CMSA

PORTFOLIO OF LEARNING

Diploma in Geriatric Medicine of

The College of Physicians of South Africa

DGM(SA)
 PORTFOLIO OF LEARNING

CONTENTS

SECTION 1 Purpose of the portfolio of learning

SECTION 2 Curriculumfor the DGM(SA)

SECTION 3 Learning and training requirements

SECTION 4 Candidate Details

SECTION 5 Certification of completion of Basic diploma in Geriatric Medicine

curriculum course and practical course in Comprehensive
Geriatric Assessment

SECTION 6 Portfolio/case study record

SECTION 7 Cumulative record of supervised and unsupervised clinical

Geriatric Medicine experience

SECTION 8 Cumulative record of theoretical education and training in

Geriatric Medicine

SECTION 9 Programme supervisors review and declaration on completion of

training
 SECTION 1

PURPOSE OF THE PORTFOLIO OF LEARNING

What is the Portfolio?

Your portfolio is based on the “CRITICAL” Portfolio (Certified Record of In-service Training
Including Continuous Assessment and Learning). It is a professional resource document
structured in a flexible format which allows trainees to plan and meet the objectives of the
specialty training programme through a documented process of work experience, learning and
reflection.

Purpose of the portfolio

1. To stimulate students to think consciously and objectively about their own training.
(This is known as reflective learning). This is its primary purpose.
2. To document the scope and depth of the candidate’s training experiences.
3. To provide a record of the trainee’s progress and personal development as training
proceeds.
4. To provide an objective basis for discussion with the candidate’s supervisors about work
performance, objectives, and immediate and future educational needs.
5. To provide documented evidence for the CMSA of the quality and intensity of the training
the trainee has undergone.

The portfolio is not just a logbook of signed procedures undertaken or witnessed.

It should contain the candidate’s written reflections and systematic documentation of his/her
learning experience. It includes opportunities for candidates to reflect, to explore, to form
opinions, and to identify the strengths and weaknesses in their own abilities and knowledge.
It provides the facility for trainees to follow their own progress, not only through the training
programme, but also towards the learning goals they have set for themselves.
In this way the portfolio provides an opportunity to record and document the subjective aspects
of training.

Objectives

For the trainee, the objectives of the portfolio are to:

 develop a structured learning plan
 identify goals and actions required to achieve them
 record progress in achieving those goals
 document personal strengths
 identify areas needing improvement
 reflect on progressive professional development
 encourage quality two-way communication with supervisors
 provide documentation for the continuous evaluation, review and direction of one’s
progress.
Who looks at the Portfolio of Learning?

1. The candidates. The primary audience are the trainees themselves.

2. Supervisors. It is expected that candidates formally meet with their supervisor several
times each year. At this meeting, supervisors will review the candidate’s progress and
should use entries in the portfolio as a basis for discussion. This allows a structuring of the
supervision process. By referring to and discussing specific areas of learning and
experiences, the supervisor is able to provide informed feedback and constructive advice
with regard to problems and deficiencies. In this way the portfolio allows a structuring of
the supervision process. Ideally, the portfolio should be made available to the supervisor
before the meeting.
3. The CMSA. The CMSA requires evidence that learning has taken place as part of a
structured programme. The portfolio is an important piece of evidence for this.

This portfolio is a guide and cumulative record of your personal learning, goals, needs,
strategies and activities throughout your training programme. The sections in the portfolio are
not exhaustive, but rather an indication of the minimum that you should be doing. You will learn
a great deal more than what is written on these pages. We trust that this will provide you with a
positive and valuable learning experience.

