​Fellowship in Paediatric Neurology

Background

The Aga Khan University (AKU) is a private, not for profit, international University first established in 1983, with 11 teaching sites in eight countries. 

 The Aga Khan University Hospital, Nairobi is offering training in Paediatric Neurology in the Department of Paediatrics and Child Health. This fellowship has been offered to contribute to attainment of the highest possible level of health for all children in East Africa by promoting neurological health through high quality care, teaching, research and advocacy. The program exists to promote and advance knowledge, skills and practice of healthcare workers in Paediatric Neurology in East Africa.

The successful candidate will have a duo reporting to Fellowship Program Director and Chair department of Paediatrics and Child Health. This is a two-year competency based program offered at the Aga Khan University Hospital during which fellows complete a specified written course study in Paediatric neurology and also engage in case based study and competency attainment as outlined in the Paediatric neurology curriculum. 

Program Objectives include:

  • To provide standards and guidelines for certification of neurology training and practice.

  • To promote and advance knowledge, skills and practice of Paediatric neurology. 

  • To promote relevant research in neurosciences

  • To develop relevant guidelines for prevention, diagnosis, treatment and care of neurological disorders. 

  • To collaborate with relevant colleges, organizations, and associations in the Region and internationally as appropriate

  • To promote neurological health through advocacy for improved awareness, prevention, and access to high-quality care for neurological disorders 

Minimum fellowship admission requirements:

Candidates will be considered eligible for trainee fellowship in the Paediatric Neurology Fellowship Program if they have completed:

  • MBChB or equivalent

  • Post-graduate MMED training in Paediatrics and child Health or equivalent

Training posts will be offered through a transparent competitive selection process that would include consideration of a written application, a shortlisting and interview process.

Personal attributes: 

  • Demonstrate high level clinical skills and display an understanding of family engagement in the care of children with neurology conditions.  

  • Good communication skills 

  • Ability to be an effective team player and manager

  • An organized learner with an appropriate training mindset

Key Responsibilities:  

  • Assess and manage patients 

  • Conduct daily ward rounds. Participate actively in all matters relating to patient care and contribute to decision-making during daily rounds, with assistance from the attending staff 

  • Review and examine patients consistently by performing such duties as taking case histories, conducting physical examinations, and ordering diagnostic laboratory and radiology studies in discussion with consultants.  

  • Monitor patients’ progress on a regular basis. 

  • Participate in clinics and external rotations as assigned / determined by the curriculum rotation while being mindful of timely completion of log book requirements.

  • Initiate discussions with patient and care givers to enable better diagnostic and therapeutic medical care and services. 

  • Provide telephone guidance to physicians seeking advice from the AKUHN affiliated staff for acute Paediatric neurology problems during evenings and weekends/holidays, with backup provided from the attending staff. 

  • Assist in the performance of certain technical procedures, such as central venous catheter insertion, arterial line insertion, review of neurophysiology test procedures and results etc. as per privileges under the supervision of the attending physician 

  • Approve/clarify orders (investigations, consultations and treatments) written by junior house staff in cases of uncertainty 

  • Assist in the examination and observation of emergency cases by performing such duties as taking case histories, conducting physical examinations, and ordering diagnostic laboratory and radiology studies

  • Attend to critical patients in a timely manner. When necessary, carry out privileged and potentially life-saving emergency surgical and medical procedures as per privileges and competency. 

  • Educate patients on wellness, prevention and early detection of neurology conditions.  

  • Provide appropriate materials, resources and referrals to patients, family members/care givers. 

  • Educate patients on informed consent, choice of attending physician and right to seek second opinion. 

  • Present cases at ward and clinic-pathology/ multidisciplinary rounds, Morbidity and Mortality Rounds. 

  • Provide regular junior resident teaching, under the supervision of the attending staff 

  • Supervision and education of junior house staff.

  • Take charge of morning rounds, and be the first voice in generating patient management 

  • Liaise with the consultants and various department. Initiate timely discussions with relevant consultants/departments to arrive at the best treatment plan for specialized cases. 

  • Attend morning hand-over and sign-out rounds to assist in transferring care to/from the on-call teams. Ensure that daily progress notes are made on all patients. 

  • Assist in screening potential transfers/admissions to/from critical care units, with assistance from the attending staff.

