Bachelor of Medicine Bachelor of Surgery (MBBS)

Entry Requirements to the Bachelor of Medicine Bachelor of Surgery (MBBS) programme

There is no direct entry into the Bachelor of Medicine Bachelor of Surgery program at Faculty of Medicine. The only opportunity for an applicant to be considered directly is when they have attained A-levels, BSc year 1 or equivalent be it in Botswana or abroad.

Admission to the Faculty of Medicine

The University of Botswana selects students to enter the medical degree programme in August, over May and June. Students seeking admission must apply immediately when the announcement is made. These students will be selected on the basis of their year one results in BSc, A’ level results or equivalent, followed by assessment of their application form, short essay and interviews. Personal and professional behaviour, academic performance and communication skills will be considered in the process. Successful candidates will be immediately enrolled in the Faculty of Medicine MBBS program to begin the Phase One, Problem Based Learning (PBL) Curriculum.

Undergraduate Degree Programme

The undergraduate programme is five years in length and divided into two parts. Part One (Phase 1 of the MBBS program) consists of 2 years in a fully integrated curriculum of basic medical sciences within clinical PBL cases and clinical skills teaching with regular clinical attachments. A 10-week Winter Semester has been added to allow for the greater intensity of medical education and Public Health training. The teaching methodology is based on body systems and includes plenary lectures, PBL within small groups, workshops, with laboratories and clinical skills for practical learning. The curriculum is intended to have a strong focus on the community. It is flexible to meet the needs of both faculty and students, and respond to changing health care demands of the country. Design of the PBL content reflects the health problems and resources of the community. 

The second part, or the three subsequent Phase 2 years, requires hospital and clinic rotations in the major disciplines. These experiences are enhanced with an opportunity to explore community services and public health efforts. Phase 2 of the programme consists of years 3-5. The students are exposed to learning in a clinical context that eventually enable them to acquire the competencies for independent practice as graduates of medicine at the end of their internship program.

Acquiring most competencies in the clinical years is progressive throughout the undergraduate life. Therefore, the complete phase 2 competencies can only be fully assessed at the end of 5th year.

Special Regulations under Faculty of Medicine for the MBBS Programme

The important requirements to note for students reading for Bachelor of Medicine Bachelor of Surgery (MBBS):

  1. One needs to pass Continuous Assessment (CA) to be allowed to sit for the Final Examination.
  2. Students are required to score 50% and above in the Final Examination to pass the course.

ASSESSMENT AND ACADEMIC PROGRESSION REGULATIONS

1.0 Regulations guiding assessments in Phase II of the MBBS program

1.1 Senate’s General Academic regulations

  • The Senate’s General Academic regulations of the University of Botswana (modified where necessary to accommodate the peculiarities of assessment in medical education), shall apply to all assessments in phase II.
  • All assessments in the phase II of MBBS program shall be blueprinted to the three core themes of the program:
    • Medical and related science
    • Doctor-patient relationship
    • Public Health & Medicine 

1.2 Academic year

  • The academic year shall comprise 40 teaching weeks, a one week of reading (revision) and two weeks of examination.
  • All courses in both phase I and phase II shall be yearlong courses and progression decisions shall only be made at the end of the year. There shall be no semester courses. For Phase I, even though some assessments are made at the end of the semester, academic standing is determined at the end of the academic year.

1.3 Attendance

  • Attendance of all contact sessions (clinical rotation, PBL, whole class lectures, community placements tutorials and others as may be determined by the department) in all courses in phase II is compulsory. Students are expected to have 100% attendance during their clinical rotation and community programmes. Students who have attended less than 80% of the contact periods in any course (without valid reasons) will not be allowed to participate in the end of year examination in that course and shall be awarded zero mark in that particular examination. They will have to repeat the clinical rotation period in that course and meet up the minimum 80% attendance before being assessed.
  • If a student is unable to meet the required minimum of 80% attendance of contact sessions in any course(s) due to exceptional or extenuating circumstances, the candidate may be admitted in the end of year assessment provided that the Dean had been notified in writing (with copies to the Phase II coordinator and Head(s) of department concerned) within 48 hours of the event. Such letter should describe the nature of the circumstance. In all cases,
  • the department(s) concerned should advice on the preparedness of the candidate to sit for the exam or be considered for a special examination.
  • If a student has made all the requirements in any course (s), but is unable to sit for the end of year examination due exceptional or extenuating circumstance (bereavement, ill health or other circumstances that may cause emotional trauma), for which the Dean has been duly notified, the candidate can apply to be considered for a special end of year examination. The special examination must take place before the beginning of the next academic year but not earlier than 48 hours after the student is certified fit to sit for the examination.
  • Once a student has sat for the end of year examination, he or she may not afterwards apply for a special  examination on the basis of unforeseen circumstances.

