relevant information and perspectives of patients/clients and families, communities, colleagues and other professionals.
  • Convey relevant information and explanations accurately and effectively to patients/clients, families, communities, colleagues and other professionals as well as statutory and professional bodies.
  • Develop a common understanding of issues, problems and plans with patients/clients, families, communities, colleagues and other professionals, to develop a shared plan of care/action.
  • Convey effective and accurate oral and written information about a clinical encounter.

    Assessment Associated Criteria for Exit Level Outcome 3:
  • Participate effectively and appropriately in multicultural, interprofessional and trans-professional teams, as well as teams in other contexts (the community included).
  • Work effectively with other healthcare professionals to promote positive relationships and prevent, negotiate and resolve interpersonal conflict.

    Assessment Associated Criteria for Exit Level Outcome 4:
  • Participate in activities that contribute to the effectiveness of the healthcare organisations and systems in which they work.
  • Manage their practise and career effectively.
  • Utilise finite healthcare resources appropriately.
  • Serve in administration and leadership roles, as appropriate.
  • Provide effective healthcare to geographically defined communities.

    Assessment Associated Criteria for Exit Level Outcome 5:
  • Respond to individual patient/client health needs and related issues as part of holistic care.
  • Respond to the health needs of the communities that they serve.

    Assessment Associated Criteria for Exit Level Outcome 6:
  • Maintain and enhance professional competence through ongoing learning, both as healthcare professionals and as responsible citizens, locally and globally.
  • Ask practice questions, locate relevant evidence, critically evaluate and interpret information and sources, and consider the application of the information.
  • Facilitate the learning of patients/clients, families, learners, other healthcare professionals, the public, staff and others, as appropriate.

    Assessment Associated Criteria for Exit Level Outcome 7:
  • Demonstrate commitment and accountability to their patients/clients, other healthcare professions and society through ethical practice.
  • Demonstrate a commitment to their patients/clients, healthcare professionals and society through participation in profession-led self-regulation.
  • Demonstrate a commitment to own health and sustainable practice.

    Integrated Assessment:
    The MBChB qualification will include formative (low-stakes) and summative (high-stakes) assessments. Formative assessments prepare learners for summative assessments. Summative assessments may consist of assignments, tests, demonstrations and exams.

    Formative assessment will be used to promote and monitor learning, i.e. to provide practice and extrinsic motivation, and to assess progress. Marks may be awarded for formative assessment, but they will not count towards the "classmark" except perhaps as a small percentage to acknowledge attendance or taking responsibility (e.g. for maintaining the learning portfolio, see below).

    Summative assessments will be cumulative and comprise the "class mark." In the first three years (Basic Sciences), the "classmark" will comprise at least three class tests (or assignments) and will count 60% of the final mark. The final assessment (assignment or examination) will count 40% of the final mark. The marks for the cumulative assessments in the final three years (Clinical) will comprise 40% of the final grade and the final assessment 60%.

    The final summative assessment (whether a test, assignment, exam or a combination thereof) will assess the learning outcomes of the whole module. Although it will only be possible to test a sample of the learning, it will nevertheless be a representative sample at a level of difficulty that represents that of the module.

    The overall aim of the assessment strategy is to achieve validity and reliability of all assessments. Due to the variability of assessments and the importance of the demonstration of competency, it will be important to implement a standard-setting strategy (based on valid assessment criteria) to increase the accuracy of the pass/fail judgements for summative assessments.

    Monitoring performance in the workplace and providing feedback is one of the most significant limitations of clinical training qualifications globally. In the final three years during clinical rotations, the final summative assessment includes a clinical (practical) component, which needs to be assessed and passed independently of the theory summative assessment.

    During the rotation, learners will be assessed via continuous clinical assessments using workplace-based assessment strategies. The summative examination for the clinical component will comprise an end of year OSCE with all departments contributing to the stations. Also, the final practical assessment includes a structured oral examination of the cases (patients) recorded in the learners' portfolios. A standardized assessment process (six questions) is used and learners discuss the management of patients they have cared for. The oral presentation assesses learners' ability to communicate with colleagues. Record keeping can also be assessed if a copy of the patient records is contained in the portfolio.

    Assessments by supervising clinicians will include:
    A global rating with comments at the end of a rotation: This evaluates the learner's performance with patients. Learners receive a rating at the end of a rotation, from a variety of supervising clinicians.

    Structured direct observation with checklists for ratings: a supervising clinician directly observes learners whilst a learner performs focused history-taking and physical examination. Learners may also be audio-visually recorded during a patient encounter, and this reviewed and rated by the supervising clinician. Learners have to demonstrate the integrated application of theoretical knowledge and practical skills. 
    		•

    INTERNATIONAL COMPARABILITY 
    This qualification compares favourably with international standards of medical practice by implementing transformative learning in the training of primary healthcare-oriented practitioners following the National Health Act, the Department of Health Strategic Plan 2015-2021, the National Development Plan 2030, and the proposal for National Health Insurance (NHI). Internationally, these national plans speak to the sustainable development goals set out by the United Nations (UN, 2015).

    Medical schools call their undergraduate degrees MD (Medical Doctor - used in the United States), MD-Physician (Russia), MBChB or MBBS (Medicinae Baccalaureus and Baccalaureus Chirurgiae Bachelor of Medicine and Bachelor of Surgery).

