The internship year in the RSA--a need for change.

A survey of all interns doing their compulsory internship year in the RSA during 1982 and 1983 was carried out by means of a questionnaire (978 interns responded, a response rate of about 85%). Various problem areas were identified, most notably long working hours, insufficient opportunities to practice required procedures, heavy clerical duties leaving little time for training, lack of formal training, and negative attitudes engendered towards the medical profession. The significance and impact of the internship year is evaluated and the way in which South African Medical and Dental Council regulations are applied is examined. Recommendations for improvements in the effectiveness of interns' training are made.

The management structure for research in the RSA, with a proposed management model for medical faculties.

Government accepts responsibility for stimulating and supporting research and development for the welfare of the entire community. Research is therefore a matter of serious concern which should be approached with the greatest degree of responsibility by those trained and qualified to engage in its pursuit. A description is given of those institutions established for overall planning of matters of common concern to all research bodies: the Scientific Advisory Council, the Science Planning Branch of the Department of Constitutional Development and Planning, and the Scientific Priorities Committee. Medical research has made significant progress since the establishment in 1969 of the Medical Research Council, which has devised a management structure to discharge its responsibilities effectively on a national basis. This structure and its underlying philosophy are discussed. There is a great need to strengthen the management structures of research at medical faculties, teaching hospitals and other medical institutions to ensure cost-effectiveness and provide an ongoing flow of research manpower. A research structure for this purpose is proposed and described.

Equitable evaluation in the teaching of integrated clinical medicine.

When clinical medicine is offered as an integrated subject for undergraduate students it poses a problem when it comes to evaluation. Departmental heads become concerned about students' tendency to neglect or even disregard 'minor' subjects because of their small contribution to the composite evaluation mark. A method for allocating weights to various subjects was devised and a computer programme for random allocation of the percentage content of major and minor subjects established. As experience over the past 5 years has shown, the system has been found acceptable by both teachers and students.

[The objective-structured clinical examination (OSCE)]. / Die objektief-struktureerde kliniese eksamen (OSKE).

The objective-structured clinical examination (OSCE) as described by Harden and Gleeson could be evaluated for a specific, limited skill (history and physical examination) on two third-year classes. The candidates were also evaluated on the same skills by conventional techniques in the Departments of Paediatrics, and Obstetrics and Gynaecology during the same examination period. The results were comparable and had significant Spearman rank correlations with the overall mark. The new method is highly acceptable to both students and examiners, and especially noteworthy was the fact that 93% of students experienced this test as a learning situation. They assessed it as an objective and fair evaluation, an opinion shared by most of the participating examiners. It would appear justified to use this test instrument more often, and in other combinations of disciplines and for other skills in subsequent years of the course.