Legal Requirements

Medical and Dental Professions Board
Guidelines for good practice in Medicine, Dentistry and the Medical Sciences 
Professional Self-Development 

PRETORIA
NOVEMBER 2002 

Health Professions Council of South Africa
Post Office Box 205
Pretoria 0001


Telephone: (012) 338 9300
Fax: (012) 338 9418


cpd@hpcsa.co.za  
www.hpcsa.co.za


The Spirit of Professional Guidelines

Medicine, dentistry and the medical sciences are professions based on a relationship of trust with patients. The term “profession” means “a dedication, promise or commitment publicly made”. To be a good doctor, dentist or medical scientist requires a life-long commitment to good professional and ethical practices and an overriding dedication to the good of one’s fellow humans and society. In essence, the practice of medicine, dentistry and the medical sciences is a moral enterprise. In this spirit the Medical and Dental Professions Board presents the
following ethical guidelines.

Table of Contents

Section One: Ethical Background 1
1. Ethical guidelines 1
2. The ethics of professional self-development 1

Section Two: Continuing Professional Development (CPD) 2

Introduction 2

Adm7inistration 2

Time requirements 3

Categories of educational and development activities and allocation of points 3

Category 1: Organisational activities 4

Category 2: Small-group activities 4

Category 3: Individual activities 4

Deferment 6

Non-compliance 7

Providers of CPD activities 7

Accreditors of CPD activities 7

Tax 8

Contact details 8

List of Accreditors 9

Professional Self-Development
Section One
Ethical Background

1. Ethical Guidelines

Being registered as a doctor, dentist or medical scientist under the Health Professions Act, 1974 (Act No. 56 of 1974), confers certain rights and privileges. Corresponding to these rights and privileges are ethical duties a doctor, dentist or medical scientist owes to individuals and society.

The Medical and Dental Professions Board has embarked on a project to bring together ethical guidelines that spell out these duties of registered practitioners, as well as of medical researchers. In the series Ethical guidelines for good practice in medicine, dentistry and medical sciences, this is the fourth Booklet.

The first booklet in this series, General ethical guidelines for doctors and dentists, sets out the general ethical guidelines that doctors or dentists should respect as members of the medical and dental professions. They form the background to more specific ethical guidelines, duties or rules relating to a range of ethical issues with which doctors and dentists have to contend in their practices.

This booklet, Professional self-development, contains the guidelines and rules governing the system of Continuing Professional Development (CPD).

2. The Ethics of Professional Self-Development

The following general ethical guideline or duty, namely the duty of professional self-development, taken from Booklet 1 in the series Guidelines for good practice in medicine, dentistry and medical sciences, grounds the ethical reasoning behind the CPD system:

“Maintain and improve the standard of your performance by keeping your professional knowledge and skills up to date throughout your working life. In particular, regularly take part in educational activities that relate to your branch or discipline of medicine, dentistry or medical sciences.”

Section Two
Continuing Professional Development (CPD)

1. Introduction

1. The Interim National Medical and Dental Council of South Africa (INMDC) introduced a system of Continuing Professional Development (CPD) for all medical practitioners and dentists on 1 January 1999. As of 1 January 2003 the CPD programme will also be compulsory for biomedical engineers, clinical biochemists, genetic counsellors, medical biological scientists, medical physicists and supplementary medical biological scientists (herein after referred to as medical scientists).
   
   
2. The CPD system is intended to be user-friendly and the 50 points required annually should be easily obtainable. CPD is intended to be neither complicated nor costly for the individual practitioner and takes South African conditions into consideration.
   
   
3. The priority in CPD is to achieve improved patient care, while it will at the same time be of benefit to development in the medical, dental and medical science professions as a whole.
   
   
4. Every medical practitioner, dentist or medical scientist registered in terms of the Health Professions Act, 1974 (Act No. 56 of 1974), irrespective of the category (nature) of their registration, must comply with the requirements relating to Continuing Professional Development, unless their names appear on the to-be-established registers for non-clinical practice in medicine and dentistry. Exemption will be granted to medical practitioners and dentists who are engaged in international peace keeping activities for a period exceeding 12 months. Applications will have to be accompanied by a motivated request from the Surgeon-General of the South African Military Health Services.
   
   

2. Administration

1. The CPD system is administrated by the Medical and Dental Professions Board under the jurisdiction of the Health Professions Council of South Africa (HPCSA). However, the responsibility to accredit and review CPD activities according to specific criteria and guidelines is outsourced to professional societies and associations, medical and dental faculties, and other professional bodies such as the Colleges of Medicine of South Africa and the Academy of Family Practice/Primary Care as Accreditors of CPD Activities. The Board ensures that the responsibilities outsourced are carried out in a fair, equitable and responsible manner. The Board therefore retains the right to review or withdraw any outsourced responsibilities from Accreditors, should the circumstances so require.
   
   
2. It is important to note that prior approval of educational and developmental activities for CPD purposes must be obtained from an Accreditor by provider bodies. The Accreditor will furnish the providers of such activities with the criteria and guidelines for approval and for the allocation of points. Approved activities will be allocated a specific reference number by the Board for easy reference and administration purposes. The Accreditor will communicate the approval number of approved activities to provider bodies.
   