1.4 Progression from year to year.

A student must pass all the components of the exam (written, clinical, etc) and meet all the requirements for that year in all courses before progressing to the next year of study. There shall be no carry over. The pass mark shall be 50%. All high stakes examinations shall undergo minimum standardization before being administered, or during the examination in case of the clinical component.

1.5 Minimum standardization requirements (standard setting)

  • According to the Faculty of Medicine Regulations on assessment, both internal and external moderation of assessment tasks shall occur.
  • All written examination questions shall be internally moderated by a panel of examiners selected from the clinical specialties. This panel will carry out a pre-assessment moderation of all the questions not later than 4 weeks before the date of the examination and determine the level of score that an average student will be able to achieve and set a pass mark as such for that exam. This will then become the minimum 50% pass mark requirement of the University. All internally moderated questions must also be externally moderated by an external examiner (in each course) appointed by the Dean, FOM on behalf of Senate, following departmental recommendation and endorsement of the Board. All HODs must ensure that their internally moderated questions are sent to their appointed external moderators not later than 6 weeks before the commencement of the examination. Such an external examiner shall serve for three consecutive years and shall not be re-appointed. The function of the external examiner shall be limited to the moderation of questions in all high stakes examination in year 3. In year 4 and the final year however, the external examiner shall moderate the questions and be invited to examine in the clinical component of the examination.

1.6 Assessment

1.6.1 Continuous Assessment

Assessment of students’ progress shall be on a continuous basis. Formative assessment shall take place informally all through the clinical rotation period in all the courses. Clinical instructors are expected to monitor each student’s performance in their courses through various methods such as case presentations, PBL sessions, directly observed clinical and procedural skills, etc and promptly give feedback to the students on their level of performances. The summative continuous assessment shall carry 40% of the year mark in each course. The following shall form the components to be assessed using the log book:

  • Clerking and presentation of patients:
    Each student in the firm must clerk and present a minimum of one case per week (assigned by the clinical instructor(s). This shall carry 10% of the continuous assessment mark.
  • Directly Observed Clinical and Procedural Skills (DOCPS):
    This shall consist of mini-Cexs and clinical procedures involving generic skills. Each student must complete the number of procedures outlined in the department’s log book. The procedures shall be categorized into those observed (O), assisted in (A) or performed (P) by the student. This must be dated and signed by the supervising clinician. Students are expected to carry out 100% of the listed procedures to be logged in as determined by the department before they can sit for the examination. This shall carry 10% of the continuous assessment mark.
  • Formulation of management plan and evidence based decision making:
    This shall follow the student’s patient presentations and will involve requisition of Laboratory or imaging procedures to aid the diagnosis/management and interpretation of the same by the student etc. In all cases, the student is expected to follow-up the patient until discharge or demise of the patient. In the latter case, if an autopsy is requested the student must attend the autopsy session and write down the findings as part of the documentation of the patient’s illness. This shall carry 10% of the continuous assessment mark. 
  • Engagement with the PBL process:
    All students areto be assessed during their PBL session for attendance, contribution and reflective ability on each case. This shall carry 10% of the continuous assessment mark.

All summative continuous assessment (CA) marks must be ready and be forwarded to the phase II coordinator not later than one week after the rotation. The Board shall consider and formally issue progress reports on each student during the following monthly meeting of the Board after each rotation.

A student is expected to have a minimum mark of (50%) in the continuous assessment (20 marks out of 40) to be in academic good standing. Any student who fails the continuous assessment (course marks) shall not be admitted to the end of year examination. The format of continuous assessment shall be the same for all the clinical years. The continuous assessment in Public Health Medicine will consist of student presentations on the field activity (10%), personal reflection (10%) and report on the community project (20%).

The Basic pharmacology block in year 3 and the Forensic Medicine and Toxicology block in year 4 shall be assessed 100% by CA. A student who fails to pass the CA in these blocks shall be requested to re-take the test in the coming year. Although failing any of these blocks will not hinder students from progressing to the next year of study, passing them is a requirement before graduation.

Similarly, the Elective block in year 4 shall be graded as pass or fail. At the end of the 8-week elective block, students are expected to submit a 1500 words scientific report on the project and/or what they studied during the elective period under the guidance of a designated supervisor (s). It is a requirement to pass the elective block before graduation. A formal report from the student’s supervisor shall be submitted to the School of Medicine.

1.6.2 End of year Examination

There shall be an end of year examination which shall carry 60% of the year mark. Progression decisions on each student shall only be made at the end of the year. There shall be written and clinical components of the examination in all the core clinical specialties except in year 3 in which the end of year examination shall consist of two written papers. There shall be no structured oral (viva voce) examination.

