Casuality- structure

  • Run by medical officers and clinical associates 

  • Number of clinicians in casualty varies 

  •  Based on triage system 

  • Emergency patients are seen immediately in the emergency room 

  • One pediatric room available

  • One obstetrics and gynecology room available 

Casuality- routine

  •  Doctor on cover starts at 07:00

  • Remaining staff join after the morning meeting at 09:00am

  •  Casualty cover roster is set by medical officers in the unit 

  • Casualty day cover ends at 16:00

  • All patients seen by a clinical associate must be reviewed by a doctor 

  • Team work is encouraged to clear casualty before 16:00

  • Doctors on call get pre-call from 14:00
        -Tuesdays and Thursdays
        -Allocations are done by clinical manager 
        -Acts as a “local clinic”

           -Starts after the morning meeting at 09:00am 

Casuality- calls

  •  Call starts at 16:00 in the emergency department 

  • Each medical officer has between 4-6 calls a month 

  • The roster is always reviewed and signed off by the clinical manager prior to release 
    • All calls completed on hospital premises 
    • One hour rest/lunch permitted
    • All medical officers on call must attend the morning meeting at 08:00 and present ALL patients admitted 
    • Post call begins at 11:00
    • Weekday calls (Mon-Fri):
             - 16:00 - 07:00
             - one or two medical officers
             -assistance by clinical associate on busy days
    • Weekend calls (Sat/Sun/Public Holidays)
            -12 hour shifts 
            - 07:00-19:00 or 19:00-07:00
            -two medical officers +/- clinical associate
            - Saturday and Sunday day calls are done by the    same medical officers 
            -Friday night and Sunday night is done by the same medical officer 

internal medecine-structure

  • Separated into male and female wards

  •  Each ward has atleast 2 doctors

  • Generally one senior MO and one junior MO/Clinical associate per ward 

  • One MO is allocated to OPD

  • MOPD 
         -Monday- Thursday 
         -General OPD Mon-Wed
         -Thur- Psychiatry OPD 
         -INR clinic everyday 

internal medecine-routine

  • •Ward rounds start after the morning meeting 

  • Cover until 16:00 is arranged by ward doctors 

  • After the ward round, medical officers assist in OPD 

  • OPD doctor starts OPD after the morning meeting 

  • ALL high risk patients must be discussed with Witbank Hospital and Steve Biko Academic Hospita

allied health

  • Includes Physiotherapists, Occupational therapists, Speech therapists  Dieticians and social workers.

  • Physiotherapy department: next to Thuthuzela, opposite new administration.

  • Occupational therapy: Ward 4

  • Speech/audiology: Ward 7

  • Dieticians : Ward 6B

  • Social Worker : OPD

  • Services available to inpatients and outpatients on request.

  • Ensure the appropriate forms are filled in to compete the request


  • Transport department is located  at OPD.

  • Requests are

  • Unstable patients must be transported with Emergency medical services (EMS/ Ambulance)

  • •Transfer forms and all other supporting documents must be prepared, placed in the patients file and sisters informed of the patients arrangements.

obstetrics and gynecology-structure

  •  Separated into two wards 

  • Each ward has at least 2 doctors

  • Generally one senior MO and one junior MO  

  • Three clinic days per week
    • Two theater days
    • Emergency theater everyday

obstetrics and gynecology-routine

  • Ward rounds start after the morning meeting 

  • Two medical officers are on cover for emergencies until 16:00

  • Theatre
         -Elective theatre on Tuesday and Wednesday
         -Minor cases for gynecology and obstetrics 
         -Daily emergencies 
    • Results Clinic
         -Monday clinic for patients following up laboratory results

  • Gynae clinic
        -Wednesday clinic for all follow up Gynae patients

  • High Risk Obstetric Clinic
        -Thursday Clinic 
        -High numbers of patients seen 

  •     -The team is excused from the morning meetings on     Thursdays

general surgery - structure

  •  Divided into female and male surgical wards

  • Each ward has atleast 2 doctors

  • Generally one senior MO and one junior MO/Clinical associate 
    • Two clinic days per week
    • One theatre day per week
    • NO emergency theatre-all cases are referred to Witbank

general surgery - routine

  • Ward rounds start after the morning meeting at 09:0

  • One medical officer is on cover for ward emergencies until 16:00

  •  Surgical OPD
         -Tuesday & Thursday
    • Theatre
         -Elective theatre on Wednesday
         -Minor cases

pediatrics- structure

  • One allocated ward 

  •  General pediatrics (medical and surgical)

  • Neonatal section

  • Ward has atleast two doctors and a clinical associate

  • Generally one senior MO and one junior MO  

  • One consultant who does rounds

pediatrics- routine

  • Ward rounds start after the morning meeting at 09:00am

  • One medical officer are on cover for emergencies until 16:00

  • Grand Ward round on Wednesday morning 

        -circumcisions done on occasional Thursdays
    • POPD
       -One medical officer 
       -Starts after the morning meeting at 09:00am 

high care-structure

  • One allocated ward 

  • Ward has atleast two Medical officers

  • 4 adult beds 

  •  7 neonatal beds 

high care- routine

  •  Ward rounds start at 07:00

  •  All medical officers are on cover for emergencies until 16:00


helpful hints


  • • Start ward rounds before the morning meeting 
    • Start ward rounds earlier on clinic days
    • Divide the unit up into clinic/theatre/ward to share the load of the work
    • Start theatre days as early as 07:30 to account for emergencies that may arise 


  • See as many patients as possible during the day to clear casualty for on call team

  • Split the day amongst yourselves to avoid working from 07:00-16:00 non-stop 

  • Discuss all complicated patients with senior medical officers and Witbank hospital

  • Always call the laboratory when urgent goods are taken to decrease patient waiting time 

  • Do not be afraid to ask!Everyone is still learning.


  • Always arrive on time for call to receive handovers from the day team 

  • When the opportunity to eat or rest presents itself, always take it 

  • Emergency patients always take priority.Do not get overwhelmed with the number of patients accumulating when busy with emergency 

  • Discuss ALL high risk patients with the senior on call prior to admission

  • Keep a record of all patients admitted for presentation at the meeting