Modules

• Year 1
  • Introduction to Year 1 and FunMed
  • Fundamentals of Medicine
  • Human Development 1
  • Cardiorespiratory 1
  • Metabolism 1
  • Locomotor 1
  • Brain and Behaviour 1
  • Medicine in Society 1
  • Inter-Professional Education 1
• Year 2
  • Introduction to Year 2 and Year Outcomes
  • Cardiorespiratory 2
  • Metabolism 2
  • Brain and Behaviour 2
  • Human Development 2
  • Human Sciences and Public Health 2
  • Locomotor 2
  • Medicine in Society 2
  • Extended Patient Contact 2
  • Moving and Handling Training
  • Year 2 Lifesaver Programme
• Year 3
  • Clinical Science and Professionalism (Weeks 1-3)
  • Cardiovascular, Respiratory and Haematology (CR3)
  • Gastroenterology and Cancer (MET3A)
  • Endocrinology and Renal Medicine (MET3B)
  • General Practice and Community Care
  • Public Health
• Year 4
  • Obstetrics and Gynaecology
  • Child Health
  • Neuroscience
  • Psychiatry
  • Ophthalmology
  • HIV & Sexual Health
  • Musculoskeletal
  • Health Care of the Elderly
  • Dermatology
  • General Practice and Community Care
  • Ear, Nose and Throat
  • Global Health and Ethics
  • ALL CSP WEEKS
  • B&B Classroom Skills
• Year 5
  • Introduction to Year 5 and Year Outcomes
  • Teaching Week 1
  • Acute Medical Care (AMC)
  • Surgery, Anaesthetics and Perioperative Care (SAPOC)
  • Community Care
• Year GEP 1
  • Movement and Posture
  • Carriage of Oxygen
  • Human Sciences and Public Health
  • Digestion, Growth and Metabolism
  • Infection and Immunity
  • Brain and Behaviour
  • Consolidation and Integration
  • Human Development
  • Medicine in Society (GEP)
  • IPE Programme Week (inc. IP Days within Modules)

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Year 1 FM1: Fundamentals of Medicine

• Dr Lesley Robson
• l.g.robson@qmul.ac.uk

Introduction

The aims of the FunMed Module are:

1. To develop independent learning and critical reasoning skills necessary for a University course
2. To acquire basic Information Technology (IT) skills in accessing information and in word processing
3. To develop time management skills in planning and scheduling work
4. To work and communicate effectively in small groups
5. To appreciate the development of modern medicine and its historical context
6. To appreciate the historical, social and demographic characteristics of the East End of London, and the implications of these for the health of the local population
7. To develop an understanding of normal biological structure and function, at the cellular and molecular level; and knowledge of cellular pathology and basic pharmacology sufficient to provide a foundation for subsequent stages
8. To obtain a basic knowledge of anatomical terms and of the location of the main organs and structures, including the use of medical imaging
9. To begin to understand the contribution of genetic, social, environmental, political, occupational and behavioural factors to health, illness and disease
10. To begin to appreciate the effect of illness on people and their families
11. To begin to understand the role of the doctor and other health professionals in society
12. To prepare students for meeting patients in clinical settings, by addressing communication skills and ethical principles in the health professional - patient relationship
13. To develop basic skills of resuscitation and emergency care
14. To provide a broad overview of the entire MBBS course

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Index

• General Outcomes for the Whole Person
• General Outcomes for Community Care
• Bronchiectasis and Cystic Fibrosis (Priority 3)

• General Outcomes for the Whole Person
  • Medical knowledge: ANATOMY
    • Anatomical Positions, Planes and Movements
      1. Describe the main features of the human body, by using appropriate anatomical language.
      2. Describe the anatomical position and use correct anatomical terms to describe body directions, regions and body planes or sections.
      3. Locate and name the major body cavities and their subdivisions and list the major organs contained within them. Name the serous membranes and indicate their common function
      4. Use the basic language of anatomical directions and movements (superior, inferior, anterior, posterior, proximal, distal, pronation etc)
      5. An introduction to the anatomy laboratory
      6. Identify the main components of the cardiovascular, respiratory, digestive, urinary, endocrine and reproductive systems of the body.
      7. Understand the anatomical position and planes of section
      8. Locate the major organs in cross section and on MRI and CT
    • Blood and the Circulatory System
      1. Identify the structural difference between arteries and veins related to function. Name and locate the major arteries and veins in the systemic circulation.
