DEPARTMENT OF FAMILY MEDICINE

AMINU KANO TEACHING HOSPITAL

DEPARTMENTAL BYE-LAWS

1.0 INTRODUCTION
Family medicine is the discipline which integrates several medical specialties into a new
whole. It is concerned with the holistic approach to patients care in which individual is seen
in his/her totality, within the context of his family and community.
Family Medicine training aims to provide an effective, comprehensive, high quality
postgraduate training for doctors who desire to follow a career in Family medicine in
Nigeria/West African sub-region. Graduates of such training will be equipped with the
attitude, knowledge and skills needed to competently practice wherever they found
themselves.
The Department of Family Medicine, Aminu Kano Teaching Hospital (AKTH) offers both In-
Patient and Out-Patient services. These services are provided through General Out-Patient
Clinics, NHIS, Accident and Emergency, Staff and Retainership clinics.
The Department has full accreditation for Residency training in Family Medicine by the
National Postgraduate Medical College of Nigeria and The West African College of
Physicians.

2.0 ORIENTATION FOR NEW DOCTORS

2.0.1 Consent

 All residents should read and understand the Departmental Bye-Laws and sign an
informed consent form, Appendix 1, to abide by the Bye-Laws as a prerequisite for
commencement of the residency training programme in the Department.

2.1 Punctuality

 Lateness shall be defined as not present at your duty post by 8:30am

 Recurrent /habitual lateness shall be defined as coming late to work for 3 or more times
in any week or 6 or times a month.
 Absenteeism: absent from duty for the whole day without a valid permission.
 For any anticipated lateness/absenteeism. The Doctor/Officer should establish a chain
of communication with the Chief Resident or HOD/ anybody acting in that capacity to
tender plausible reason before 8:30am of the affected day.

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2.1.1 Sanctions

 Lateness: additional 7-10 patients shall be added to the Officer in addition to the day’s
duty and this shall be verified by the Chief Resident.
 Recurrent/Habitual lateness: A query letter shall be served to the erring Officer and a
copy sent to the hospital management for necessary action.
 Absenteeism: Without meaningful and appropriate communication with the
Department, an Officer who absents his/herself for the whole day shall receive a query
letter and a copy sent to the hospital management for necessary action.

2.2 Dress code

 Every doctor is expected to dress decently and always put on the clinical coat and attach
his/her identity card.

2.2.1 Penalty

 For any doctor not properly dressed, the Chief Resident should notify the consultant on-
call to take necessary action.

2.3 Departmental activities

Days Activities Frequency Time Venue

Tuesday Medical audit Weekly 8:00-8:30am Seminar room
Journal club Fortnightly 1:30-3:00pm Seminar room
Departmental Last Tues of the 1:30;3:00pm Seminar room
meeting month
Wednesday Hospital Fortnightly 8:15-9:00am Conference hall
presentation
Clinical weekly 1:30-3:00pm Seminar room
presentation
Thursday Clinical /drug Weekly 1:30-3:00pm Seminar room
presentation
Friday Dermatology Weekly 8:00-9:00am Seminar room
lecture

2.3.1 Departmental meeting

 Every doctor must have 75% attendance to all meetings (clinical/departmental)

 Hand written apology from absentee is to be read on the day of the meeting.
 Ground rules for meeting must be followed: all phones should be put on silent mode,
must seek for and be given permission to exit any meeting when in session.

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2.3.2 Departmental Library

 Out of bounds to all doctors not under the Department of Family Medicine.
 Headed by a Librarian: He/she should be a Senior Registrar to be selected at a
Departmental meeting with tenure of six months.
 Books can only be borrowed through the Librarian.
 Books should be held by an individual for NOT more than 2 weeks.
 Renewal subject to demand for a particular book
 The register should be properly filled when any book is leased out and when it is
expected to be returned and when returned.
 Loss of any book from departmental Library shall attract a penalty……Replacement.
 Failure to return a book as at when due shall attract a penalty of 100 Naira/day.
 Library users must ensure the library is kept clean.
 Ground rules for the use of library should be strictly adhered to.

2.3.3 Sleeping/rest rooms

 Users of the Sleeping and Rest rooms must ensure that the rooms are kept clean always.

3.0 CLINICAL ACTIVITIES

3.1 Clinics

 General out patients clinic runs on Weekdays 8:00am -9:00pm

Weekends/Public holidays 8:30am-2:00pm
 National Health Insurance Scheme Clinic (NHIS) runs 8:00am-9:00pm daily (weekends
and public holidays inclusive).

Antenatal clinic:

 All residents must acquaint themselves with the protocol of the ANC clinic.
 Residents who do not conform to the protocol, if detected will be made to spend
TWO consecutive Weeks (additional) on ANC clinic days to properly acquaint
himself/herself with the protocol.

3.2 Consultation

 All consultations should be based on acceptable clinical guidelines /protocols.

