About 70% of Ghanaians depend on Alternative health practice for their primary health care needs. Hence, there is the need to streamline and regulate these practices. Graduates from the Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology (K.N.U.S.T), Kumasi-Ghana were assessed by the Professional Qualifying Examination Board of the Traditional Medicine Practice Council (TMPC), Ghana, after two years of internship training. A model of assessment took into consideration, the scope of the university training, internship and the primary health care needs of the society

Adusi-Poku, Yaw

Agyemfra, George

Arhin, Peter

Dabra, Togbega

Fleischer, Theophilus C

Hlortsi-Akakpo, F K

Mensah, E N

Mensah, M L K

Okine, Laud K-N

PubMed

About 70% of Ghanaians depend on Alternative health practice for their
primary health care needs. Hence, there is the need to streamline and
regulate these practices. Graduates from the Faculty of Pharmacy and
Pharmaceutical Sciences, Kwame Nkrumah University of Science and
Technology (K.N.U.S.T), Kumasi-Ghana were assessed by the Professional
Qualifying Examination Board of the Traditional Medicine Practice
Council (TMPC), Ghana, after two years of internship training. A model
of assessment took into consideration, the scope of the university
training, internship and the primary health care needs of the society

Okine, Laud K. N.

Hlortsi-Akakpo, F. K.

Fleischer, Theophilus C.

Mensah, M. L. K.

Togbega Dabra, VI

Mensah, E. N.

University of Toronto Research Repository

Assesssing Herbal Medical Practitioners In Professional Qualifying
Examination In Ghana, A Model

adusi-poku, Yaw

Okine, L. K. N.

Fleischer, T. C.

Arhin, P.

Dabra VI, T.

