World Unite! - Final year rotation at Muhimbili Hospital Dar-es-Salaam

Final year rotation at Muhimbili Hospital Dar-es-Salaam

The "Muhimbili University of Health and Allied Sciences" (MUHAS) in Dar-es-Salaam is the only Tanzanian public university of higher learning in Health Sciences in Tanzania. The 3000 beds "Muhimbili National Hospital" is the associated teaching hospital.

To foreign students, clinic and university are offering a program of final year rotation clerkships, which is generally fully accredited by European and US medical faculties. The program is very well planned and carried out. Medical students must be at least in the fourth year of their course. It is possible to start at any moment and the duration is flexible, however there is a limited number of positions available in each ward. Foreign final year medical students are being classed with and supposed to join the existing group of Muhimbili's 4th year Medical Students in their particular ward.

Final year rotations are possible in the following departments: Internal Medicine, Surgery, Paediatrics, Orthopaedic Trauma, Psychiatry, Obstetrics & Gynaecology, ENT and Dentistry.

Final year medical students are supposed to join ward rounds and assist at consultations and at the operational theatre besides attending lectures and seminars with the Tanzanian medical students. They are expected to take history from the patients, examine them, present their finding and discuss it during ward rounds. Student must record the number of cases seen and examined, procedures assisted and procedures performed in a log-book, which will be countersigned by a supervisor. At the end of their rotation they are supposed to write a report.

For a final year rotation at Muhimbili Hospital, a weekly contribution to the hospital of 45 USD applies, additional to our trouble-free package. The registration fee of 100 USD is already included in our trouble-free package. For surgery it is best to apply 6 months prior to the intended starting date. For other wards it is often possible to arrange a clerkship within a shorter time.

The Muhimbili University of Health and Allied Sciences offers diplomas, undergraduate and postgraduate courses in health sciences through its five schools and two institutes:

• School of Dentistry (with 3 academic departments)
• School of Medicine (with 18 academic departments, including Histopathology & Morbid Anatomy department
• School of Nursing (with 3 academic departments)
• School of Pharmacy (with 4 academic departments)
• School of Public Health and Social Sciences (with 5 academic departments)
• Institute of Allied Health Sciences (with 6 diploma & advanced diploma schools)
• Institute of Traditional Medicine (with 3 academic departments)

The Muhimbili teaching hospital has a capacity of 3000 beds. There are 300 doctors and 500 nurses, which can make use of an X-ray department, medical scientific library, radiology department, laboratory with routine haematological and HIV & Hepatitis B screening, 14 operating Theaters out of which 4 are specifically for traumatology/othopaedics and one for neurosurgery, emergency facilities and an intensive care unit and hospital pharmacy. Surgery has 300 in-patient capacity. There is a clear PEP (Post-Exposure Prophylaxis) policy in place.

Details about the departments:

Paediatrics and Child Health Department – Head - Dr. R. Kisenge

The department has four firms. Firms I & II deal with general paediatric conditions including infectious diseases, congenital heart conditions, oncological conditions and haematological conditions such as sickle cell anaemia, lymphomas etc. Firm III deals with diarrhoea and malnutrition. Firm 4 is a neonatal firm that also has postnatal care with outpatient clinics twice a week. The neonatal firm has a 150 bed capacity and it is the only one in Dar es Salaam. The other 3 firms have over 200 beds in total.Obstetrics and Gynaecology Department- Head Dr. P. Muganyizi

The department has eight teaching staff in four clinical firms that all deal with general gynaecology and obstetrics, handling primarily emergencies. There is general antenatal and gynaecological out-patient clinic four times a week. Obstetrics includes child deliveries. In total there are around 400 patients per week.

Internal Medicine Department – Head Dr. J. Lutale

The department has 3 firms, and 2 female and 2 male wards. All the firms normally have two out-patient clinics. Each hospital ward has a capacity of 26 beds. Firm I is for Medical, Respiratory and Dermatology, Firm II is Neurology and endocrinology, Firm III is cardiology. Once a week the following special treatements are being done: Cardiology with over 25 patients, Respiratory with around 10 patients, Diabetes with around 50-60 patients, Nephrology with 25 to 30 patients, Neurology with around 20 patients, HIV treatment and care with 80 or more patients, and Dermatology with 40 to 60 patients. Other conditions are handled as general medical problems within each firm.

Surgery department – Head Prof. N. Mbembati

The department has 5 firms which are General and Gastroenterology, General and Cardiothoracic, Urology, and Paediatric surgery, Plastic/Reconstructive Surgery. The firm of Cardiac Surgery is currently being developed with the plan to cater for open heart surgery. All firms have theatre 2 to 3 times a week, except urology theater which is daily. Each firm has one outpatient clinic once a week. While two major ward rounds are done per week, service ward rounds are done daily. Each firm has an average of 25 beds and bed occupancy varies between 100 to 200%. In general outpatient clinics are attend by about 60 patients per day.

Psychiatry Department – Head Dr. K.M. Mrumbi

The department has a total of 5 teaching staff. For working purposes the Psychiatry and Mental Health Department is divided into 4 firms. Each firm deals with all psychiatric conditions with patients suffering from depression, mania, schizophrenia etc. Each firm is headed by a psychiatrist, psychologist and social worker. Acute patients are hospitalized in a separate secure ward; and there is a general female and male ward. In total, the department has 40 to 45 beds with bed occupancy rate of 80-100%.

School of Dentistry - Dean Dr. E. Mumghamba

The School of dentistry is headed by a Dean who works closely with 3 department heads and the Muhimbili National Hospital dental Department Head. The departments are Oral Surgery and Oral Pathology, Preventive and Community Dentistry, and Restorative Dentistry.

The department of Oral Surgery and Oral Pathology has a total of 5 teaching staff and the 3 distinctive units Oral surgery, Oral medicine and oral pathology. There is a lot of surgery with major operations that in Tanzania can only be done at MUHAS and students get very good exposure. Oral Pathology activities are carried out under the general pathology department with 4 specialists in the department. Oral medicine is still under development with only one specialist.

The department of Preventive and Community Dentistry has a total of 7 teaching staff. The department is involved with preventive and community dentistry and also hosts the paedodontics and orthodontics units. The orthodontics unit is still under development; hence one does not expect to get much exposure from this unit given the level of the country development and financial constraints. Preventive and community dentistry is basically conducted during semester time and students carry out their study in communities outside the university, mainly in Morogoro. Therefore, elective studies have to be planned such that they coincide with other MUHAS teaching activities.

The department of Restorative Dentistry has 4 units, namely cariology/operative dentistry, prosthodontics, dental biomaterials and periodontology. The department has a total of 6 teaching staff. Restorative dentistry is however not well developed compared to services available in Europe and other developed countries.

School of nursing – Dean Dr. K. Malima

The School of nursing is headed by a Dean, and it has a total of 3 departments, namely Clinical Nursing, Community Health Nursing and Nursing Management. The head of Clinical Nursing department works closely with the head of nursing services at the Muhimbili National Hospital. The Clinical Nursing Department has a total of 7 teaching staff. The Community Health department has 3 teaching staff while Nursing Management department has 4 teaching staff.