      2. Describe the position of the heart and identify the great vessels
      3. Follow the main vessels to the viscera and to the periphery, identifying the main vessels
      4. Differentiate between systemic, portal and pulmonary circulation
      5. Describe the general location of lymph nodes.
    • Epithelia and Glands
      1. For each of the various types of epithelial tissue, outline its structural characteristics, functional capabilities, cellular specialisations and be able to give an example of a body site where it would be located.
      2. Recognise the various epithelial cell types in photomicrographs and predict their function from their structure
      3. Recognise glandular tissue in photomicrographs, identify the gland type and its likely function
      4. Name the various types of glands, relate their structure to their function, and give an example of where each might be found in the body.
      5. Understand and master the use of the system for classifying different types of lining epithelia based on number of layers and shape of cells on the surface
      6. Recognise the basement membrane and list its functions
      7. Describe the basic structure of a mucosa and a serosa, and predict their functions from the different types of epithelial cell found on their surface.
      8. Recognise the mucous and serous membranes in photomicrographs and be able to identify different structural components found in each of these complex tissues
    • Bones and Joints
      1. Name the major parts of the axial and appendicular skeleton and describe their relative functions
      2. Name and describe the major bones of the skull and the important foramina
      3. Classify the different types of joints
      4. Use the correct anatomical terms to describe movements at these joints
    • Muscles, Nerves and Connective Tissue
      1. Describe the categorisation, main structural features and functions of the connective tissues.
      2. Recognise the different types of connective tissue in photomicrographs
      3. Compare and contrast the structure, function and location of the three major types of muscle.
      4. Recognise nervous tissue and be able to distinguish neural and glial components
      5. Describe the different cell types found in mature connective tissue.
      6. Identify common cell types found in connective tissues
      7. Describe the major responses of muscle to use and disuse.
      8. Relate the functional organisation of the neuromuscular synapse (junction) to the process of neuromuscular transmission.
      9. Show understanding of how different cell types within nervous tissue and the organisation of the tissue contribute to its functions
      10. Relate the composition of extracellular matrix components to the functional requirements of the various connective tissues.
      11. Understand differences in the make-up of the extracellular matrix between various connective tissues and how types are differently organised
      12. Outline the distinctive structural and functional characteristics of nervous tissue.
      13. Compare and contrast the structure and functions of the two types of adipose tissue.
      14. Relate organisation of different types of connective tissue to their function
      15. Relate the structures of the neuronal cell body, dendrites, axon and synaptic terminal to their function.
      16. Recognise different types of muscle and different components of muscle tissue in photomicrographs
    • Surface Anatomy - General
      1. Describe the body's organ systems and their location and relationship to the body's surface and skeleton
      2. Describe basic surface anatomy especially that relevant to general clinical examination and diagnosis
    • Autonomic Nervous System
      1. Compare and contrast the SNS and ANS
      2. Draw labelled diagrams to show the general arrangement of motor and somatic reflexes.
      3. Name the divisions of the ANS, and describe the segmental organisation of the sympathetic and parasympathetic nervous systems.
      4. Draw a series of labelled diagrams to show the arrangement of nerve fibres in the divisions of the ANS at the anatomical and neurochemical and receptor levels,
      5. Describe how the adrenal medulla acts as a modified post-ganglionic cell.
      6. Briefly describe how the enteric nervous system can control gut function.
  • Medical knowledge: PHYSIOLOGY
    • General Outcomes for Nervous System Physiology
      1. Describe how sensory nerve endings transduce and encode stimuli with examples including peripheral stretch (mechano) and thermoreceptors
      2. Be able to describe the biophysical requirements for action potentials to take place
      3. What are the membrane properties essential for excitability? Including an introduction to resting and action potentials and voltage-gated ion channels
      4. Explain the effects of nerve fibre diameter and myelination on conduction velocity
      5. Be able to discuss the principle characteristics of an action potential
      6. Why everything depends on the Na-pump
      7. Describe what is meant by threshold, sub-threshold and supra-threshold responses, and how a neuronal dendritic tree can integrate many synaptic inputs, taking the spinal a-motor neuron as an example
