Postgraduate Certificate/Diploma in Medical Specialisms (ENT, Cardiology, Urology, Ophthalmology, Diabetes, Musculoskeletal Medicine, Family Medicine, Dermatology, Minor

Surgery)

Student Programme Handbook 2012/2013

Validated by Middlesex University, London, UK

Programme Leader: Professor Ram Dhillon Student Name:

MODULE TWO Full Module Title:

ADVANCES in Family Medicine

Short Module Title: Module Code: RILAFAM1 (from Quality and Standards Office ) Credit Value: 45 School and Department:?? Module Leader(s): Dr Riadh Dawood Credit Level: 7 Length: 4

Extension:

Email: admin@rila.co.uk

Host course: Postgraduate Certificate & Diploma in Medical Specialism (Family Medicine) Status: Subject Board: Pre-requisites: Co-requisites: Assessment: Each subject area within the Advances module is presented as a core reading article and/or an online interactive session. Each has an associated formative assessment with Higher Order Thinking (HOT) questions (untimed) and formative online mini tests (timed) covering several topics. The student is strongly recommended to participate in this activity and aim to achieve a mark threshold of 50% There is a final summative examination covering the module for both the Postgraduate Certificate and the Postgraduate Diploma. The pass mark is 50%. Study Abroad:

N/A
Qualifying Mark(s) for Assessment(s): All components have a 50% pass mark Special features: Access restrictions: Only available to practising medical practitioners Summary of Module content: This module builds on and extends the module content of the core generic module and focuses on the core clinical knowledge base for specific for Family Medicine Module Aims: The Module provides the opportunity to acquire the knowledge and skills in Family Medicine required to raise clinical standards of practice, and to deliver care as an intermediate tier care specialist in primary care . The areas of clinical specialism covered are advanced knowledge and skills in the management of clinical disorders. The importance and need for collaborative working is emphasised as essential to delivering high quality care. Syllabus/topics: Systems assessments (cardiovascular, respiratory, abdomen, neurology, ophthalmology, ENT, musculoskeletal medicine, dermatology, male and female genitourinary), communicable diseases, screening, sexual health, emergencies (general principles, common emergencies, ABCD symptoms, dangerous diagnoses and urgent mental health), Tropical medicine (general tropical diseases, diarrhoea, oral rehydration and malnutrition), Chronic diseases (hypertension, diabetes, coronary heart disease, stroke, respiratory disease, chronic kidney disease, palliative care, HIV/Blood Borne Viruses and Care of the older person), antenatal care, family planning, breast feeding, postnatal depression, childhood illnesses, childhood development, immunisation, child protection young peoples health, mental health promotion and diagnosis, depression, alcohol and substance misuse, severe mental health, dual diagnosis, learning disabilities, neuroses and stress.

Family Medicine Programme handbook V2 Middlesex

Learning outcomes: On successful completion of the module you will be able to: Critically evaluate and apply to patient scenarios, current research into the pathophysiology of the diseases and conditions in general family/community medicine covered in the syllabus, taking into account lifestyle factors, complications (general and related to specific risk groups and stages of the diseases, and effects on lifestyle; Demonstrate thorough understanding of the pharmacology of treatment options and the decision-making processes for safe prescribing and treatment planning for treatments covered in the syllabus; Critically evaluate differential diagnoses, on a foundation of systematic knowledge and current approaches, to justify a specific diagnosis, and identify appropriate treatment plans for patient scenarios representing the full range of lifestyles, complications, specific risk groups and stages of the disease. Demonstrate understanding and an ability to deal with the complex factors and issues that determine the health of the individual and the community in relation to general medical disorders, and the principal factors governing the delivery of prevention and care.