In year 3, the end of year examination shall consist of the following components:

1.6.2(i) Written examination:

This shall normally hold at the end of the academic year. It shall be administered in each course as follows:
a. Knowledge and understanding paper: comprising MCQs and EMIs worth 90marks (1hour 30 mins) in each course.
b. Key clinical features: short answer questions around clinical presentations worth 90 marks (1 hour 30 mins)

Each component of the examination must be passed. There shall be no compensation of marks from one component to the other. All examination questions in all the courses shall be externally moderated by external examiners appointed by the Senate of the University of Botswana.

In year 4, the following shall form the components of the examination:

1.6.2 (ii) Written Examination

This shall normally hold at the end of the academic year. There shall be one written paper principally assessing knowledge and understanding. It shall be a 2 –hour paper comprising of MCQs, EMIs and SAQs. This shall carry 20% of the year mark. The overall mark allocation to this paper is 120.

All examination questions shall be externally moderated by external examiners appointed by the Senate of the University of Botswana.

1.6.2(iii) Clinical Examination

This shall normally be in the form of objective structured clinical examination (OSCE). There shall be a minimum (16 OSCE stations in all) for this part of the examination. The time allocation to each station must be equal and it will range from a minimum of 10 minutes to a maximum of 15 minutes per station. This shall carry 40% of the year mark. OSCE stations assessing communication skills and professionalism must be included. All clinical examination shall be externally moderated by the external examiners appointed by the Senate of the University of Botswana. There shall be one external examiner for each course.

In Public Health Medicine, the following shall be the format of assessment:

1.6.2 (IV) Continuous assessment

  • Personal reflection (10%)
  • Presentations (10%)
  • Project report (20%)

1.6.2 (V) End of year examination in Public Health

  • Shall consist of a 2-hour paper as for the other courses above but it shall carry 60% of the year mark. The Examination paper shall be externally moderated.

Each component of the assessment must be passed. There shall be no compensation of marks from one to the other. Students who fail to pass their CAs may not be admitted to the end of year examination.

In year 5, there shall be a final (exit) examination at the end of the academic year. Both the written and clinical components of the examination shall take place at the end of the year in all courses. Both the written and the clinical components of the examination shall be subjected to external moderation.

The learning framework in the final year is largely contact with a wide variety of patients through an “assistant intern scheme”. The PBL process continues but the emphasis changes to consider broader issues of patient management. Apart from the PBL sessions (which should as much as possible be on real patients), the tutor’s role should concentrate on observation of and feedback on the student-patient encounter rather than on transfer of factual information which the students can find out for themselves with appropriate guidance. Students must keep a record of skills they have acquired which has been signed off by a senior member of staff.

1.6.2 (VI) Assessment

a. The Continuous assessment shall be of similar format as for year 4 and it shall carry 40% of the year mark.
b. Final (exit) examination. This shall hold at the end of the academic year and shall consist of the following components:

i. Knowledge and understanding paper which shall tests elements across the biomedical (Phase I) and clinical sciences. The questions shall be a mixture of MCQs and EMIs. It shall be worth 150 marks to be written in 2 hours 30 minutes. This shall carry 20% of the year mark.
ii. Integrated Clinical Management Paper (ICMP): this shall consist of short answer questions oriented around common patient management problems including appropriate investigations, prescribing and preventive strategies. There shall be 20 questions in all drawn from the 5 courses in year 5. The paper shall last 2 hours 30 minutes. This shall carry 20% of the year mark.
iii. Final Clinical Practice Examination (FCPE): This shall be in the form of OSCE. There shall be up to 24 OSCE stations altogether for this component of the examination. Each shall be for a minimum of 10 minutes and a maximum of 15 minutes. Each station must be of the same time allocation. The FCPE shall carry 40% of the year mark. Students are expected to obtain a satisfactory grade at each station before they can progress to graduation.
OSCE stations assessing Ethics, communication skills and Professionalism must be included.

1.7.0 Re-assessment opportunity

1.7.1 Supplementary Examination

Subject to the Senate General regulations on assessment (section 00.95), and the Faculty of Medicine Special Regulations on assessment in the MBBS program, supplementary examination shall hold within six (6) weeks after the end of year examination result has been published and in any case, not later than the 3rd week of July. The six weeks’ time shall be a remediation period for the students who qualify for supplementary examination at the end of year 3 and 4. In the final (exit examination) at the end of year 5, a reassessment opportunity is only available 6 months after the final exit examination results have been published. The 6 months period shall be a remediation time for students who qualify for supplementary examination. Reassessment is only available for up to two failed courses.

The following regulations shall apply to students who fail to obtain pass marks at the first assessment opportunity:

1.7.2 A student who fails to obtain a pass mark in up to two courses (40% of attempted year credits), shall apply for supplementary examination in the failed courses. The mark for the reassessed courses shall be recorded as the minimum required for the student to pass if the student scores higher than this. However, if a student obtains a lower mark after being reassessed, the initial mark obtained in the end of year examination shall be recorded as the final mark. The course marks (CA) for any student supplementing a course shall count in the final computation of the year mark.