Portfolio Completion Criteria

 The Portfolio should always be used in conjunction with the Regulations and Syllabus for
admission to the Diploma in Geriatric Medicine of the Colleges of Physicians of South
Africa, as may be amended from time to time.
 Entries must at all times be legible and, where indicated, supported by the required
signatories (Supervising Consultants and Heads of Departments and their contact
details). Add pages to each Section as necessary. Ensure that your name appears on
every page. It is strongly advised that you keep an electronic backup copy of all entries,
as well as a printed copy, in case of computer failure or theft.
 The letter from the candidate’s HOD/ programme supervisor confirming approval of the
portfolio and supporting certificates and documents must reach the Academic Registrar of
the CMSA (together with the relevant assessment fee, if applicable) at the time of applying
for Dip Geriatric Med (SA) Examination. Failure to submit the letter of confirmation will
result in the candidate not being invited to the examination.
 The Declaration (Section 9) must be signed before submitting the portfolio to the
HOD/programme supervisor.
 To the Programme Supervisor / Head of Department
This portfolio helps to support you in executing your responsibilities as the overall
Programme Supervisor. Please complete the Programme Supervisor's Annual Review
form and advise the candidate of any deficiencies or problems. Please note you are
required to sign all cumulative records at the end of the training period. Note also the
requirement that the candidate become proficient in the performance of procedures
generally performed by a practitioner with additional skills in Geriatric Medicine. This
includes verifying that the candidate has the required competency in Comprehensive
Geriatric Assessment.
 SECTION 2
CURRICULUM FOR THE DIPLOMA IN GERIATRIC MEDICINE
1.1 Basic concepts: Gerontology and Geriatrics
1.1.1 Basic Concepts in population demographics
• Population trends in Africa and South Africa specifically
• Demographic Determinants and Consequences
1.1.2 Basic concepts of Social Gerontology
• Socio-cultural changes and their impact
• Social security systems including social pensions and care grants
• Sexuality in the elderly
• Older person’s rights
• Team approach to management of older persons
1.1.3 Theories and biology of ageing
1.1.4 Introduction to Geriatrics
• Concept of healthy ageing and disease prevention
• Ageing and disease
• Principles of rehabilitation
• Principles of assessment
• Care settings/requirements including: acute, sub acute/rehabilitation,
long term, institutional, and respite.
• Support service for older persons
1.2 Geriatrics
1.2.1 Physiological changes and homeostasis
• Including changes in body composition, organ-based changes and reasons for
atypical presentation of diseases.
1.2.2 Geriatric syndromes: including falls, immobility, syncope, incontinence, frailty,
insomnia, self-neglect, cognitive impairment, and iatrogenesis.
1.2.3 Specific disease spectrum in older persons
• Delirium/dementia/depression/psychosis
• Neurological diseases: Parkinson's, essential tremor, stroke syndromes
• Cardiovascular diseases: hypertension, ischaemic heart disease, cardiac
arrhythmias, valvular heart disease.
• Metabolic diseases: diabetes mellitus; hypo-and hyper-thyroidism, calcium
metabolism including parathyroid dysfunction
• Respiratory diseases: COPD, asthma, respiratory tract
infections,aspiration pneumonia
• Rheumatology/orthopaedics: Inflammatory arthritis, gout, osteoarthritis,
polymyalgia rheumatica and giant cell arteritis, osteoporosis
(including management of fragility fractures)
• Hematological diseases: anaemia
• Electrolyte disturbances: hyponatremia
• Genitourinary: urinary incontinence, prostatic hypertrophy and cancer,
atrophic vaginitis
• Gastroenterology: peptic ulcer disease, gastro-intestinal bleeding,
constipation, swallowing problems, oral problems
• Hepatobiliary diseases: gall stones, malignancy
• Dermatological: pressure ulcers, leg ulcers, pruritus, dermatitis and skin
neoplasms
• Infections and immunosenescence: influenza, Herpes Zoster, tuberculosis,
urinary tract infections, HIV /AIDS
• Sensory (vision and hearing) and dental assessment.
• Chronic pain
• Nutrition and weight loss
• Peri-operative assessment and post hospital discharge management
1.3 Assessment and Management of a Geriatric Patient
 Comprehensive Geriatric Assessment
 Functional assessment
 Cognitive assessment
 Mood assessment
 Nutritional assessment
 Interpretation of laboratory investigations
 Pharmacotherapy
 Restorative rehabilitation and assisted devices
 Palliative care and end of life issues
 Legal and ethical issues
 Screening and prophylaxis
 Carer assessment
 Elder abuse/neglect
 SECTION 3
LEARNING AND TRAINING REQUIRMENTS
Within the three years preceding the examination, the candidate will have to satisfactorily
complete the following training components:
• Completion of a course covering the basic Geriatric Diploma curriculum.
• Portfolio or case studies.
• Practical course in comprehensive Geriatric Assessment with certified competency
• Accumulated 1000 credit points in the log book comprising the following 3 categories:
3.2.1 Supervised training (Earns full1000 points)
3.2.1.1 Certified post-internship fulltime, or sessional supervised training in a
geriatric medicine unit at a teaching or CMSA-approved hospital at a rate of
1credit point per hour, to a maximum of 170 points per continuous month
(6 months fulltime is sufficient)
3.2.1.2 A logbook of training experience must be kept including record of theoretical
training under 3.2.3