Teaching and Learning Methods:

Teaching strategies include:

On-line resource based learning through directed and verifiable study. As an autonomous learner you have the opportunity for managing your own learning, including research and reading related to cases seen in General Practice . Assessment Rationale: Depth of knowledge and judgment in each online topic is assessed through Higher Order Thinking questions in formative untimed assessments and timed mini-tests. The final summative examination consists of HOT questions covering module 2 for both the Postgraduate Certificate and the Postgraduate Diploma pathways. HOT questions are employed by all the Royal Colleges in assessing and examining doctors in postgraduate medical examinations Medical qualifications are awarded on a Pass/Fail basis, with all components required to be passed

Assessment criteria The structure of the formative assessments is related to each topic of the module. It is suggested that the student aims for a minimum of 50% for each formative topic and mini test assessment within this module. In the final summative assessment a mark of 50% must be obtained across the syllabus in the module to obtain a pass. The assessments will assess all Learning outcomes, 1-4 Assessment Methods It is strongly recommended that you attempt all the formative assessment components in this module. 1. Online Topic formative assessments: these are untimed and have a cut off deadline date: aim to achieve 50% on each assessment 2. Online Mini-tests, formative assessments: these are timed and hive a cut off deadline date: aim to achieve 50% on each mini-test. 3. Final summative examination covering module 2 for the Postgraduate Certificate and the Postgraduate Diploma: Pass or Fail with the threshold set at 50%.

Family Medicine Programme handbook V2 Middlesex

Sources: Course reader supplied online Lee LM, Teutsch SM, Thacker SB, St. Louis ME (eds.). Principles and Practice of Public Health rd Surveillance. 3 ed. New York: Oxford University Press; 2010 General information on screening, including links to evidence and policy papers www.screening.nhs.uk British Association Sexual Health and HIV www.Bashh.org Van Tulder, M., Becker, A., Bekkering, T., Breen, A., del Real, M.T., Hutchinson, A., Koes, B., Lrum, E., Malmivara, A. (2006). Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2006 Mar;15 Suppl 2:S169-91 Mental health ABC of Community Emergency Care Doy R, Blowers EJ, Sutton, E. EMJ 2006;23:304-12 Lecture notes on Tropical Medicine (6 Ed). G.V. Gill and N. J. Beeching Blackwell Publishing 2009 WHO (2003). The treatment of diarrhoea. World Health Organisation. (www.who.int) NICE (2009). Diarrhoea and vomiting in children under 5 (NICE guideline). www.nice.org.uk Kliegman, R., Behrman, R.E., Nelson, W.E., Jenson, H.B., Stanton, B.F. (2007). Nelson Textbook of th Paediatrics (18 Ed). Saunders Elsevier: Philadelphia Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JP, Sever PS and Thom S McG; The BHS Guidelines Working Party Guidelines for Management of Hypertension: Report of the Fourth Working Party of the British Hypertension Society, 2004 - BHS IV. Journal of Human Hypertension 2004; 18: 139-185 Useful paper on diabetes : D. Devendra et al: BMJ 2004:328:750-754 Chapman S, Robinson G, Stradling J, West S. Oxford Handbook of Respiratory Medicine, Oxford University Press 2005 Better health in old age (Department of health). Professor Ian Philp http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4093 215.pdf Doyle D., Hanks G., Cherney N and Calman K., Oxford Textbook of Palliative Medicine Third Edition (2005) Oxford University Press British Association Sexual health & HIV (BASHH) http://www.bashh.org/directory.asp Abramsky L, Botting B, Chapple J, Stone D. Has advice on preconception folate supplementation reduced neural-tube defects? Lancet 1999;354:998-9. Liden A, Berglund G, Hansson MG, et al; Genetic counselling for cancer and risk perception. Acta Oncol 2003;42(7):726-34 NHS Lothian. Substance misuse in pregnancy: resource pack. Scotland, 2003. Mattar CN, Chong Y, Chan Y. et al : Simple Antenatal Preparations to Improve Breastfeeding Practice. A Randomised Control Trial: Obstetric & Gynaecology 2007; 109: 73-80 NHS Direct. Breastfeeding www.nhsdirect.nhs.uk
th

Antenatal and postnatal mental health: clinical management and service guidance. NICE Clinical Guideline 45. (2007) National Institute for Clinical Excellence: London National Institute for Health and Clinical Excellence. Feverish illness in children (2005) Guideline 47
Family Medicine Programme handbook V2 Middlesex

