Important Note


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Important Note

  1. 1. Important Note These curriculum’s are reproduced from those present in the Vocational Training Record for General Practice. Colleagues are welcome to copy these pages for use as part of their learning/teaching. But should not change or incorporate them in other training packages without the express permission of the author. My contact details can be found in the VTR. Dr. Julian Page Research Fellow Department of Postgraduate Medicine & Dentistry University of Manchester A & E Curriculum Clinical Acute Presentation & Management) Cardiac Resuscitation Acute general surgery Acute Medicine Gynaecology Problems in the elderly ENT conditions Paediatric medicine & surgery Eye conditions Paediatric trauma Psychiatry Adult major trauma Pain control Orthopaedic trauma X-ray interpretation Soft tissue injury Legal / ethical issues Wound management Dealing with difficult patients Maxillo-facial trauma Dealing with distresses/bereaved relatives Clinical Skills- Resuscitation Basic life support Defibrillation Oral airway IV access in adults Nasopharyngeal airway IV access in children* Bag & mask ventilation Intraosseuos access* Intubation Needle thoracocentesis* Needle cricothyroidotomy Chest drain* Heimlich manoeuvre Central venous line* Clinical Skills- Trauma Fracture reduction Wound assessment, cleaning & debridementDislocated shoulder reduction Spinal immobilisation Suturing Log-rolling Steristrips Limb splinting Wound glue Plaster backslab Dressings Clinical Skills- Other Skills Digital nerve block* Joint aspiration Femoral nerve block* Bladder catheterisation Abscess I & D Nasal packing* * The above criteria are less relevant for general practice The above headings represent the minimum core curriculum Reproduced from the North West Training Record for SHO’s in Accident & Emergency Medicine.
  2. 2. Dermatology Curriculum Dermatological Conditions Dermatological Skills Eczema Dermatological examination Seborrhoeic dermatitis Examination with Wood's light Hyperkeratosis and icthyoses Skin scapings etc Psoriasis Acne vulgaris Skin (punch) biopsy Rosacea Excision biopsy Shave biopsy Pigmented lesions and malignant melanoma Curretage and cautery Basal cell carcinoma Crytocautery Squamous cell carcinoma Solar keratosis Scabies and lice Fungal infections Pityriasis versicolor Pityriasis rosea Herpes simplex and zoster Warts and molluscum contagiosum Urticarias Pruritis Bullous conditions Alopecia Lichen planus Thanks to Dr. Mike Pollard for developing this curriculum
  3. 3. ENT Curriculum Knowledge of basic anatomy, physiology and pathology of the Ear, Nose & Throat Be able to use- a head mirror, nasal and aural speculae, tuning fork, indirect mirror examination of the larynx and postnasal space, audiometer. Be competent to examine and recognise normal and abnormal ears, noses, throats and necks. Be able to recognise and manage the following common conditions:- Otitis media Nasal polyposis Otitis externa Epitaxis Discharging ears Allergies of the nose & throat Ear wax Sinusitis Glue ear Tonsillitis Deafness Epiglotitis & croup Vertigo Hoarseness Foreign bodies in noses & ears Neck lumps Be able to perform:- Nasal packing, anterior and posterior Nasal cautery Aural toilet and dressing Be able to relate and communicate with:- Patients Colleagues and co-workers The deaf Post laryngectomy patients Patients with treatment for malignancy to the head & neck The above curriculum was developed from the Chelmsford Vocational Training Scheme Logbook
  4. 4. Medical Curriculum Myocardial Infarction Insulin Dependant Diabetes Cardiac Arrest (CPR) Non-Insulin Dependant Diabetes Angina Uncontrolled Diabetes & Ketoacidosis Heart Failure Hypoglycaemia Common Arrhythmias Hypo / Hyperthyroidism Hypertension DVT & Pulmonary Embolism Headaches/Migraine CVA & TIA Asthma Meningitis & septicaemia COAD Epilepsy & Status Epilepticus Pneumonia Confusion / Dementia Bronchial Carcinoma Acute Confusional state TB Coma Pneumothorax Multiple Sclerosis Parkinson’s Disease Dyspepsia, Peptic Ulceration Acute GI bleeding Pressure Sores Diarrhoea Urinary Incontinence Jaundice Faecal Incontinence Inflammatory Bowel Disease Falls, “Gone off legs” Managing patients with poor vision Renal Failure Managing patients with poor hearing Urinary Tract Infections Effective discharge of patients into the community Rheumatoid Arthritis Managing the elderly with multiple pathologies and poly-pharmacyOsteoarthritis Acutely Inflamed Joint Hypothermia Overdoses Palliative care Anaphylaxis Metastatic carcinoma Anaemia Pain control Anticoagulation Alcohol Disturbed & Violent Behaviour The above headings represent the minimum core curriculum. It is based on a Core Curriculum for SHO’s in General (Internal) Medicine and the Medical Specialities, the Royal College of Physicians, with advice from Dr. Mike Cheshire, Consultant Physician, Manchester Royal Infirmary