      8. Have an understanding of the importance of saltatory nerve conduction for activities of daily life
      9. What is the basic mechanism of local anaesthetics (an example of pharmacological manipulation of excitability)
      10. Describe a synapse and the role of both excitatory and inhibitory neurotransmitters with examples
      11. Why is pre-synaptic Ca2+ important?
      12. Understand the concept of a ligand-gated receptor
    • Neuropharmacology
      1. Be able to explain how neurotransmitters can produce electrical changes by activating / inhibiting receptors in the post-synaptic cell
      2. Be able to outline the role of G-proteins in coupling a hormone/NT receptor complex to a) adenylate cyclase; b) hydrolysis of inositol phospholipids
      3. By means of simple diagrams and suitable examples, be able to describe the properties of the receptor-regulated ion channels and the neurotransmitters which activate them
      4. Describe the major neurotransmitter systems in the central and peripheral nervous systems
      5. Describe the role of protein kinases in transmitting the intracellular effects of second messengers
      6. Explain how an action potential is initiated by the summation of synaptic inputs
    • Autonomic Nervous System
      1. Compare and contrast the SNS with the autonomic nervous system (ANS)
      2. Draw labelled diagrams to show the general arrangement of motor and somatic reflexes
      3. Name the divisions of the ANS, and describe the segmental organisation of the sympathetic and parasympathetic nervous systems
      4. Draw a series of labelled diagrams to show the arrangement of nerve fibres in the divisions of the ANS at the anatomical, neurochemical and receptor levels
      5. Describe how the adrenal medulla acts as a modified post-ganglionic cell
      6. Briefly describe how the enteric nervous system can control gut function
    • Gastrointestinal Physiology - General
      1. Analyse how the gut handles carbohydrate
      2. Describe the hormonal control of blood glucose
    • Function of the GI Tract
      1. Distinguish between the handling of simple and complex carbohydrates
    • Homeostasis
      1. Be able to apply the principles of homeostasis to one human physiological system - body temperature; blood glucose concentration; body fluid volume
      2. Be able to define homeostasis in relation to the physiological systems
      3. Be able to discuss the contribution of negative feedback, positive feedback and positive feed-forward to the process of body homeostasis
    • Acid-Base Balance
      1. Be able to define the term buffer system and explain how it resists changes in pH
      2. Be able to state the normal pH and hydrogen concentration of human blood plasma and the ranges compatible with life
      3. Be able to cite a common clinical example of acid-base becoming unbalanced
    • Body Fluids
      1. Be able to describe how water and ions enter and leave the body in a controlled way
      2. Be able to describe the process of osmosis and distinguish between exudates and transudates
      3. Be able to discuss the contributions of ion pumps to cellular function
  • Medical knowledge: CELL BIOLOGY
    • Biological Energy
      1. Define the principal energy stores in human cells
      2. Describe the principal biological roles of ATP in relation to biosynthesis reactions, transport and motility
      3. Describe the principal mechanisms of energy generation within the cell and distinguish between ATP generation through substrate level phosphorylation and via the proton motive force
      4. Explain the significance of B-group vitamins in terms of coenzyme structure and function
    • Cell and Tissue Structure
      1. Understand the functions of the principal components of the extracellular matrix and relate to cell function and disease
      2. Identify the organelles and ultrastructural features of cells; describe organisation and functions of the following and, where applicable, relate to human disease
      3. Discuss the structure and function of inter-cellular connections in relation to tissue function eg adherens junctions, tight junctions, gap junctions, desmosomes, synapses and relate to disease
      4. nucleus; mitochondrion; endoplasmic reticulum (rough and smooth); Golgi complex; lyosomes; peroxisomes; cytoskeleton; plasma membrane
      5. Relate the specialised structure of the cell surface (microvilli, cilia, pseudopodia) to the functions of the tissues and cells concerned
    • Membrane Function
      1. Be able to describe the function of membrane proteins
      2. Understand the functions of biological membranes and associated proteins including adhesion, transport and communication
      3. Distinguish between passive diffusion, facilitated diffusion, secondary active transport, and active transport giving examples of each in human tissues
      4. Relate specialisations of the plasma membrane to its function