    The most widely used approach to training medical practitioners is a theoretical qualification in the "basic medical sciences" followed by an applied qualification in a hospital. Countries throughout the world follow this approach, including other African and Commonwealth Countries, the European Union, the Middle East, India, China, Russia, Australia, and North and South America.

    In the six-year post-school model, the first three years focus on the basic sciences and courses on behavioural science, ethics and professionalism, which underpin clinical skills. Learners spend the next three years learning in hospital departments ("clinical rotations"). Nelson Mandela University proposes this model.

    One variation of this is the Graduate Entry Medical qualification (GEMP), which follows a three-year undergraduate degree. The qualification entails two instead of three years of Basic Medical Sciences and then rotations and an internship, as in the six-year model.

    Few or no countries will license medical doctors from other countries except in emergencies. Most of all countries require that medical graduates at least serve supervised internships in hospitals, and sometimes also write medical board exams, as in India, the USA, UK and South Africa, before licensing them to practice. These professional boards set a demanding comprehensive exam. In the United States, learners must qualify for the internship bypassing US Medical Licensing Exam (USMLE) Step 2, which is in two parts: Clinical Knowledge (CK) and Clinical Skills (CS). They then become medical interns, where they study for their final board exam, USMLE Step 3, which is case-based, Multiple Choice Question (MCQ), and spread over two days. Day 1 is Foundations of Independent Practice (FIP).

    The post-secondary health science qualification followed, for example, in Britain is demanding from the outset. In the first three years, it includes foundations in physics, chemistry and mathematics, and the basic sciences include embryology, human genetics and genomics, anatomy, biochemistry, histology, physiology, microbiology, molecular medicine, immunology, pathology, internal medicine, basic and clinical pharmacology, and epidemiology. At the same time, learners learn clinical skills including physical examination and history taking, as well as professionalism, ethics, psychology, sociology, anthropology, multiculturalism, medical systems, managerial skills, and one or two additional languages. After the basic science years, learners proceed to "clinical rotations" which take place in a hospital. A rotation entails spending an eight to ten-week period in a clinical discipline (see below) in the context of hospital wards. Specialists take learners on their rounds, discuss their cases, and then learners research the cases so they can discuss them with the specialists on subsequent rounds. Learners need a sound knowledge of the basic sciences to engage with specialists.

    The clinical disciplines include Internal Medicine, Surgery, Urology, Orthopaedics, Ophthalmology, Obstetrics and Gynaecology, Psychiatry, Paediatrics, Ear Nose and Throat, Family Medicine & Primary Care, Emergency Medicine, Anaesthetics, and Radiology. There are numerous sub-disciplines. Learners manage a wide variety of clinical cases while working closely with clinical staff.

    After they graduate, learners spend a year or more in an internship where they work under supervision. This is the same model that South Africa has adopted.

    China Medical University provides three years of basic medical sciences followed by three semesters of clinical courses, and then a year of internship. (China Medical University syllabus) Graduates must then comply with board certification requirements.

    The Indian MBBS has nine semesters: two pre-clinical semesters of Anatomy, Biochemistry and Physiology; three para-clinical semesters of Community Medicine, including Forensic Medicine, Pathology, Pharmacology, Microbiology and clinical postings inwards; and four clinical semesters of Community Medicine, Medicine and allied subjects (Psychiatry, Dermatology), Obstetrics and Gynaecology, Pediatrics, Surgery and allied subjects, and Clinical postings. (All India Institute of Medical Sciences, 2005).

    This qualification compares favourably with those of the developed world and includes transformative innovations that are recommended internationally. The opportunity to develop a new qualification has added advantages, in particular, the possibility of integrating important parts of the curriculum and teaching them in context to improve their relevance and application. 

    ARTICULATION OPTIONS 
    This qualification allows possibilities for both vertical and horizontal articulation.

    Horizontal Articulation:
  • Bachelor of Nursing Science, NQF Level 8.
  • Bachelor of Arts in Human Movement Science in Biokinetics, NQF Level 8.
  • Bachelor in Emergency Medical Care, NQF Level 8.
  • Bachelor of Medical Science Honours, NQF Level 8.

    Vertical Articulation:
  • Master in Public Health, NQF Level 9.
  • Master in Family Medicine and Primary Care, NQF Level 9.
  • Master in Paediatrics, NQF Level 9.
  • Master in Obstetrics and Gynaecology, NQF Level 9.
  • Master in Surgery, NQF Level 9. 
    		•

    MODERATION OPTIONS 
    N/A 

    CRITERIA FOR THE REGISTRATION OF ASSESSORS 
    N/A 

    NOTES 
    N/A 

    LEARNING PROGRAMMES RECORDED AGAINST THIS QUALIFICATION: 
     
    NONE 


    PROVIDERS CURRENTLY ACCREDITED TO OFFER THIS QUALIFICATION: 
    This information shows the current accreditations (i.e. those not past their accreditation end dates), and is the most complete record available to SAQA as of today. Some Primary or Delegated Quality Assurance Functionaries have a lag in their recording systems for provider accreditation, in turn leading to a lag in notifying SAQA of all the providers that they have accredited to offer qualifications and unit standards, as well as any extensions to accreditation end dates. The relevant Primary or Delegated Quality Assurance Functionary should be notified if a record appears to be missing from here.
     
    NONE 


    All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.