Abstract
Purpose
The purpose of this study was to follow up a cohort of South African doctors who had previously failed a validated musculoskeletal assessment tool, to examine the effect of a two-month Orthopaedic internship rotation on musculoskeletal competency.
Methods
A validated competency examination in orthopaedic medicine was used as the assessment tool. Topics included fractures and dislocations, arthritis, basic anatomy and emergencies that require immediate referral to an orthopaedic surgeon. The questionnaire consists of twenty-five short-answer questions. A validated answer key and scoring system were used to mark the questionnaire. In a previous study, we found that 91 per cent of South African doctors in our study group, at the start of their internship, failed to demonstrate basic competency on the examination. We concluded that medical school preparation in orthopaedic medicine in South Africa is inadequate. We reapplied the examination at the end of 2011 to a study group of seventy-six first and second-year interns, to assess whether a two-month orthopaedic rotation during internship had a significant effect on musculoskeletal competency.
Results
A response rate of 61 per cent was achieved (46 of 76). Doctors from all eight medical schools participated. The recommended mean passing score for the assessment of basic competency was 73.1 per cent. The mean score for the group was 56.8 per cent. Those who had completed an orthopaedic rotation during their internship achieved a mean score of 63.1 per cent, compared to 54.1 per cent amongst those who had not yet completed an orthopaedic rotation.
Conclusion
Whilst those who had completed an orthopaedic rotation during internship performed marginally better in the assessment (9 per cent improvement), we found that the majority of the group still did not demonstrate basic competency in musculoskeletal medicine. We therefore believe that interns are not competent in musculoskeletal medicine after their Orthopaedic rotation at our institution.
NO DISCLOSURES