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  Doctors must write their names and signature at the end of every consultation on the
consultation sheet. Signatures ONLY is not acceptable.

Patient Examination

 Patient examination should always be done in the presence of chaperon. Clinical

assistants will suffice while examining patients.

Investigations

 Fill appropriate forms properly

 Ensure that all the information is entered correctly.
 Requesting Doctor’s name must be on the forms.

Admissions

 The Senior Registrar on call, Chief Resident and the Consultant on-call must be notified
of any admission.
 Admissions are done through GOPC and the A and E.

In-patient ward rounds

 Monday/Friday Resident ward rounds 8:00-10:00 am

 Wednesday Senior Resident ward rounds 8:00-10:00am
 Tuesday/Thursday Consultant ward rounds 8:00-10:00am

Referrals

 A Senior Registrar must review all referrals before they are sent out of the department.
 Clinical details and reason for referral must be clearly stated.
 Emergency cases must be accompanied by a clinical assistant to the A and E.

Medical certification

 Excuse duty must be justified and properly documented in the patients folder
 Medical report: must be reviewed and endorsed by a Consultant.
 Medical certificate of Fitness: a proper history and focused medical examination must
be carried out and documented in the patients’ case note.
 All investigations must be done, retrieved and properly documented.
 Failure to carry out the appropriate documentation by the initial attending
doctor will have the patient sent back to him/her for proper documentation.

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4.0 OFFICE OF THE CHIEF RESIDENT
 Should be a Senior Registrar
 Coordinate all departmental activities
 Should serve for a minimum of FOUR (4) uninterrupted months tenure.
 Responsible for orientation of new Doctors
 Should introduce new doctors to all members of the department during departmental
meetings.
 All communications should be channeled to the office of Chief Resident and respective
mentors.

5.0 RESIDENCY TRAINING

AT RECRUITMENT

5.1 Checklist-for trainability

 Must have primaries from both colleges or obtained an exemption from the other
college if he/she had primaries from only one college.
 It is compulsory for Residents to prepare for part I in both colleges.
 Primary Examination/Exemption: It has a time frame before a resident is eligible to sit
for part 1 examination –refer to college prospectus.
 Physician in training registration: Should have been done 1 year before the next exam.
 Associate Fellows Annual Subscription (AFAS) done each year for NPMCN, before 31 st of
January.
 Log book: Residents should obtain a copy as soon as possible from the Department
Secretary (IF AVAILABLE) at an affordable price or purchase from the college
 Flow charts for posting- Models A-D: Resident is free to choose from A-D ( See last page)
 Mentor/Supervisor: Guides resident on all academic activities in the programme,
presentation, postings and other relevant matters. This is further explained below.
Annual progress report: to be submitted to the college before 31st January of every year.
 Departmental dues: Monthly Departmental dues to be paid to the Department in cash
or through departmental account:
 Bank name: Access bank
 Account number: 0701448121
 Account name: Family Medicine Departmental account

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5.2 Pre-part one rotation

 Family Medicine Posting: Lecture/presentation and tutorials of Family Medicine topics

to be supervised by Senior Registrars and consultants while in the department.
 Resident must present at least one Family Medicine topic before he/she goes out for
posting.
 In-patient admission while in the department: Resident must be actively involved in the
management of in-patients.
 End of posting evaluation: At the end of every posting, Resident must sit for end of
posting MCQ exams. The Chief Resident will supervise and file the result in the residents
file.
 The end of Posting Exams will be held in the last Wednesday before the next posting

Formative assessment: Total scores from end of posting evaluation =

Total number of posting

 Mock exams: Mandatory for all Residents to be taken twice a year (February and
August) in preparation for part 1 examination.
 Departmental presentation: All residents are advised to attend. It is mandatory for those
in family medicine posting and the presenter
 A team of Consultants will periodically visit Residents on posting to ascertain their level
of involvement in their respective postings.
 Log books must be appropriately filled while a Resident is on posting.
 NO BULK SIGNING OF LOG BOOK AT ONCE (EXAMS PERIOD) WILL BE ENTERTAINED.

In case the Residency training committee found a Resident not eligible for the examination:

 The candidates deficiencies will be identified and made known to him/her

 The candidate remains within the department to correct those deficiencies under the
guidance of his/her Supervisors
 Should he/she wish to go out on some postings, he/she may be allowed to do so.

Offences/Penalties: (Resident will spend extra 2 weeks plus ward work for committing any
of the following offences).

 Deliberate disruption of posting flow chart (rotation)

 Failure to do a Departmental presentation

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  Failure to participate in the Mock Exams/ End of posting evaluation
 Failure to admit where and when indicated

5.3 Eligibility for Part I Exams

 Resident must have completed his/her rotations

 Score 50% in Summative assessment
 Good financial standing in the Department
 The Residency training committee will review the performance of each prospective
part I candidate and make a final recommendation on his suitability for the
Examination.