      5. Describe how deficiencies in folding, trafficking and function of the CFTR protein cause cystic fibrosis
    • Proteins
      1. Understand the role of the ribosome in mRNA translation; how and where, including co-translational translocation of membrane and secreted peptides at the ER
      2. Outline the common structural features of the amino-acids and the roles of their side chains in protein structure and function
      3. Describe the structure of proteins and the stabilising forces of the a-helix, b-pleated sheet and collagen triple helix
      4. Comprehend the problems of protein folding in vivo and the role of molecular chaperones in dealing with this
      5. Explain how post translational modifications can be important for stability and modulation of function
    • Cell Differentiation and Cell Death
      1. Define programmed cell death
      2. Explain the difference between stem cells and differentiated cells
      3. Visualisation of cell behaviour including movement, cell division and death
      4. Describe the role of stem cells in cancer
      5. Explain the changes that occur with ageing at the cellular and tissue levels
    • Sugars and Polysaccharides
      1. Distinguish between the terms monosaccharide, disaccharide and polysaccharide and name a physiologically important example of each group
      2. Define the terms: glycosidic bond; sugar esterification (phosphates + sulphates); amino sugar, giving a physiologically relevant example of each one
      3. Define the mechanism and biological importance of protein glycosylation
      4. Outline the structures and biological roles of glycogen, heparin, proteoglycan and bacterial lipo-polysaccharide
    • Enzymes
      1. Define the following terms in relation to enzyme catalysis: substrate specificity; active site; activation energy; cofactor and co-enzyme; proenzyme
      2. Explain by reference to the Michaelis-Menten equation how the rate of enzyme catalysed reaction depends on enzyme concentration and substrate concentration
      3. Enzyme activity assays
      4. Explain the effects of enzyme catalysis of changes in temperature and pH; distinguish between competitive and non-competitive inhibition, giving a physiological example of each
      5. Define the term isoenzymes and their value in diagnostic enzymology
    • Lipids and Membranes
      1. Understand the architecture and components of the currently accepted view of biological membranes
      2. Describe the general structural features, properties and biological roles of triglycerides (triacylglycerols); phospholipids; glycolipids; cholesterol and steroids
      3. Distinguish between essential and non-essential fatty acids
      4. Relate the lipid and protein composition of biological membranes to the membrane's properties
  • Medical knowledge: MOLECULAR BIOLOGY and GENETICS
    • Genetics - General Outcomes
      1. PCR and its uses in pre-natal diagnosis / pre-implantation genetic diagnosis
      2. Evaluate the contribution of genetic and environmental factors to normal human variation and to disease
      3. Use of high density single nucelotide polymorphism (SNP) arrays of disease gene mapping and cancer diagnostics
      4. Describe the basic principles of Mendelian inheritance and understand the difference between monogenic, multigenic and multifactorial disorders
      5. Old and new sequencing: how to sequence your genome for £2000
      6. Understand the role of cytogenetics and molecular genetics in clinical diagnosis
    • Inheritance and Mutation
      1. Define the following terms in relation to human genetics and disease: homozygous; heterozygous; proband; sibling; recessive; dominant; co-dominant; penetrance; anticipation; imprinting phenotype; genotype; allele
      2. Describe, with examples, the different patterns of inheritance of single gene disorders
      3. Describe the different types of gene mutation and their consequences
      4. Describe how mutations in different genes can result in the same clinical disorder
    • Genetic Variation
      1. Define the terms rare and polymorphic genetic variation
      2. Discuss how DNA polymorphisms can be detected and how they may be used to identify individuals
      3. Understand the basic principles of population genetics with reference to allele frequencies and the Hardy-Weinberg equilibrium
      4. Explain how genetic variation contributes to common disease
    • Epigenetics
      1. Define the term epigenetics
      2. Describe the role of epigenetic markers in controlling gene expression
      3. Understand the extent to which epigenetics impacts on human disease
    • The Human Genome
      1. Describe in outline the structure and organisation of the human genome
      2. Understand the differences between coding and non-coding the DNA-sequences, introns and exons, pseudogenes, control elements and repetitive sequences
