Information for new registrars

This document is intended to give information on frequently asked questions and

important regulations governing registrar posts in family medicine.

What is a registrar post?

All successful candidates for the MMed programme must also enter a registrar post.
Registrar posts are specifically numbered and accredited by the HPCSA for the
purpose of specialist training. Even if you are already employed by the District Health
Services within the training complex you will need to transfer from your current post
to a separate registrar post and sign a 4-year contract. The registrar posts are on the
District Office establishment and are not part of any specific facility in the training
complex. This arrangement allows you move between facilities within the training
complex during the 4-year programme. At the end of the programme you will be
obliged to vacate the post (for a new registrar). While there is currently a huge
demand for family physicians in South Africa the programme does not guarantee a
family physician post at the end of training.

What is my job description and contract?

On entering your registrar post you will be asked to sign a contract with the Province
and you should take note of all the terms of this contract. A detailed job description
has been agreed to by the Province and Universities. Please ensure that you obtain
a copy from the HR department or University. In summary the job description
specifies 85% of time on service delivery, 15% of time for your academic activities.
Service delivery includes consulting and managing one’s own patients and can also
include in-service training (while seeing patients) of medical students or other health
workers. Academic activities, for example, can include educational meetings with
your supervisor on-site, attending the University, studying in WebCT and your
research.

What about clinical training of medical students or other health workers?

Registrars may be called upon to supervise medical students (or sometimes others
such as clinical nurse practitioners) while they consult patients as part of in-service
training / service delivery. Such duties should be formally agreed to by the facility
manager, family physician and registrar.

What does the University require in terms of my professional experience?

The registrar’s professional experience must be documented in the logbook, which

acts as a portfolio of the registrar’s clinical experience, learning, progress and
performance. At the end of each year the logbook must be handed in with all 4
sections completed:
Section 1: Verification of the professional experience obtained at different facilities
Section 2: Record of a minimum of 24 hours of personal educational meetings.
Section 3: Assessment of the level of competence in the core clinical skills
Section 4: Confidential supervisors report (returned separately by the supervisor).
What salary will I receive?

Registrars are usually in Senior Medical Officer posts (Level 10), but if you are
already at Level 11 then you should be able to retain your existing salary level. The
highest salary level permissible for a registrar post is level 11 and within this the
different notches can also be considered.

What about overtime?

Registrars are required to contract for commuted overtime as part of their contribution
to service delivery. The University also expects registrars to participate in overtime
and emergency care as part of their training requirements. Overtime will usually be
done at the facility where the registrar is placed. Overtime will be remunerated by the
District Office and claimed back internally from the facilities budget. At the end of
every month the form Verification of Commuted Overtime must be signed by the
supervisor and returned to the District Office.

What about the rural allowance?

Registrars will be entitled to the rural allowance when they work at a facility that is
designated as rural. In some training complexes no facilities attract rural allowance
(e.g. Metropole) while in others some of the facilities do and some do not. The
allowance will only be paid for the time that a registrar rotates to a designated facility.

Can I work outside the public service?

Remuneration for Work Outside the Public Service (RWOPS) is not permitted for
registrars.

Can I work part-time?

At present there is no provision for part-time work as a Registrar.

How much leave am I entitled to?

Standard leave rules apply as for all PGWC employees and must be approved by the
head of the facility at which the registrar is working. Ask the HR department at the
District Office for further information and see the detailed information in your contract.

What if I fall pregnant during the programme?

Standard maternity leave applies to registrars. In some circumstances it may be

possible to work half-time for a period of 2-years following the birth of a child.
However this will be at the discretion of the District Office and University.

How can I claim for my travel costs?

Once the rotation has been planned the registrar will be based at specific facilities at
different times. Work related travel from this base station to other locations can be
claimed from the District Office. Travel from home to work cannot be claimed.

What about re-locating during the training?

The Province will pay for initial re-location at the start of the programme (if you are
already in a government post) and for 1 further re-location during the programme if
this is necessary.

What about hospital accommodation?

The registrar is responsible for organizing their own accommodation. When needed
and if possible the Province will try their best to make accommodation available to
the registrar.

What is a training complex?

The training complex is a collection of facilities that have been grouped together for
the purposes of postgraduate training in family medicine. The complex includes
primary care facilities, district hospitals and the relevant secondary level hospital in a
specific area. The University has identified a Clinical Training Complex Co-ordinator
for each complex and the Province a Training Complex Manager. Please ensure you
know who these people are and how to contact them. Within the complex there may
also be a number of Supervisors. Supervisors will be Family Physicians in the District
Health Services or Specialists working at the secondary hospital. At any time the
responsibility for direct supervision will lie either with the Family Physician or, if in the
regional hospital, the relevant specialist.

What does the HPCSA require?

The HPCSA accredits the Training Complex and each of the Family Physician
trainers within it. The Family Physician must be on the specialist register with the
HPCSA. The number of permissible registrars is dependent on the number of
accredited Family Physicians in a ratio of 2 to 1. The HPCSA gives specific post
numbers to the University for each of the accredited posts in the training complex.
The University will assist each registrar to register with the HPCSA using Form 9.

How will I rotate in the training complex?

The main aim of the training in clinical family medicine is to achieve the learning
outcomes and clinical skills as defined by the University. The clinical skills are listed
in the logbook. The training complex co-ordinator therefore must plan a 4-year
rotation, with the registrar, through the available facilities, which enables the registrar
to achieve these outcomes. Usually this will include exposure to primary care and
district hospital and when necessary secondary level hospital disciplines. Planning
must take prior training and experience into account. The context of training is
important and where possible we prefer training to occur within the District Health
Services.

Who will complete my SPMS for the Province?

The annual performance appraisal will be the responsibility of the Clinical Training
Complex Co-ordinator who may consult with or delegate this task to the relevant
supervisor.