Van den Bruel. Haj-Hassan T, Thompson M, Buntix F, Maunt D. Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: a systemic review Lancet (2010) 375; 834-45 Paediatrics and Child Health, Ed. M Bellman and N Kennedy, Churchill Livingstone 2000 The Green Book: available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_079917 The Child in Mind: A Child Protection Handbook. J Barker, Deborah Hodes (2004), Routledge Goldberg D & Murray R (2006) Maudsley Handbook of Practical Psychiatry (Fifth Edition), Oxford Medical Publications Department of Health. Drug Misuse and Dependence - Guidelines on Clinical Management. London: Department of Health, 1999. Mueser KT, Drake RE, Wallach MA (1998). Dual Diagnosis: a review of etiological theories. Addictive Behaviors, 23(6): 717-734. NTA (National Treatment Agency) 2006: Models of Care for treatment of adult drug misusers: An Update. London de Board, R. (1998) Counselling for Toads. London: Routledge May, R (1989) The Art of Counselling. London: Souvenir Burnard, P. (2005) Counselling Skills for Health Professionals (4 Ed). Cheltenham: Nelson Thornes Ltd Hassiotis, A. (2007) Mental Health, learning disabilities and adolescence; a developmental perspective. Advances in Mental Health in Learning Disabilities, 1, 32-39. Turk, J. (2005) The Mental Health Needs of Children with Learning Disabilities. In: Mental Health Learning Disabilities, A Training Resource, (eds.: Holt, G., Hardy, S. & Bouras, N.). Brighton: Pavilion Publications www.intellectualdisability.info - useful resources for professionals and carers Roberts G, Hegarty K, Feder G. Intimate partner abuse and health professionals: New approaches to domestic violence. London: Elsevier; 2005 Responding to Domestic Violence; a handbook for health professionals http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_412616 1 Gelder, Mayou: Shorter Oxford Textbook of Psychiatry, Fifth Edition 2006
th

Family Medicine Programme handbook V2 Middlesex

MODULE THREE Full Module Title:

CLINICAL PRACTICE in Family Medicine

Short Module Title: Module Code: RILAFAM3 (from Quality and Standards Office ) Credit Value: 60 School and Department: ?? Module Leader(s): Dr Riadh Dawood Extension: Email: admin@rila.co.uk Credit Level: 7 Length: 5 months

Host course: Postgraduate Diploma in Medical Specialism (Family Medicine) Status: Core Subject Board: Pre-requisites: none Co-requisites: Assessment: Each subject area within the clinical practice module is presented as a core reading article and/or an online interactive session. Each has an associated formative assessment with Higher Order Thinking (HOT) questions (untimed) and formative online mini tests (timed) on all the topics covered in the module. The student is strongly recommended to participate in this activity and aim to achieve a mark threshold of 50% There is a final summative examination covering module 3. The pass mark is 50%. Study Abroad: Qualifying Mark(s) for Assessment(s): All assessments have a 50% pass mark Special features: Access restrictions: Participants must be licensed to practice and registered with the relevant Medical Council or appropriate professional organisation, have at least one years experience in practice, and be working in active clinical practice. Summary of Module content: The module extends on and applies the knowledge content of the core generic and the advances modules to the practical skills required in Family Medicine

Module Aims: This Module develops practice skills related to Family Medicine and the application of the knowledge through directed learning and self-directed research.

Family Medicine Programme handbook V2 Middlesex

Learning outcomes: On successful completion of the module you should be able to: 1. Consistently demonstrate a comprehensive competence in the full range of skills in family medicine to manage the diseases in the community and have critical awareness when to refer cases to the secondary sector. 2. Communicate effectively with a wide range of patients, carers and clinical staff the complex issues and factors that determine the outcome after consultation and investigation the management plan. 3. Conduct a physical examination that is informed by up to date evidence in the discipline and informed by a thorough knowledge of underlying patho-physiology. 4. Demonstrate self-direction when selecting which practical procedures and investigations are required in clinical scenarios where full information may be unavailable. Such initiative should also demonstrate the acceptance of personal responsibility for any decision making. 5. Demonstrate independent learning and continuing professional development to ensure that management plans of prevention and/or disease management is current and evidence based. 6. Work collaboratively with other health care professional and agencies to make decisions in complex and difficult circumstances. 7. Reflectively evaluate your own performance by identifying and following through on areas for further research, continuing professional development and the acquisition of new and advanced skills.