      3. Compare the different ways in which we can access the human genome
    • RNA Structure and Synthesis
      1. Describe the Central Dogma and the basic structure of a gene
      2. Describe the process of transcription and explain the function of RNA polymerase
      3. Explain what a promoter is and its role in transcription
      4. How is RNA modified before leaving the nucleus?
      5. Describe the different types of RNA and their role in translation
      6. Describe how antibiotics can interfere in the process of transcription
    • Cell Division and its Control
      1. Describe the main features of the cell cycle
      2. Describe the main mechanisms and biological functions of mitosis and meiosis
      3. Discuss the role of genes in co-ordinating the cell cycle
      4. Give examples of human diseases associated with mutations in these genes
      5. Explain how some chemotherapeutic drugs may inhibit cell division in cancer cells
    • Forensic Molecular Pathology
      1. Appreciate the difference in requirements when analysing DNA for medical and criminal justice purposes
      2. Gain an understanding of what is meant by a DNA Profile
      3. Learn about how different parts of the human genome provide molecular tools that are used for intelligence and crime-fighting purposes
    • DNA Structure and Synthesis
      1. Describe, using simple diagrams, the structure of DNA and its organisation into nucleosomes and chromatin
      2. Describe the organisation of human genes, both internally and into gene families
      3. Outline the mechanism of DNA synthesis (replication) and describe how some antibiotics interfere in this process
      4. Explain the very low level of mistakes in the DNA replication process
      5. Outline methods of DNA repair, with an example of the clinical consequence of a defective repair mechanism
    • Protein Synthesis
      1. Outline the key features of the genetic code
      2. What are the essential RNA species for translation
      3. Describe the events and regulation in the ribosome cycle of protein synthesis
      4. Describe the structural changes undergone by a newly synthesised polypeptide in order to constitute a biologically active protein in the appropriate site (post-translational modifications / targeting and sorting)
      5. How does viral and bacterial interference effect protein translation
      6. Know that antibiotics are used to target ribosomes
      7. Outline protein synthesis defects in inherited disease
  • Medical knowledge: PATHOLOGY
    • General Pathology
      1. Describe how the basic tissue types are organised in the skin and the colon
      2. Describe the types of investigations that can provide tissue for histological analysis, and discuss the clinical value of such analysis
      3. Describe the morphological changes undergone by cancer cells as seen in a photomicrograph
  • Medical knowledge: CANCER
    • Cancer and Genetic Disease
      1. Discuss the types of genetic changes that occur during cancer development
      2. Account for the fact that cancer risk can be inherited
      3. Define a tumour suppressor gene and an oncogene
    • Pathology of Cancer - General
      1. Have insight into cancer research and treatment at Barts and the London
      2. Explain cancer incidence and mortality
      3. Describe the cancer screening programmes in the UK
      4. Explain cancer treatment options.
    • Neoplasia
      1. Define the terms: tumour, neoplasm, benign, malignant, histogenesis, differentiation, metastasis
      2. Revise the principles behind the classification of malignant neoplasms
      3. Revise the principles behind the classification of malignant neoplasms
      4. Define the terms: tumour, neoplasm, benign, malignant, histogenesis, differentiation, metastasis
      5. Define the term paraneoplastic syndrome and give some examples
      6. Describe the behaviour and pathological features of malignant neoplasms
      7. List aetiological agents that have been linked to the development of some malignant neoplasms
      8. Give a brief classification of benign and malignant neoplasms according to their cell of origin
      9. Give a brief classification of benign and malignant neoplasms according to their cell of origin
      10. Name the aetiological agents that have been linked to the development of some malignant neoplasms
      11. Describe the behaviour and pathological characteristics of malignant neoplasms
      12. Compare and contrast the pathological features of benign and malignant neoplasms
      13. Describe the effects of a neoplasm on the host
      14. Compare and contrast the pathological features of benign and malignant neoplasms
      15. Define the term Paraneoplastic Syndrome and give some examples
      16. Describe the effects of a neoplasm on the host
    • Chemical Agents Causing Disease
      1. Account for the aetiological agents (chemical, physical, biological) causing ancer.
  • Medical knowledge: IMMUNOLOGY and INFLAMMATION
    • The Immune Response in Health
      1. Know that many pathogens invade the spaces between cells eg extra-cellular bacteria
      2. Know how bacteria are eliminated using the humoral immune response
      3. Know what an antibody is
      4. Know how phagocytes (eg neutrophils) interplay with antibodies
      5. Understand complement and know its function
    • Immunology - General Outcomes
      1. Understand cytokines and their function
      2. To understand how the immune system can sometimes do more harm than good
      3. Understand that immunology is related to disease including infections, autoimmunity and allergy (hypersensitivity)
      4. Appreciate the key concept that cytokines are very beneficial molecules in small localised controlled doses, but are extremely harmful molecules in high prolonged and systemic doses
      5. To understand that the immune response normally can tell the difference between ‘self’ and ‘non-self’
      6. Be aware of the main players in the immune system including lymphocytes (T-cells, B cells and NK cells), myeloid cells (macrophages and granulocytes), dendritic cells and antibodies
      7. Know that the immune system is an agent of harm in the modern age
      8. To give examples in which this ability to discriminate breaks down - autoimmunity
      9. Appreciate that communication between cells is critical
      10. To understand that an appropriate immune response is sometimes undesirable, such as in transplantation
      11. Realise the importance of long term immunological memory
      12. To be aware of the basic therapeutic mechanisms by which we deliberately suppress the immune system in auto-immunity and transplantation.