   
3. As from 1 January 2003, attendance data will be transferred to Council electronically by the Accreditor.
   
   
4. Practitioners will be advised annually of the number of points recorded to their credit and of their CPD status. However, practitioners can at any time view their CPD status on the i-Register on Council’s website at www.hpcsa.co.za

3. Time Requirements

1. Every practitioner is required to accumulate at least 50 points within any one year in order to retain his or her registration, provided that any points accumulated during one year in excess of 50 points may be forwarded to the subsequent year only. Any person who registers for the first time as a medical practitioner, dentist or medical scientist after 
   1 January of a particular year, will commence with his or her CPD programme immediately and will have to obtain points on a pro rata basis for the remainder of that year.
   
   
2. Any person whose name is restored subsequent to 1 January 2003 to the registers of medical practitioners, dentists or medical scientists after it had been removed from the relevant register for a period exceeding 12 months, will be subject to compliance with any condition(s) which the Board may specify prior to the restoration of the name of such practitioner to the relevant register.
   
   
3. Any person registered as a medical scientist, as well as as a medical technologist will have to comply with the CPD requirements set out herein and with those applicable to the Professional Board for Medical Technology.
   
   
4. Students undertaking advanced study in biomedical engineering, clinical biochemistry, genetic counselling, medical biological science or medical physics shall be considered to have complied with the requirements specified in rule 5 of the relevant Rules for each year of such study on submission of documentary proof of being enrolled for such study at an accredited educational institution in South Africa or a recognised teaching institution abroad.
   
   

1. The basic premise of the point allocation for activities in the three categories of educational and developmental activities for CPD purposes is that one hour equals one point. However, the responsibility rests with the Accreditors to award an appropriate point allocation for the activities and to recommend to the Board accordingly.
   
   
2. In complying with the requirements, a maximum of 80 percent of the points may be accumulated in any one of categories one, two and three of the specified CPD categories and a minimum of two points in professional ethics will be required from all practitioners per year. Practitioners who have obtained more than four points in professional ethics during 1999, 2000 and 2001 may carry forward the excess points for a maximum of four years. Excess points in professional ethics obtained subsequent to 1 January 2002 will be carried forward for one year only.
   
   
3. A maximum of five points may be obtained in non-clinical but health related activities in any one year. This restriction relates primarily and specifically to business practice and activities related to administration and management. The activities that belong to the specialities of Community Health (Public Health) and Community Dentistry is considered to be clinical in nature, also for practitioners not registered as specialists in these specialities.
   
   The aim of the proposed points allocation is to simplify administration and to reward only activities which lead to or assist in professional development and which can be reasonably monitored.
   
   
4. Any relevant educational or developmental activity that does not fall within the activities listed in the following categories, may be submitted to the Forum of Accreditors who will submit it to the Board with a proposal regarding the approval and, if agreed to, will be accredited. However, it is not the intention of the Board to grant exceptions as a matter of course.
   
   

4.4.1 Category 1: Organisational activities

Attendance of formal educational meetings will be credited with one point per hour of attendance.

These activities are educational and research-based conferences/congresses, large-group workshops, lectures, seminars, and refresher courses. These meetings are organised on a regional, national or international basis and are non-recurring.

International activities (monitored attendance) will be credited with up to 10 points per day.

International activities (unmonitored attendance) will be credited with up to 6 points per day.

National activities (monitored attendance) will be credited with up to 10 points per day.

National activities (unmonitored attendance) will be credited with up to 6 points per day.

The Accreditor will evaluate the application according to the criteria and guidelines for accreditation as provided by the Board.

All category 1 CPD activities must be designated for credit by a recognised Accreditor of CPD activities. Organisers of category 1 activities will provide documentation of CPD points earned.

4.4.2 Category 2: Small group activities

Participation in recurring small group learning opportunities will be credited with one point per hour.

The envisaged activities in this group are the following: Appropriately structured small group workshops, courses, departmental meetings (of a clinical nature e.g. “grand rounds”), inter-disciplinary departmental/divisional teaching ward rounds, journal clubs and small group discussions.

An appropriately structured small group workshop should comply with the following requirements: The group has to reflect a spectrum of expert opinion, the meeting may not be promotional and an identifiable organizer has to be responsible for administration. A feedback mechanism may also be required.

4.4.3 Category 3: Individual activities

Premise:

¨ It is not the intention to reward activities that do not contribute to the professional development of an individual. Activities that form part of an individual’s broad job description, will also not attract CPD credits. Therefore ward rounds and lectures to undergraduate students by full-time lecturers, will not be credited.

¨ The intention is to credit only activities that can reasonably be monitored.

a. Self-study

It is important to note that only accredited self-study activities provided by an approved provider will count.

These activities include, but are not restricted to studying of journals, as well as electronic or computerised material, for which an approved method of assessment is in place. Providers will have to provide reasonable proof that credits applied for are justified.

b. Individual learning

These activities will be credited with one point per hour and include, but are not restricted to skills training, e.g. endoscopy and short-term study at university departments. These activities are envisaged to qualify only when such an activity is part of an accredited, structured course.