Syllabus content: How to perform general clinical examination and examination of specific organ systems as required, diseases, including the use of diagnostic procedures such as the otoscope, ECG, blood pressure measurement etc. and formulate management and treatment plans and protocols for the range of disease categories, stages, complications, and work in collaboration with other medical specialists for optimum patient care. The syllabus requires competency in the following: Have the ability to perform general clinical examination of organ systems, including digital rectal and vaginal examinations. Also be proficient in the use of the following instruments and procedures: Auriscope. Ophthalmoscope Sphygmomanometer Stethoscope Foetal stethoscope and/or Sonicaid Patella hammer Thermometer Tuning fork. Visual acuity and colour tests Proctoscope Vaginal speculum Cardio-pulmonary resuscitation including use of a defibrillator Controlling a haemorrhage Venepuncture Giving intravenous, intramuscular, subcutaneous or intradermal injections including via a syringe driver Performing and interpreting an electrocardiogram Performing basic respiratory function tests Administering oxygen safely Use of a nebuliser Near patient testing e.g. urinalysis Removal of ear wax Passing a urinary catheter Performing a cervical smear Collecting other relevant samples including endocervical or per-nasal swabs

Understand the use of protocols for the diagnosis and treatment of common disorders presenting in the community. This will include patient monitoring, early detection of late stage complications and acute complications of a variety of diseases in Primary Care.
Family Medicine Programme handbook V2 Middlesex

Formulation of preventative programmes based on lifestyle modification to reduce risk factors for disease, including self-monitoring for signs of acute complications; Teaching and Learning Methods: The main teaching/learning strategies employed during this Module will be demonstrations and interactive clinical sessions, online and supplemented by workshops at the beginning and towards the middle of the programme. The online elements will include a wide range of skills and procedures. Assessment Rationale: . Assessment criteria: The structure of the formative assessments is related to each topic of the module. You must provide a reflective assessment of 2 key clinical scenarios/skills through an online dialogue. The latter assessed as pass or fail and require a pass for the PG Diploma award. It is strongly recommended that the student aims for a minimum of 60% for each formative topic and mini test assessment within this module. In the final summative assessment a mark of 60% must be obtained for a pass. The assessments will assess all Learning outcomes, 1-8 Depth of knowledge and judgment in each online skills session is assessed through Higher Order Thinking (HOT) questions in formative untimed assessments and timed mini-tests. The final summative examination consists of HOT questions. HOT questions are used by all the Royal Colleges in assessing and examining doctors in postgraduate medical examinations Medical qualifications are awarded on a Pass/Fail basis, with all components required to be passed

Assessment Methods It is suggested that you attempt all the formative assessment components in this module. 1. Online Topic formative assessments: these are untimed and have a cut off deadline date: aim to achieve 50% on each assessment 2. Online Mini-tests, formative assessments: these are timed and hive a cut off deadline date: aim to achieve 50% on each mini-test. 3. Final summative examination covering module 3 for the Postgraduate Diploma: Pass or Fail with the threshold set at 50%.