ATHMSI Journals

Adusi-Poku et al.,  Afr. J. Trad. CAM (2010) 7 (1): 85 - 87 85Education                                                        ISSN 0189-6016©2009ASSESSSING HERBAL MEDICAL PRACTITIONERS IN PROFESSIONAL QUALIFYING EXAMINATION IN GHANA, A MODELYaw Adusi-Poku1, Laud K.-N Okine1 F. K. Hlortsi-Akakpo2, Theophilus C. Fleischer3, M. L. K Mensah3, Peter Arhin4, George Agyemfra4, Togbega Dabra VI5, E. N. Mensah61Centre for Scientific Research into Plant Medicine (CSRPM), Mampong-Akuapem, Ghana, 2Traditional & Alternative Medicine Directorate (TAMD), Ministry of Health, Ghana, 3Department of Herbal Medicine, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, KNUST, Ghana, 4Traditional & Alternate Medicine Directorate, Ministry of Health (TAMD), Ghana, 5Weija, Accra, 6West Africa College of Physicians and Surgeons, Accra, Ghana.*E-mail: togobay@yahoo.comAbstractAbout 70% of Ghanaians depend on Alternative health practice for their primary health care needs. Hence, there is the need to streamline and regulate these practices. Graduates from the Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology (K.N.U.S.T), Kumasi-Ghana were assessed by the Professional Qualifying Examination Board of the Traditional Medicine Practice Council(TMPC), Ghana, after two years of internship training. A model of assessment took into consideration, the scope of the university training, internship and the primary health care needs of the society.Key words: Practitioner, Model, Professional Qualifying Exams, Herbal MedicineIntroductionApart from the indigenous traditional medicine practices, whose apprentices understudy by mentorship, there has been an increase in the establishment of schools for the training of alternative medicine - herbal medicine, homeopathy and other health care paradigms. Since seventy (70%) of Ghanaians depend on alternative health care practices (GHP, 2007) for their primary health care needs, there is the need to streamline and regulate these practices.The philosophy behind the establishment of the Department of Herbal Medicine at the Faculty of Pharmacy and Pharmaceutical Sciences, K.N.U.S.T, Kumasi-Ghana was to produce a crop of Herbal Medicine Practitioners who would have a formal knowledge of medicinal plants and identification and who could apply these scientifically-harnessed herbal medicines to disease processes diagnosed from the conceptual view point as in allopathic medicine. This involves a well structured course (Table 1).The first year of internship involves that the Herbal Medical Practitioners register with an indigenous herbal practitioner to understudy the methods of practice, and methods of herbal preparation.During the second year, the Herbal Medical Practitioners go through a rotation programme at the Centre for Scientific Research into Plant Medicine (CSRPM), Mampong-Akuapem, Ghana to further strengthen theirbasics of the theoretical framework taught at school and the practical application. This offers the interns the opportunity to interact with patients on a health personnel-patient basis under the supervision of medical officers with background in plant medicine to familiarise themselves with the common medical conditions often presented. On the basis of equipping them with good management of patients thorough history taking, physical examination, laboratory investigations and quality of herbal medicine production, and its application, the interns at the CSRPM are supervised through the various Departments and undergo various activities (Table 1).The next important arena of internship is to identify patients at risk for prompt referral. Interns go through rotations at an allopathic hospital to identify emergency cases, be it either medical or surgical, under the supervision of allopathic specialists and general medical practitioners. They are taught of writing referral of clarity to an allopathic practitioner for prompt and expert management when the need arises.Afr. J. Traditional,Complementary and Alternative Medicineswww.africanethnomedicines.netAdusi-Poku et al.,  Afr. J. Trad. CAM (2010) 7 (1): 85 - 87 86The need to apply the plant knowledge gained from theory or folkloric usage is emphasized in their management of patients. Good monitoring techniques of patients are prioritised to enable documentation of any adverse drug reaction and/or secondary benefits patients may gain from the herbal medicines.The objectives of the professional qualifying examination (PQE) are therefore to evaluate: Their knowledge of medicinal plants in the West African sub region. Their ability to apply herbal materials especially common ones of the West African sub-region for the management of the first top ten diseases in Ghana and other diseases. Their research skills in evaluating herbal medicines for human consumption. Their knowledge on standard operating procedures (SOP) and quality control of herbal products preparation. Their knowledge of the laws and ethics of the Traditional Medicine Practice Council. Ability to take history and examine patients. Ability to recognise patients at risk for prompt referral. Ability to manage some of the chronic diseases. Non- Pharmacological management of diseases.MethodologyThis was a two–day examination; a theoretical section on day one and a clinical section comprising long cases’ presentation and oral conference on day two. The theoretical paper consisted of a three hour paper on multiple choice questions and written essays. The multiple choice questions (MCQ) touched on candidates ability to understand the philosophy behind taking very good history and the ability to recognise cases for prompt referral; emphasis on pharmacological management of diseases using herbal preparations and non-pharmacological treatments. Candidates were also expected to be familiar with the top ten disease conditions and appropriate corresponding laboratory tests that could be requested. Candidates were also assessed on standard operating procedures (SOP) and quality control of herbal products preparation as well as laws and ethics of the Traditional Medicine Practice Council.The essays were in two parts. Part (a) touched on clinical presentation of some severe medical