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 Neurology within the Department of Internal Medicine. This is a pioneering neurology training programme in the region, in line with the goals of the regional Neurosciences Committee of the Aga Khan Development Network's (AKDN), vision of working towards a Neurosciences Centre of Excellence. The AKU network of hospitals in Nairobi and Dar es Salaam already have established allied speciality services such as neuro-radiology, neurophysiology, neurosurgery and neuro-rehabilitation, which all work together as exemplified by their successful in-hospital stroke pathways.
Program Structure
The Neurology fellowship is a 3-year sub-specialty training program for people who have already completed MMed residency training in internal medicine. It is modelled on the equivalent British 2013 curriculum and adapted by the NFC for an East African context. The program will entail extensive inpatient and outpatient supervised clinical experience. The graduating fellows will have expertise at the subspecialty level in the broad range of adult clinical neurology. This is a competency based program consisting of structured didactic and clinical rotations, during which period trainees will be mentored towards attaining specified competencies, and are expected to complete course requirements as outlined in the program curriculum.
The didactic component is comprised of onsite teaching activities, short courses, online, and university based courses. Clinical training will consist of 36 months of clinical rotations, including a 6-month elective rotation which will include the option of rotating through a neurology training centre of excellence overseas. The fellow will also undertake a clinical research project which should be submitted for publication prior to completion of the program, and also publish one other case series.
Program Learning Outcomes
The fellowship programme is geared towards producing sub-specialists capable of independently offering good clinical care of neurology patients. By the end of the training, graduates will have knowledge about the core principals of electro-diagnostic testing, and should have published at least two papers in peer-reviewed journals. Successful trainees will be able to:
- Competently examine, diagnose, manage or refer clients presenting with a range of common as well as uncommon neurological disorders
- Communicate effectively and coherently with colleagues, patients, their family members and care givers; as well as clients from diverse backgrounds, including those with special communication needs
- Exhibit knowledge of different presentations of common and less common neurological diseases.
- Demonstrate a thorough understanding of the roles and usefulness of investigations including neuroimaging and neurophysiology.
- Demonstrate appropriate focused and comprehensive examination of mental and physical state
- Adopt assessments and interventions that are inclusive, respectful of diversity and patient centred
- Formulate an appropriately ordered differential diagnosis based on an appreciation of the patient, the past history and current problems and the likely causes
- Plan and order appropriate observations, liaise with other members of the multi-disciplinary treatment team, determine and
- Prescribe immediate treatment, seek appropriate opinions and interventions and with others, develop an overall plan for the individual patient.
- Demonstrate self-management: organising and managing themselves while taking into account of the needs and priorities of others.
- Support team members to develop their roles and responsibilities and continue to review performance of the team members to endure that planned service outcomes are met.
- Ensure patient safety at all times, continue to encourage innovation and facilitate transformation
Key Responsibilities
1. Clinical responsibilities
- Acute neurology admissions
- Ward consults and reviews
- Outpatient clinics and reviews
- Be the point of contact between consultants and service users
2. Educational responsibilities
- Reading round cases encountered during clinical work
- Contribute to weekly case-based learning, including journal clubs
- Participate in the modular programme
- Maintain a contemporaneous and up-to-date case log with reflective learning
- Participate in clinical governance initiatives e.g. audits, quality improvement of clinical pathways etc.
3. Teaching responsibilities
- Bedside and outpatient neurology skills teaching of undergraduate, elective and post-graduate students, as well as newly joined neurology fellows.
- Help deliver the Neurology module to MMed students
- Participate in the hospital clinical and educational meetings and activities
4. Research/scholarship requirements
- The fellow will be required to have had two manuscripts accepted for publication in a peer-reviewed journal.
- One article should at least be a case series, and the other article can be a review article, or systematic review.
- The fellow should have finalised their project proposal for the research paper by the end of the first quarter of the second year.
- The fellow can apply for funding from the intra-mural AKU URC grants cycle with the help of their supervisor.
5. Internal collaborations
- Working together with other medical specialties (cardiology, respiratory, gastroenterology, endocrinology, diabetes, nephrology, oncology, and psychiatry being the main ones), as well as other disciplines such as neurosurgery, neuro-radiology, neuro-critical care, neuro-rehabilitation, ophthalmology, pain management, spinal orthopaedic surgeons, Ear Nose and Throat (ENT), maxillofacial and dental surgeons, urology, paediatric neurologists, and psychology and counselling services.
- Working closely with the nursing staff and may be involved in updating nurses on neurological management e.g. for patients on the stroke pathway.
- Working with the therapy department on aspects of physiotherapy, occupational therapy and speech therapy for neurology patients.
- Cross-campus collaboration for both clinical work as well as research work across the AKHS sites.
6. External collaborations with regional public/private, and international institutions
Personal attributes
- Excellent communication skills.
- Able to work in a team i.e. the immediate neurology team, the wider care team, the hospital, faculty and other health workers
- Focused, motivated, self-driven and curious learner
- Demonstrable honesty, integrity, compassion and respect for diversity and applies ethical principles appropriately in all settings.
- Flexible, optimistic, persistent, organised, and supportive.
- Knows own limits: seeks help and accepts advice when needed.
- Time management: punctual and obeys deadlines, with good work-life balance.
Minimum fellowship admission requirements
Candidates will be considered eligible for trainee fellowship in the Neurology Fellowship Program if they meet the following minimum requirements:
- Hold a MBChB/MBBS degree from a recognised university
- Postgraduate Master of Medicine (MMed) degree in Internal Medicine recognized by AKU
- Registration with the Kenya Medical Practitioners and Dentists Council (KMPDC), or equivalent body. Non-Kenyan applicants should be eligible for registration by the KMPDC.
Training positions will be offered through a transparent, competitive selection process that would include consideration of a written application, testimonials and panel interview process.