3.2.2 Unsupervised experience (Earns a maximum of 600 points)

3.2.2.1 Fulltime general/primary care/non-specialist practice or experience in non-
CMSA-approved hospitals/including old age residential facilities which
embrace aspects of geriatric medicine care at the rate of 250 points per
annum, or 20 points per continuous month
3.2.2.2 Part-time general/primary care/non-specialist practice or experience in non-
CMSA-approved hospitals which embrace aspects of geriatric medicine care
at a rate of 0.125 point per hour, provided that no credit will be granted for
part-time practice of less than 45 hours per continuous month
3.2.2.3 Unsupervised experience will attract a maximum of 600 credit points, which
must be claimed by affidavit in the logbook
3.2.2.4 Credit points claimed in terms of 3.2.2 (Unsupervised experience) will be
awarded only if claimed in conjunction with a minimum of 400 credit points
awarded under 3.2.3 (Theoretical education/training)
3.2.3 Theoretical education/training (Earns 400 points to complement 3.2.2 of unsupervised
experience)
3.2.3.1 Credit points in sections 3.2.3.1.1to 3.2.3.1.4 will be awarded at the rate of
5 points per hour, only if recorded in the logbook available for this purpose
from the CMSA, certified by either the presenter or the organiser of the ward
round, course, conference, congress, lecture, or symposium, and declared as
correct by the candidate
3.2.3.1.1 Teaching ward rounds, mortality/morbidity meetings, patient
presentations in Geriatric Medicine at a recognised hospital
3.2.3.1.2 Formal courses, congresses or conferences in Geriatric Medicine
care
3.2.3.1.3 Formal lectures or symposia in Geriatric Medicine care
3.2.3.1.4 Formal consultations in Geriatric Medicine with a registered
specialist
3.2.3.1.5 Relevant research publications in reputable journals
3.2.3.2 in section 3.2.3.1.5 credit may be awarded to a maximum of 100 points at 50
points per acceptable publication. The decision of the CMSA with regard to
acceptability of publications offered will be final
3.2.3.3 A maximum of 400 credit points may be claimed in the logbook for theoretical
education/training
3.2.3 Portfolio (pertains to all candidates)- this requires completion of 5 case studies in each
of the major syndromes in geriatric medicine, namely: dementia, delirium, urinary/faecal
incontinence, iatrogenesis, and falls/immobility. Case studies must demonstrate a
comprehensive geriatric assessment and management approach and include a
discussion supporting management choices made. The candidates affiliated training
unit head will certify that the portfolio is satisfactorily completed.

3.2.4 The course covering the basic curriculum will be via distance learning or run by an
academically accredited Geriatric Training unit. The practical course in Comprehensive
Geriatric Assessment will also be under the auspices of an accredited Geriatric Training
unit. For list of accredited training units please see College of Physician’s rules and
regulations (appendix C).
 SECTION 4

CANDIDATE DETAILS

SURNAME: .........................................................................................................................

FIRST NAMES: ...................................................................................................................

ID NUMBER: .......................................................................................................................

HPCSA NUMBER: ..............................................................................................................

WORK ADDRESS: .............................................................................................................

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RESIDENTIAL ADDRESS: .................................................................................................

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PREFERRED POSTAL ADDRESS: ...................................................................................

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EMAIL ADDRESS: ..............................................................................................................

TELEPHONE NUMBER: (Work):……………………………….(Home): ………………………

CELLPHONE NUMBER: .....................................................................................................

FAX NUMBER: ...................................................................................................................

UNDERGRADUATE MEDICAL QUALIFICATIONS

UNIVERSITY: ..................................................................... ....YEAR:……………………….

INTERNSHIP

HOSPITAL: ......................................................................... .... YEAR:……………………….

TRAINING EXPERIENCE: ..................................................................................................

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COMMUNITY SERVICE

HOSPITAL: ......................................................................... .... YEAR:……………………….

TRAINING EXPERIENCE: ..................................................................................................

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SUCCESSFUL COMPLETION OF RELEVANT QUALIFICATIONS

EXAMINATION DETAILS:

MONTH:…………………… YEAR:……………………….

MONTH:…………………… YEAR:……………………….

OTHER REGISTERABLE POST-GRADUATE QUALIFICATIONS

DIPLOMA/DEGREE: ........................................................... .....YEAR:………………………

INSTITUTION: ....................................................................................................................

