SA Orthopaedic Journal
On-line version ISSN 2309-8309
DACHS, Rob et al. Assessment of undergraduate orthopaedic training at medical schools in South Africa. SA orthop. j. [online]. 2010, vol.9, n.4, pp. 33-37. ISSN 2309-8309.
BACKGROUND: A familiarity with basic musculoskeletal disorders is of vital importance for medical school graduates. The purpose of this study was to assess a group of newly qualified South African medical school graduates commencing internship at Groote Schuur and Tygerberg Hospitals for competency in musculoskeletal injury and disease. METHODS: An internationally validated competency examination in musculoskeletal medicine was used as the assessment tool. The examination consisted of 25 short-answer questions and was marked using a validated answer key and scoring system. Topics included fractures and dislocations, back pain, arthritis, basic anatomical knowledge and emergencies that require urgent referral to an orthopaedic surgeon. The study group comprised 79 interns who were in their first postgraduate year at Groote Schuur or Tygerberg Hospitals. The examination was administered during the orientation programme on their first day at work. The examination was also administered to all registrars in orthopaedic surgery at the University of Cape Town. Data was analysed using Stata 11 to estimate percentages and their binomial exact 95% confidence intervals. RESULTS: The recommended mean passing score for the examination was 73.1 ± 6.8 per cent. The mean score for the 17 orthopaedic registrars was 96.0 per cent, and that for the 79 interns in their first postgraduate year was 45.3 per cent (95% CI 42.3-48.4). Seventy-two (91 per cent) of the 79 interns failed to demonstrate basic competency in the examination. CONCLUSION: In summary, 91 per cent of medical school graduates in our study failed a valid musculoskeletal competency examination. We therefore believe that medical school preparation in musculoskeletal injury and disease in South Africa is inadequate and that undergraduate training programmes should be reassessed throughout the country.