  5. 5. Obstetric & Gynaecology Curriculum OBSTETRICS The routine procedures used in modern antenatal care Epidemiology of maternal & perinatal morbidity & mortality Be able to assess women for hospital, shared or GP care Counselling for parents with possible or real foetal malformations Parent education for pregnancy, childbirth & care of the new born Detection of congenital malformations The initial management of common obstetric conditions and emergenciesRecognise early labour Management of normal labour Management of common problems for which pregnant women are admitted to hospitalInduction of labour Foetal monitoring in labour Management of abnormal labour- twins, breech, shoulder dystociaRoutine examination of the new born Recognise problems in labour requiring interventionManagement of 3rd stage of labour Suture epesiotomies Resuscitate a shocked mother and/or babyBreast feeding Immunisation (Rubella & Anti-D) Psychological problems post-natally Record keeping Special requirements of home delivery To be able to communicate with women in labour in order to be aware of their wishes and fears so they can be active participants in the decisions concerning its management, so they can understand the procedures proposed for their own safety and that of their babies. GYNAECOLOGY Health education and prevention of gynaecological conditions Infections of the genital tract Early diagnosis of genital neoplasia Gynaecological history, examination & investigations The menopause and HRT Incontinence and prolapse Psychosexual counselling Family planning Infertility The role of other team members Abortion/ miscarriage Ethical and legal implications- chaperoning, age of consent, assault, STDProblems with menstruation Based on the training objectives for Obstetrics & Gynaecology from the booklet General Practitioner Vocational Training in Obstetrics & Gynaecology The above headings represent the minimum core curriculum
  6. 6. Ophthalmology Curriculum Eye Injuries and Foreign Body External examination of eye Conjunctivitis Direct ophthalmoscopy Blepharitis Indirect ophthalmoscopy Styes and Meibomian Cysts Visual field testing Corneal Ulcers and Keratitis Slit lamp examination Episceritis and Scleritis Uveitis investigations Iritis and Uveitis Optometric methods Vascular Haemorrhages and Occlusions Amaurosis Fugax Orthoptic report Diabetic Retinopathies Hypertensive Retinopathy Fluroscein angiograhpy Vitreous and Retinal Detachment Ultrasonography and biometry Papilloedema and Optic Neuritis Chalazion incision and curettage Closed/acute Glaucoma Repair of entropion Open/chronic Glaucoma Repair of ectropion Cataract Thanks to Dr. Mike Pollard for developing this curriculum
  7. 7. Paediatric Curriculum Ability to relate to children in illness and health, and to their parents, including parental anxiety and stress Prescribes safely and appropriately for children Examine the new-born, recognise abnormalities and problems and take appropriate action. Experience dealing with still birth and neo-natal death Awareness of developmental milestones and experience in developmental assessment. Knowledge of childhood handicap and services available. Knowledge of normal growth and physical development and deviation from this. Awareness of the principals of nutrition and infant feeding. Ability to assess stages of puberty Recognise limitations of parents’ ability to cope with illness and recognise deterioration Confidently differentiate – a well child, a well ill child and an ill child and take appropriate action Knowledge of vaccination schedules and ability to advise appropriately Awareness of functions of health visitors and social services and appropriate laws appertaining to children Awareness of family interaction and dynamics Ability to communicate with other doctors and other health professionals regarding the care of children at home and in hospital Awareness of genetic principles and relevance to general practice Good working knowledge of the common and/or important childhood complaints Asthma Recurrent abdominal pain Eczema Child abuse Infections: Exanthemata Allergy URTI (Croup, otitis media, tonsillitis) Behavioural problems Failure to thrive Diarrhoea & vomiting Convulsions Undescended testicles Diabetes Heart murmur Awareness of less common conditions Awareness of and ability to treat paediatric emergencies Autism Asthma Dsylexia Injuries & poisioning Learning and allied problems Meningitis Congenital heart disease Torsion of testis Cerebral palsy Removal of foreign bodies Cot deaths Unconcious child Muscular dystrophies Dehydrated child Malignancy in children Convulsion Diabetic come & hypoglycaemia Able to resuscitate children and neonates Epiglottitis / stridor Acute abdomen The above headings represent the minimum core curriculum. It is based on “The Paediatric Component for Vocational Training for General Practice.” The Royal College of General Practitioners and The Royal College of Paediatrics and Child Health