1.7.3 A student who supplements a course(s) and fails to obtain a pass mark shall repeat the year of study. Such a student must repeat all the courses for that year and meets all requirements for that year before being admitted to the end of year examination. 

1.7.4 A student who fails to obtain a pass mark at the end of a repeat year shall be discontinued from the MBBS programme. A student who is discontinued from the MBBS programme shall not be eligible for re-admission into the programme. Such a student may apply to another programme for which the student qualifies.

1.7.5 A student who fails up to 3 or more courses in the year (up to 50% or more of the year attempted credits), shall repeat the year of study. Such a student must repeat all the courses for the year and meet all the requirements including continuous assessment before being admitted to the end of the repeat year examination. Any student who fails to obtain a pass mark at the end of the repeat year shall be treated as in (1.7.4) above.

1.7.6 Any student who repeats the final year and fails to obtain a pass mark shall be discontinued from the MBBS program as in 1.7.4 above.

1.7.7 Notwithstanding the forgoing Faculty of Medicine special regulations on assessment in phase II of the MBBS programme, Senate has the power to overrule any of the regulations. In such cases, the Senate General regulations on assessment shall supersede the provisions of any or all sections of the regulations set forth in this document.

Internship 

Following graduation of their medical training with UB, doctors are expected to complete an internship before being registered by the Botswana Health Professions Council (BHPC) as independent practitioners.

PHASE 1 PROGRAMME (TWO YEARS)

Semester 1

SOM201 Foundations of Medicine (5)
SOM202 Cardiovascular and Respiratory Systems (5)
SOM203 Gastrointestinal and Urinary systems (6)

Semester 2

SOM204 Growth, Reproduction and Endocrine system (6)
SOM205 Blood and Immune system (4)
SOM206 Muscular Skeletal, Nervous System and Special Senses (6)

First Winter Semester

SOM207 Psychological Health (5)
SOM208 Community Attachment – Public Health (4)

Semester 3

SOM301 Skin pathology, Atherosclerosis and Cancer (5, pre-requisites SOM201-SOM208)
SOM302 Infections; Viral, Bacterial and Parasitic Disease (6, pre-requisites SOM201-SOM208)
SOM303 Pregnancy, Birth and Child Health (5, pre-requisites SOM201-SOM208)

Semester 4

SOM304 Urinary System II (2, pre-requisites SOM201-SOM208)
SOM305 Cardiovascular and Respiratory System II (5, pre-requisites SOM201-SOM208)
SOM306 Muscular Skeletal System II (5, pre-requisites SOM201-SOM208)
SOM307 Nervous System and Senses II (4, pre-requisites SOM201-SOM208)

Second Winter Semester

SOM308 Community Attachment, Public Health Project II (4, pre-requisites SOM201-SOM208)
SOM309 Gastro Intestinal Diseases (5, pre-requisites SOM201-SOM208)

PHASE 2 PROGRAMME – THREE YEARS

Year Three

SOM402 Internal Medicine I (General) (8, prerequisites MBBS year 2 courses SOM301-SOM309)
SOM404 Family Medicine I (8, pre-requisites MBBS year 2 courses SOM301-SOM309)
SOM405 Surgery I (General, Anaesthesiology) (8, pre-requisites MBBS year 2 courses SOM301-SOM309)
SOM406 Obstetrics & Gynaecology I (8, prerequisites MBBS year 2 courses SOM301-SOM309)
SOM407 Paediatrics & Adolescent Health I (8, prerequisites MBBS year 2 courses SOM301-SOM309)

Year Four

SOM502 Internal Medicine II (General Internal Medicine, Infectious Diseases,Dermatology, (8, pre-requisite SOM402-SOM407)
SOM503 Electives (Special Project) (8, pre-requisites SOM 502, SOM 504, SOM 505, SOM 507)
SOM504 Psychiatry (8, pre-requisite SOM402-SOM407)
SOM505 Public Health Medicine (8, pre-requisite SOM402-SOM407)
SOM507 Surgery II (Orthopaedics, Ophthalmology, Otorhinolaryngology,) (8, pre-requisite SOM402- SOM407)

Year Five

SOM602 Internal Medicine III (General) (8, prerequisite SOM502-SOM507)
SOM603 Obstetrics & Gynaecology II (8, pre-requisite SOM502-SOM507)
SOM604 Paediatrics & Adolescent Health II, (8, pre-requisite SOM502-SOM507)
SOM605 Family Medicine II (8, pre-requisite SOM502-SOM507)
SOM613 Surgery III (General, Anaesthesiology, Emergency Medicine) (8, pre-requisite SOM502-SOM507)

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