conditions such as severe hypertension, diabetes and first aid treatment where necessary prior to referral and Part (b) tested candidates’ aptitude on clinical research on herbal products.The practical section consisted of long cases and the viva. With respect to the long cases, candidates were examined on their aptitude in taking history, performing physical examination and arriving at a diagnosis within a stipulated time. Within this same time, candidates were also expected to plan for proper management of their cases. Candidates during their presentation were asked to demonstrate their clinical skills in examining patients. Plan of management of the diagnosis arrived at by the candidates involved pharmacological (Herbal application, mode of preparation, dosage and referral if necessary) and non-pharmacological methods of management. For the viva, marks were awarded for candidates’ appearance, ability to express themselves; and demonstration of general knowledge. They were also given a chance to clarify issues which the examiners found as problematic in their theoretical and clinical answers. A candidate who did not score at least 50% of the long case clinical work was considered failed irrespective of how well he or she performed in the theoretical work.Results and DiscussionSo far three batches of Herbal Medical Practitioners have been examined and certified by the TMPC as Herbal Medical Practitioners. As a new model of assessment, there was bound to be review of the examination structure. It was proposed in the post-examination reviews that during the period of internship, interns would carry a log book to record the diseases encountered. The log book would also propose the kind of management undertaken for that kind of disease, or the kind of herbs used and the mode of preparation. A clear documentation of follow-up was to be done. The log book would be signed by their supervisor(s). This would form part of the examination score.It was also noted that, candidates had difficulty in recalling common medicinal plants for the treatment of the specific diagnosis. It was suggested that there should be a lot of input from the university training up through to the period of internship about these plants and their preparations. In this case, the special laboratory that is being created at the Herbal Medicine Unit, KNUST, should be accelerated to introduce students to the industrial preparation of the various herbal dosage forms for specific diseases.So far, of those qualified, some are in private practice, some employed in the Clinical Department of the CSRPM as Clinical Researchers whilst others are into herbal research at the Noguchi Memorial Institute of Medical Research, Ghana. Some are still waiting for the establishment of the Ministry of Health (MOH) Herbal Clinics. This model of assessment for the graduate Herbal Medical Practitioners will be one of the models of assessment of the Traditional Medicine Practice in Ghana.Adusi-Poku et al.,  Afr. J. Trad. CAM (2010) 7 (1): 85 - 87 87Table 1: Outline of course content and internship programmeHERBAL MEDICINE PROGRAMME AT KNUST INTERNSHIP PROGRAMME AT CSRPMCourse TitleYEAR 1 SEMESTER ONEIntroduction to Herbal MedicineBotany of Medicinal PlantsPlant Morphology LaboratoryBasic ChemistryBasic Chemistry LaboratoryMicrobiology Microbiology LabCommunication SkillsPost SSS MathsInformatics (Computing)YEAR 1 SEMESTER TWOHuman PhysiologyHuman AnatomyBiochemistryBiochemistry LaboratoryBasic Organic ChemistryCommunication Skills IIYEAR 2 SEMESTER ONEHuman PhysiologyHuman AnatomyGross PathologyDispensing TheoryDispensing LaboratoryPharmacologyStatisticsLiterature of EnglishYEAR 2 SEMESTER TWOPharmacologyPharmacology LaboratoryOrganic Chemistry IIPhytochemistryPhytochemistry LabStatisticsLiterature of EnglishCourse TitleYEAR 3 SEMESTER ONENutrition, Health foods and HealthDiagnostic Skills IClinical Training IPhytotherapy 1Crude Drug Production and EvaluationCrude Drug Evaluation LabYEAR 3 SEMESTER TWOPoisons of Natural OriginResearch MethodsClinical Training IIPhytotherapy IIComplementary MedicineChemical PathologyYEAR 4 SEMESTER ONEDiagnostic Skills IIHerbal Medicine Policy, Laws & Reg.Clinical Training III Chemical PathologyEntrepreneurial Management IPhytotherapy IIIProjectYEAR 4 SEMESTER TWOProfessional EthicsEntrepreneurial Management IIClinical Training IVPublic HealthPhytotherapy IVProjectMental HealthPregnancyActivitiesMICROBIOLOGY DEPTAcquiring of skills in aseptic techniquesTaking of samples for culture and sensitivitySlide preparationEnumeration of micro-organisms i.e. viable count and microbial loadPreparation of various mediaMicrobial assays on herbal productsDISPENSARYAcquire good dispensing techniquesAttend to patients enquiries about ADR, dosage.Learn proper storage methods of herbal productsCLINICAL LABORATORYBlood sample collection via venepunctureInterpretation of haematological indices, biochemical indicesAcquire skills in the procedures involved in the various laboratory protocols Acquisition of knowledge on use of the various laboratory equipmentHERBAL PRODUCTIONUndergo field trips for identification of various plants and collection.Learn herbal raw material storageInvolve in the  preparation of various dosage forms Learn the various standardsPHARMACOLOGYParticipation in the toxicity studies and their implicationPHYTOCHEMISTRYParticipation in the phytochemical screeningof herbal productsCLINICAssessment of patients through history taking and physical examinationManagement of patients by application of herbal medica (pharmacological) and education(non pharmacologic)References1. (GHP, 2007), Ghana Herbal Pharmacopoeia (2007), Science and Technology Policy Research Institute (STEPRI) 2nd edition, pp xii

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ASSESSSING HERBAL MEDICAL PRACTITIONERS IN PROFESSIONAL QUALIFYING EXAMINATION IN GHANA, A MODEL

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Assesssing Herbal Medical Practitioners in Professional Qualifying Examination in Ghana, a Model

Assesssing Herbal Medical Practitioners in Professional Qualifying Examination in Ghana, a Model

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