It is important to note that prior approval for these activities must be obtained and attendance verified.

c. Research and publication in peer reviewed/continuing professional development journals/chapters in books

Principal author of peer-reviewed publication or author of textbook/component: 15 points.

Co-authors will be credited with 5 points per published paper or textbook/component.

d. Teaching and/or training activities by part-time lecturers to undergraduate students, lecturers to postgraduate students and formally appointed part-time trainers of interns

These activities will be credited with one point per hour.

e. Paper/poster presentation/lectures to peers

In respect of Category 1 activities: Short papers (shorter than 20 minutes), e.g. congress papers/posters, will be credited with five points. Co-authors of short papers and posters will be credited with two points.

Long papers (longer than 20 minutes), e.g. invited lectures and keynote addresses will be credited with ten points and co-authors will receive 5 points.

In respect of Category 2 activities: Presenters will receive 1 point in Category 2 and 1 point in Category 3.

f. Relevant additional qualifications (excluding prescribed qualifications to be obtained by registrars or senior registrars)

A completed six months diploma will be credited with ten points, a completed one-year diploma with twenty points, and a completed two-year diploma with forty points. A completed Masters or Doctoral degree will be credited with fifty points. The above points will be allocated only on awarding of the qualification. Where such courses have a coursework component, the coursework activity will be credited with one point per hour of accredited and validated participation in Category 2.

Please note that the Accreditor has to be aware of the “clinical/non-clinical” nature of such courses before allocating credits.

g. Examinations/Evaluations/Assessments

All formal oral or clinical undergraduate or postgraduate examinations conducted by external or part-time examiners will be credited with one point per hour to a maximum of eight points per day. Note that the preparation, marking or moderation of examination papers is not included. 

The evaluation of dissertations/theses by examiners will be credited with a maximum of five points.

h. Supervision of candidate(s) for higher degrees

These activities will be credited with 15 points per candidate per year and include being the promoter, mentor or study leader of Masters of Doctoral qualifications.

5. Deferment

Practitioners may apply for deferment of CPD and the Board will review such applications individually on the basis of reasons acceptable to the Board.

1. RETIREMENT, ILLNESS AND NON-CLINICAL PRACTICE
   
   Deferment will not be granted to practitioners who are retired, practitioners not practising due to ill health, or medical/dental administrators. The Medical and Dental Professions Board is establishing a separate register for these categories for medical practitioners and dentists.
   
   
2. PRACTITIONERS ABROAD
   
   Practitioners who are practising abroad will also not be granted deferment. However, documentary proof of compliance with continuing professional development requirements in any particular country where such requirements apply, will be accepted for continuing professional development purposes in South Africa. In the absence of such proof of compliance with continuing professional development requirements, documentation on activities attended outside South Africa will have to be submitted to an Accreditor of CPD Activities in South Africa for evaluation and, if approved, the practitioner will qualify for the specified CPD points.
   
   
3. FULL-TIME STUDENTS IN FAMILY MEDICINE, REGISTRARS AND SENIOR REGISTRARS
   
   Full-time students in Family Medicine, Registrars and Senior Registrars will be exempted from CPD requirements for the duration of their training. Compliance will have to be on a pro rata basis for the remainder of the year if the training is completed during a particular year.
   
   
4. COMMUNITY SERVICE
   
   Practitioners performing community service are required to comply with the requirements of CPD during their community service year.
   
   

6. Non - Compliance

In the event of a practitioner not complying with the requirements of the CPD system, the Board may impose any one or more of the following conditions:

• Requiring the practitioner to follow a remedial programme of continuing education and training as specified by the Board.
  
  
• Requiring the practitioner to write an examination as determined by the Board.
  
  
• Registering the practitioner in a category of registration that will provide for supervision regarded as appropriate by the Board.
  
  
• Registering the practitioner in a category of registration restricted to non-clinical practice.
  
  
• Removing the practitioner’s name from the relevant register of medical practitioners, dentists or the relevant medical science.
  
  

7. Provides of CPD Activities

1. Providers include any body such as a faculty/department at a university, a professional association / society / group (e.g. the South African Dental Association, the South African Society of Anaesthesiologists, an Independent Practitioners’ Association (IPA)), or any other body which offers educational and development opportunities to practitioners for CPD purposes, and may include other related industrial or provider organisations.
   
   
2. Providers of CPD activities are required to submit their proposed programme of activities to a relevant CPD accreditor for assessment of the professional content and CPD points value thereof. Only on approval of the proposed activities and on receipt of a Board-allocated reference number, may a provider publicise the proposed activities as approved for CPD purposes, as well as the points value thereof. The name of the relevant Accreditor has to appear on any advertising material. A provider may advertise that CPD points have been applied for, with an indication of the points applied for, provided that the name of the Accreditor is also specified.
   
   
3. Applications for approval of CPD activities must be submitted electronically to an Accreditor on Form eCPD3, which can be accessed at the following website address: www.hpcsa.co.za and by clicking on the CPDMS link.