DIPLOMA/DEGREE: ........................................................... .....YEAR:………………………

INSTITUTION: ....................................................................................................................
ADDITIONAL POST-GRADUATE TRAINING EXPERIENCE

STATUS HOSPITAL DEPARTMENT COUNTRY DURATION & DATES

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RELEVANT DETAILS / EXPERIENCE RELATING TO GERIATRIC MEDICINE

(Prior to commencing the DGM(SA))

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 SECTION 5

CERTIFICATION OF COMPLETION OF BASIC DIPLOMA IN

GERIATRIC MEDICINE CURRICULUM COURSE AND
PRACTICAL COURSE IN COMPREHENSIVE GERIATRIC
ASSESSMENT
(Copies of Certificates must be attached)

COURSE INSTITUTION DATE COURSE DIRECTOR

Basic Diploma in
Geriatric Medicine
curriculum course

Practical course in
comprehensive Geriatric
Assessment
 SECTION 6

PORTFOLIO/CASE STUDY RECORD

This requires completion of 5 case studies in each of the major syndromes in geriatricmedicine,
namely: dementia, delirium, urinary/faecal incontinence, iatrogenesis, and falls/immobility.
Case studies must demonstrate a comprehensive geriatric assessmentand management
approach and include a discussion supporting management choices made.

SUMMARY

Geriatric Syndrom Patient 1 Patient 2 Patient 3 Patient 4 Patient 5

Dementia

Delirium

Urinary/Fecal
incontinence

Iatrogenesis

Falls/immobility

A total of 25 case studies are required.

 SUMMARY OF CASE STUDY 1.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 2.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 3.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 4.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 5.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 6.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 7.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 8.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 9.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 10.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 11.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 12.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 13.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 14.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 15.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 16.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 17.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 18.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 19.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 20.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 21.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 22.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 23.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 24.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SUMMARY OF CASE STUDY 25.

Geriatric Syndrome ____________________ Date _______________

Patient Name_________________ Date of birth _____________

Problem list and supporting clinical information:

Discussion regarding choice of management:

 SECTION 7

CUMULATIVE RECORD OF SUPERVISED AND UNSUPERVISED

CLINICAL GERIATRIC MEDICINE EXPERIENCE

Supervised training in a teaching or CMSA-approved hospital at a rate of 1

point per hour

Hospital__________________________

Month/Year Hours Points Supervisor name/signature

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12

Total points supervised training = _____

Unsupervised training in fulltime general/primary care/non-specialist

practice or experience in non-CMSA-approved hospitals/including old age
residential facilities which embrace aspects of geriatric medicine care.
Points are earned at a rate of 0.125 points per hour. This equates to 250
points per annum or 20 points per continuous month.
 UNSUPERVISED TRAINING LOG
Month/Year Hours Points Practice settings
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.

Total points unsupervised training = ______ (maximum 600)

 SECTION 8

CUMULATIVE RECORD OF THEORETICAL EDUCATION AND

TRAINING IN GERIATRIC MEDICINE

Credit points are awarded at the rate of 5 points per hour

1. Teaching ward rounds, mortality/morbidity meetings, patient

presentations, journal clubs

Date Topic Venue Duration Points Supervisor

1. Continuation of teaching ward rounds, mortality/morbidity meetings,
patient presentations, journal clubs

Date Topic Venue Duration Points Supervisor

2. Formal courses, congresses or conferences in geriatric medicine care
Date Topic Venue Duration Points Supervisor
3. Formal Lectures or symposia in Geriatric Medicine Care

Date Topic Venue Duration Points Supervisor

4. Formal Consultations in Geriatric Medicine with a Registered Specialist

Date Patient Venue Duration Points Specialist

5. Relevant Research Publications/Review/Case Reports in Reputable
Journals

Maximum of 100 points in this section at 50 points per article

Name of Journal Vol. & No Full Title Pages

Summary points for theoretical education and training

Section 1 = _____
Section 2 = _____
Section 3 = _____
Section 4 = _____
Section 5 = _____

Total points = _____

 SECTION 9

PROGRAMME SUPERVISOR’S REVIEW

SUMMARY SHEET OF TRAINING COMPONENTS

S = Satisfactory U/S = Unsatisfactory

Component Completed Points

Course on basic curriculum
Portfolio of case studies
Practical course in comprehensive geriatric assessment
Supervised training
Unsupervised training
Theoretical education/training

Comments

Programme Supervisor:
(Print Name) (Signature)
 DECLARATION ON COMPLETION OF TRAINING

I, …………………………………………………………….hereby do solemnly declare that all

information contained in this PORTFOLIO OF LEARNING is a true and accurate record of my

professional experience, education and training for the Diploma in Geriatric

Medicinequalification.

Signature of Candidate: ................................................................................................

Name of Candidate: ......................................................................................................

Date: .............................................................................................................................

Signature of Academic Head of Department: ................................................................

Original document compiled by Dr WGJ Kloeck, President of the College of Emergency Medicine and modified for Diploma in
Geriatric Medicine by Dr BN Tipping, South African Geriatrics Society, December 2013.