5.4 Proposed post part 1 schedule

5.4.1 Proposal development:

 Proposal developed within 3 months post part one

 Proposal must be presented in the department before sending to the college

Sanction for not achieving milestone 5.4.1

 Any Resident that has not started working on any topic 6 Months post part 1 will have
his/her academic day withdrawn.
 Resident is advised to discuss area/topics of interest with his/her Supervisor
immediately after passing part 1.

5.4.2 Post part 1 posting

 Surgery/ O & G: Eight weeks each

Eligibility criteria for milestone 5.4.2

 At least six months post part 1

 Minimum of 3 reviewed and accepted case reports
 Had presented his/her proposal to the department

5.4.3 Tutelage

Eligibility criteria for milestone 5.4.3

 Minimum of 9 reviewed and accepted case reports

 Must have been involved in the management of at least 3 in-patients

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5.4.4 Elective/Rural posting

 Six weeks at least 2 postings in his/her Department of Choice

 4 weeks rural posting.

5.4.5 Part II Drill

 Dissertation defense: Residents are advised to finish their work early for review by
different people.
 They must present the book to department before sending to the college. Using the
format: Background, Objectives, Methodology and Results.
 Case book must be review by colleagues and senior colleagues.
 Pre-part II full mock examination (Dissertation, Case book and Orals) should be done for
all pre-part II candidate prior to examination. (Organized twice a year in March and
September).

5.5 Eligibility for Part II Examination

Candidate must have achieved 80% attendance at work and departmental

meetings/academic activities.

Candidate must have presented 80% of the topics assigned to him/her.

Must have completed writing his/her books TWO MONTHS prior to the time of
registration for the examination

6.0 Residency training committee

 The Residency training committee, headed by the Coordinator of training in the
department, and having all the Consultants in the department and the Chief
Resident, as members will sit in May and November every year.
 Committee should certify eligibility for attending both part I and part II examination.
 Update of residency training to be submitted to hospital Residency Training
Committee.

7.0 Exit from residency training for super-numerary residents

 All super-numerary residents that have attempted the part II examination will have one
month after exam to prepare and go back to their respective institutions.
 However, a post part II resident who wishes to stay longer than a month can apply for
extension through their primary employers.

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FLOW CHART FOR RESIDENTS POSTING

No. Posting Duration Dates

1. FM 6 Weeks
Surgery 12 “
ENT 4 “
Com Med 4 “
2. FM 4 “
Internal Medicine 12 “
Anaesthesia 4 “
Psychiatric 8 “
X. Rural Posting at Kumbotso 6 “
3. Family Medicine 4 “
O&G 12 “
Ophthalmology 4 “
Lab. 8 “
4. Family Medicine 4 “
Paediatric 12 “
Radiology 4 “
Dental 4 “
Y. Accident & Emergency 6 “
Total Number of weeks 112Weeks

Key Model A = ( 1 → 2 → X → 3 → 4 → Y )

Model B = ( 2 → 3 → X → 4 → 1 → Y)

Model C = ( 3→ 4 → X → 2 → 1 → Y)

Model D = ( 4 → 3 → X → 1 → 2 → Y )

X – Rural posting at Kumbotso Comprehensive Center

Y – Accident and Emergency posting.

NB: Pre-part one duration: 112 weeks of posting plus 8 weeks of annual = 120 Weeks

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DUTIES OF A MENTOR

1. To understand what the mentee is seeking from the mentoring relationship.

2. To discover key issues affecting mentee’s success, to clarify contentious issues and
advise accordingly.
3. Identify resources that will help mentees with personal development and growth e.g.
recommending learning tools and skills.
4. Assess the progress of the mentee towards the next examination or otherwise stated
milestones.
5. Assess the knowledge and skills acquired by the mentee via MCQs, direct questions log
book review etc. each after posting.
6. Assist the mentee where necessary either directly or by recommendation.
7. Periodically assess the performance of the mentee using a structured assessment tool.

DUTIES OF THE MENTEE

1. Identifying initial learning goals and measures of success for the mentoring relationship.
2. Take an active role in their own learning and help drive the process.
3. Schedule and attend mentor conversation / meetings.
4. Discuss and clarify expectation with your mentor:- roles & responsibilities.
5. Have a timeline to help you achieve your goal.
6. Assess the performance of the mentor using the structured performance assessment
tool periodically.

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 APPENDIX I

FAMILY MEDICINE DEPARTMENT CONSENT FORM

I, Dr…………………………………………………., haven thoroughly read and understood the

content of the Family Medicine Departmental Bye-Laws do hereby agree to abide by the rules
and regulations set in the bye-laws during the period of my stay and or training in the
Department.

In an event that I err, I also agree that the penalties outlined in the Bye-Laws be fully applied to
me.

Signature……………………….

Date…………………………….

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