Family Medicine Programme handbook V2 Middlesex

Sources:

Otoscopy: http://www.youtube.com/watch?v=KfHW3ES0IA4&feature=related http://www.youtube.com/watch?v=FqSCfqoCNiI http://www.youtube.com/watch?v=iIbaq15t1L0&feature=relatedhttp://www.youtube.com/watch?v=JyI UQOu7hp4&feature=related

Ophthalmoscopy: http://www.youtube.com/watch?v=-7Sh2H1jgUU http://www.youtube.com/watch?v=NE_epHjNpfo Sphygmomanoneter: http://www.youtube.com/watch?v=u6saTO8_o2g http://www.wikihow.com/Check-Your-Blood-Pressure-with-a-Sphygmomanometer Foetal stethoscope: http://www.youtube.com/watch?v=uw0CjuMuZXs http://www.youtube.com/watch?v=a209hlDCDFk Patella hammer: http://video.google.com/videoplay?docid=50678883446817253 Thermometer: http://www.ehow.com/video_4984299_use-mercury-thermometer.html Visual acuity & colour tests: http://www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-medicalconditions/vision/visual-acuity-vision.shtml http://www.youtube.com/watch?v=zDOdAfRurGs Vaginal examination, cervical smear etc: http://www.youtube.com/watch?v=5MF8Qwvqw68&feature=related http://www.youtube.com/watch?v=PpI-lWXrbxM&feature=related Digital rectal examination: http://www.youtube.com/watch?v=2xs2Q2-MySU CPR & Defibrillation: http://www.youtube.com/watch?v=vXim8rU7lY8 http://www.youtube.com/watch?v=hdIK-qCKuJ8 http://www.youtube.com/watch?v=AGznNGtT4xw&feature=related http://www.bbc.co.uk/news/health-13037602 http://www.youtube.com/watch?v=NvIPS5iBdbo&feature=related Venepuncture: http://www.youtube.com/watch?v=kP48pCAzB74 http://www.medicalvideos.us/play.php?vid=1436 IV, IM, SC and ID injections: General techniques: http://www.youtube.com/watch?v=AX_RHZ7c0Qs&feature=related IM: http://www.youtube.com/watch?v=Spoz3T5D_SU
Family Medicine Programme handbook V2 Middlesex

ID: http://www.wonderhowto.com/how-to-give-intradermal-injection-nursing-259907/ SC: http://www.wonderhowto.com/how-to-administer-subcutaneous-injection-195379/ ECG: how to perform and basic interpretation: http://www.youtube.com/watch?v=y_P_0ggH4dE&feature=related http://www.youtube.com/watch?v=LEaRyzudjw4&feature=related http://www.youtube.com/watch?v=TOkpUURCm9M&feature=related Basic Respiratory tests: PEFR: http://www.youtube.com/watch?v=dPDHsReZfQ0&feature=fvwrel Spirometry: http://www.youtube.com/watch?v=7xcv2_NeOXg&feature=related Nebuliser use: http://www.youtube.com/watch?v=IVBZVQGD9GE http://www.5min.com/Video/How-to-Use-a-Nebulizer-160125653 Urinalysis: http://www.youtube.com/watch?v=ubFsVU1EIis http://www.youtube.com/watch?v=TuWiy4_VDWY&feature=related http://www.youtube.com/watch?v=HGxO7HFZKkM&feature=related Passing a urinary catheter: http://www.nhs.uk/conditions/Urinary-catheterization/Pages/Introduction.aspx http://www.medicalvideos.us/play.php?vid=199 http://vodpod.com/watch/3644092-female-urethral-catheterisation Wax removal: http://www.ehow.com/video_4997949_removing-impacted-ear-wax.html

Family Medicine Programme handbook V2 Middlesex

Programme Evaluation Report

Enter name of programme:
(to be completed at the end of the course, you may photocopy this page)

Institutions: Middlesex University & Rila Publications

Provide a numerical score for each item: Very poor: 1 1. Organisation: a. Directed learning online reading material Comments: 2 3 4

Date:
5 6 7 8 9 10 Very good

b. Workshops Comments:

c. Assessment / Exams & mini tests Comments:

d. Online clinical activity and skills sessions Comments:

2. Quality of taught material- lectures and seminars: Comments:

3. Other facilities: RILA/local e.g. Online portal etc Comments:

4. Support for learning and queries Comments:

5. Was the suggested allocation of ~ 2 half days a week for personal study sufficient? 5. Who paid your fees?
Please provide other comments that will enable us to improve the programme of study in the space below:

Family Medicine Programme handbook V2 Middlesex