# South Africa, Short courses



## jjdjld (Dec 21, 2010)

I'm rather new to this forum, posting from the deepest darkest africa (South Africa). The question i have is regarding levels of training your country/state provide, and the requirements to gain those certifications.

In SA there have been 3 primary roles that have been utilized for quite some time now, these being the BAA, AEA, CCA. 
In order to attain an ALS qualification you're required to progress through each of these stages. BAA (depending on the institution you study through) is anywhere from 3 - 9 months (Part time, 4 times a week, every second Sat). After BAA completion you are required to register with the health professions council, in order to progress on to the AEA you have to do 1000 clinical hours on board an ambulance. AEA is anywhere from 9 - 11 months (Part time, 3 times a week, every second Sat) a further 1000 hours is then required in order to meet the requirements to apply for the CCA, CCA is roughly a full 12 months (Full Time).  
So to sum it all up, it goes like so….. BAA (3 – 9 months p/time) - 1000 hours - AEA (9 – 11 months p/time) - 1000 hours - CCA (12 months f/time). The usual alphabet soup is generally acquired along the way such as ITLS, PHTLS, ACLS, ATLS, PALS, AMLS and a few fire/rescue courses along the way like LMVR (vehicle extrication). 
These courses are now being closed and replaced with a 4 year BTECH degree in EMC, 5 year MTECH degree in EMC. Initially there was also the option for a national diploma in EMC which was a 3 year course.
The issue i forsee for the future is that our entire EMS structure is based on the BAA, AEA, CCA courses. People with many years experience in EMS can no longer progress any further up the food chain without going back to university and doing a 4 year degree. We have an extreme lack of ALS medics in SA as it is, especially in the government sector. Those that qualify as ALS generally choose to work overseas because the pay is higher and the working conditions are better.  

What are your thoughts on completely re-inventing the wheel and scrapping these courses? I agree that a better level of education is needed for our medics. But is removing the courses that currently hold our EMS world together (and have been for a very long time) a good idea? Would it not be wiser to work with what we’ve got, increase the duration of courses, increase the entry requirements, monitor all training institutions, implement a national test and try and better what we currently have. Or in the very least create bridging courses between the BAA/AEA/CCA courses to the BTECH EMC so that people who have dedicated their lives to EMS don’t have to quit their profession. What I feel our department of health hasn’t taken into consideration is that an ALS medic earns a great deal more than a BLS/ILS medic. Can we afford it when we cant afford to maintain even the most neccesary of functions such as education or healthcare as it is? I know many South Africans in the EMS industry are going to disagree and perhaps argue for whatever reasons they may have (I took this into consideration before I posted, so hit me with your opinions)


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## Porramedic (Dec 22, 2010)

Just to infotm you criteria's for entrance's are changing you also need a yearly correct cpd count at entrance, and as of 2012 all hpcsa professionals on annual registration mat be cpd audited and have to medical liability cover.

and i fully agree that short course should not be stopped those of us already working cant go 2 years to study ECT to try reach closer to ALS! think they should keep running short courses!


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## jjdjld (Dec 22, 2010)

*Options*

Hey Porra, 

It was my understanding that CPD auditing is only being conducted on random groups of people and not every individual that submits his annual renewal fees? (i know a few people so far who have had to acquire more CPD points because they were audited but given a 3 month grace period to comply). 

So far the general consensus among the South African EMS providers is that stopping the short courses is a bad idea and will negatively affect our ability to provide care. I have no issue with increasing the level of education for EMS providers but what is the right way of doing it?

My 2 cents (considering there are probably 100 things that i don't know about the subject). 

Audit all training institutions. Implement strict policies to adhere to with regards to minimum level of education, entrance requirements, pass requirements. Give a small grace period for the training institutions to comply. If not compliant by the end of the grace period close them down.
Implement a mandatory national test similiar to our Matric level (dont dumb it down for the people who have no clue what they're doing)
Adjust BAA, AEA, CCA curriculum and protocols, increase course length and review each providers capabilities. (in my opinion our BLS/ILS require a few additions. Epi for anaphylactic shock, Fluid administration, King-ltd/combi/lma in specific instances only) 
BAA should have mandatory clinical hours as part of the course, same as AEA, CCA. 
Implement a bridging course between the AEA and ECT, and ECT and ALS. 

I understand the need for a higher education level and agree to a certain extent but i believe they went about it the wrong way.


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## Porramedic (Dec 22, 2010)

My ALS told me that HPCSA wanted to attempt CPD requirement and medical liability  cover with renewal annually should have started next year but grace been given till year it was always their plan to go this route.

I agree with giving BAA clinical section such as AEA and CCA, and that certain protocols adjust including what you stated and they could even put Thiamine on ILS protocol dont see need to keep that ALS but hey my opinion we'll just have to wait and see what happens in SA


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## MrBrown (Dec 22, 2010)

Is SA not moving towards an nCert for ECT (ILS) and BTech for ECP (ALS/CCT) ?

Oh, go All Blacks!


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## jjdjld (Dec 22, 2010)

Hey Brown, 

In theory yes, although the closure of short courses was never officially approved by the health professions council (or so i have been told). Technically our ILS level is an AEA. ECT's are considered advanced life support intermediates. ECT is expected to be the bare minimum requirement (in the future) in order to work on an ambulance. It is a 2 year course with very little exposure. Our BTECH EMC has been in existence for quite some time now however too few entrants graduate to keep EMS functioning (and those that do work overseas for obvious reasons). Our country has a huge (understatement) shortage of ALS medics in every province (be it government or private). My issue is not whether or not further education is required, it's that our health deparment did not go about it the right way. Thousands of EMS workers country wide with extensive experience in the outside world will be left with no way of moving up the food chain and furthering their education. Their existing qualifications in the long run will mean nothing.

Example: At one stage i was working for a provincial ambulance service. i did roughly 22 shifts before bumping into an ALS medic (not on scene, and this will vary based on area). In private (also depending on area and service) there are generally many ILS/BLS ambulances running in an area, with only 1 ALS unit who manages everything. This is purely from experience and i know that different EMS services do things differently. If your in SA and your service runs differently i'd love to know.


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