  8. 8. Palliative Care General Multiprofessional assessments and patient-led problems Anticipating problems and developing management plans Evaluation of treatment benefits/burdens in the light of changing prognosis Quality of life and its measurement Symptom Management General Principles Nausea, Vomiting & Constipation Diagnosis of causes of symptoms Anti-emetics and their different actions Appropriate use of disease modifying treatments Management of malignant bowel obstruction Management of constipation Frequent review of symptoms and adverse effects of treatment Fungating lesions Choosing appropriate routes for drug administration Medical management of malodour Psychological approaches Dyspnoea Pharmacological, physical and psychological interventionsCauses of symptoms Pain – basic mechanisms of pain and its perception The use of sedating drugs in terminal respiratory failure Nausea and vomiting Dyspnoea Managing the last days of life Constipation Dealing with terminal agitation Appropriate use of syringe drivers Pain WHO analgesic ladder Emergencies in palliative care Different opioids and their use Acute pain Adjuvant analgesic drugs Hypercalcaemia Role of surgery & radiotherapy Superior vena caval compression Role of nerve blocks, TENS, acupuncture Spinal cord compression Haemorrhage Acute confusional states Psychological Issues Imparting information and communicating with patients and families Current thinking in bereavement care Recognising and treating anxiety and depression in severely ill patients Caring for dying patients and their families from different faiths and cultural groups Ethical Issues in Advanced Disease Cardiopulmonary resuscitation Euthanasia Hydration & feeding Based on Continuing Professional Development, A Palliative Medicine Curriculum for Specialists in other fields and General Practitioners. Produced by a working party of the Association for Palliative Medicine of Great Britain & Ireland
  9. 9. Psychiatry Curriculum Understand the doctor-patient relationship & its therapeutic value The roles of other health professionals in mental illness Liaison with social services Factors leading to mental illness Impact on family of mental illness Emotional, intellectual & social development Mental Health Act, Children’s Act & Misuse of Drugs Regulations Recognise deviations from the expected norms of development- mental handicap, dyslexia, behavioural and personality disorders Clinical skills Taking a psychiatric history Formulating the psychodynamics of a case, including a care programme approach Consultation skills- listening, recognising clues & providing explanation Advising relatives Mental state examination Planning interviews to modify behaviourPrescribing drug treatment Referral for specialist advice Knowledge and understanding of mental and emotional disorders Acute life threatening disorders and appropriate management Substance abuse Mental handicap Schizophrenia Knowledge of psychological aspects of physical illnesses and of medical and surgical treatments Early depression Postnatal depression Manic-depression illness Bereavement / grief reactions Dementia Enuresis Phobias School refusal Treatment Pharmacology of drugs used in psychiatry Non-pharmacological treatments available for psychiatric disorders Understand the placebo effect Based on the training objectives for the psychiatric component of GP vocational training, from the booklet General Practitioner Vocational Training in Psychiatry
  10. 10. Rheumatology Curriculum Good working knowledge of the common and/or important complaints Osteoarthritis Acute neck pain Rheumatoid arthritis Chronic neck pain Ankylosing spondylitis Acute low back pain Reactive arthritis Chronic low back pain Psoriatic arthritis Infectious arthritis Fibromyalgia Osteoporosis Chronic fatigue syndrome Osteomalacia Pagets disease Acute shoulder pain Rotator cuff syndrome PMR and temporal arteritis Adhesive capsulitis Vasculitis Epicondylitis Plantar fasciitis Gout Tendonitis Pseudogout Bursitis Chondrocalcinosis Carpal tunnel syndrome Awareness of less common conditions SLE Poly- and dermato-myositis Sjogrens syndrome Scleroderma Ankylosing spondylitis Systemic sclerosis Practical skills: Joint injections Shoulder Medial epicondylitis Acromio-clavicular Lateral epicondylitis 1st CMC (base of thumb) Knee (including joint aspiration) Plantar fasciitis Based on A Core Curriculum for Senior House Officers in General Medicine (RCP) and Learning Guide for General practitioners and General Practice Registrars on Musculoskeletal Problems (ARC). Developed by Dr. Mike Pollard