Academic Regulations for the Programme

1.1      Course Requirements

UnThe trainees are required to undertake the following components of the course:

A.     Undertake clinical rotations, for a minimum of 10 weeks each, in the following core areas:

  • Acute in-patient and neuro-critical care;
  • General neurology out-patient care;
  • Cerebral palsy and neurodisability;
  • Epilepsy;  
  • Neuro-developmental follow-up;
  • Neurophysiology and neuroradiology.

B.    Undertake clinicial rotation in at least 1 of the following optional areas:

  • Neurogenetics
  • Metabolic Medicine
  • Movement disorder clinic
  • Neonatal neurology
  • Neuromuscular clinic
  • Stroke
  • Autonomic medicine
  • Sleep medicine

C.   Complete the eight mandatory modules in the BPNA Distance Learning Programme:

  • Introductory Unit
  • Development and Learning
  • Central Motor Deficits
  • Membrane, Channels, Epilepsy and Paroxysmal Disorders
  • Cerebrovascular Disease, Trauma and Coma
  • Inflammation and Infection of the Nervous System
  • Vision and Hearing
  • Headache

D.   Undertake a research project, constituting at a minimum, a case-control or a cohort study, present the results of the study in at least one national forum and complete a report on the same.

E.    Undertake a teaching skills training course

1.2    Student Assessment Criteria

Trainees will be assessed using 4 parallel modalities (below), with strong emphasis on formative assessment throughout the training programme. There will be no final overall mark; rather, students must attain a pass in each of the 4 assessment modalities by the end of year 2 in order to be awarded accreditation in Child Neurology. 

1.2.1  E-portfolio, Including Development Log and Workplace-Based Assessments, Reviewed at a Bi-Annual Review of Competency Progression (RCP)

Trainees will be expected to complete work-place based assessments and keep a development log of cases seen and clinical experience reflecting their exposure to a spectrum of childhood neurological conditions as per the Child Neurlogy curriculum.  These forms will all be accessed on the trainee's on-line e-portfolio. The sub-committee will convene bi-annually to assess all trainees' portfolios on-line and the trainees will not be present at these reviews.

The trainee must complete the following (at a minimum) per training year, to be able to progress to the next training year:

  1. 1 case-based discussions (CbD) per month/12 per training year – these should reflect a breadth of clinical cases where the trainee has been a lead clinician; each case should be discussed with the Educational Supervisor and a CbD form completed (on-line form on e-portfolio, to be completed by Supervisor, highlighting key learning points)
  2. Development log – trainees should log every clinic attended and every new Neurology patient assessed on their e-portfolio, using the appropriate on-line forms, to demonstrate achievement of competecies as per the Child Neurology curriculum; they may also log other activities as supporting evidence of professional development e.g. teaching activities, courses attended
  3. Additional supporting evidence – trainees may upload to their e-portfolio documents such as teaching presentations and courses attended

1.2.2   The Distance Learning Course

All trainees must complete the 8 modules of the BPNA programme. This is expected to take 4-6 hours per week over 1-2 years; trainees will be allocated two half-days per week throughout training, in order to complete this course.

1.2.3  Research project

All trainees will be expected to conduct and write up a research project. This project should lead to at least one national or international oral presentation and one peer-reviewed publication. The publication may be original research or a case series or literature review, and should be submitted prior to the completion of the 2nd year of training.

1.2.4  Exit examination (practical)

On completion of the clinical rotations, the mandatory BPNA modules and the research project, trainees may apply to sit the Practical Examination, at any sitting of the Exam during their year 2 of training. The exit  practical exam will comprise of stations which will include clinical assessments, data interpretation and management scenarios. Candidates will be assessed by external examiners.

A pass in the Practical Examination does not imply completion of training; trainees must fulfill all competencies listed above (expected to take 2 years, or part time equivalent) and attaining a pass in each of the 4 assessment modalities in order to be awarded accreditation in Child Neurology.

Trainees are expect to undertake a minimum of 2 years (full time) Child Neurology training in order to gain the minimum experience needed to practice independently. It will not be possible to complete training within a shorter period than 2 years. Some trainees may require extra training time to complete all competencies, and this will be allocated at the discretion of the programme panel undertaking the Bi-annual Review of Competency Progression.

1.3   Grading System

Each of the 4 components above (1. E-portfolio/ workplace-based assessments; 2. BPNA distance learning; 3. Exit examination; 4. Research project with publication submitted), will be graded as either pass or fail. Upon successful completion (=pass) of all 4 components, graduands will be deemed to have earned a Fellowship in Child Neurology.