    • Recognition and Response to Antigens
      1. Understand that some pathogens live inside cells - this includes all viruses, or bacteria such as TB
      2. What is an antigen?
      3. How are these eliminated by the cell-mediated immune response including macrophages, cytotoxic T cells, NK cells and yd cells
      4. Know how the immune system recognises antigens
      5. What is the MHC and its role in presenting antigens in a form that T cells can see.
      6. Introduce the idea that TCRs and BCRs are made with random antigen recognition capacities
    • Communication between Immune Cells and Tissues
      1. Know that Th1 cells drive cell-mediated immunity
      2. Know that Th2 cells drive humoral immunity
      3. Know that Th17 cells drive responses to extracellular bacteria
      4. Know that T-reg cells retrain immune responses
      5. Know that memory T-cells remember our infection history
      6. Appreciate that CD4 or helper T-cells orchestrate adaptive immun responses
  • Medical knowledge: MICROBIOLOGY and INFECTION
    • Pathogenesis
      1. Describe portals of entry of pathogens and their adherence mechanisms
      2. For viruses, list their mechanisms of persistence, and explain their harmful effects (killing cells, alter functions of cells, giant cell formation, malignant change, hypersensitivity)
      3. For bacteria, list their mechanisms of persistence, describe how they make you ill, and how they survive the host response (involving stress, stealth, scavenging, striking back)
      4. Describe how pathogens are disseminated through host organs and how they exit from the host
    • General Outcomes for Microbiology
      1. Be able to distinguish between the different groups of pathogens
      2. List the basic characteristics of viruses and the criteria by which they are classfied
      3. Outline the structure of bacteria, emphasising differences from eukaryotic cells
      4. Describe the structure of viruses, defining the terms: capsid; capsomeres; genome; nucleocapsid, envelope
      5. Describe how bacteria can be classified on the basis of staining properties and morphology
      6. Describe how viruses replicate
      7. List those parts of the body which should be sterile and those which have a normal flora
    • Antivirals and Viral Infections
      1. Know the concept of inhibition of virus specific enzymatic activities
      2. How to inhibit cellular factors important for virus replication
      3. What are the treatment strategies and side effects
    • Antimicrobials and Bacterial Infections
      1. Describe the principle of selective toxicity
      2. Describe the structure and function of targets in microbes that differ from their counterparts in the host
      3. Discuss mechanisms and implications of microbial resistance
    • Sources of Infection and Routes of Transmission
      1. Define the terms: incidence; prevalence; endemic; epidemic; pandemic
      2. Discuss how pathogens are transmitted
      3. Discuss the significance, in terms of resistance to infectious diseases, of herd immunity, methods of control and immunisation
    • Terminology used in Microbiology
      1. Define the terms pathogen; commensal; opportunistic pathogen; carriage; colonisation resistance; virulence
  • Medical knowledge: THERAPEUTIC PRINCIPLES
    • Safe Prescribing and Drug Administration
      1. By using suitable drug examples discuss the advantages and disadvantages of the following routes of administration: oral, intravenous; intramuscular; subcutaneous; sublingual; rectal; transdermal; inhalation
    • Evidence Based Pharmacology
      1. Be aware of the various milestones and pitfalls in drug development
    • Pharmacokinetics and Pharmacodynamics
      1. Describe drug binding sites giving examples of both site and drug that attaches to it.
      2. Note G-protein-coupled receptors (GPCRs) compose largest group of drug binding sites
      3. Discuss selectivity of drug action
      4. Understand what is meant by structure-action relationships
      5. Compare and contrast routes of drug administration
      6. Understand what is meant by pharmacokinetics
    • Drug Receptor Interactions
      1. Define the terms: agonist, antagonist, EC50, efficacy and potency
      2. Draw idealised concentration vs response curves to distinguish between drugs of high and low potency and/or high and low efficacy
      3. Describe, with a clinical example, the characteristics of competitive antagonism
      4. Distinguish competitive antagonism from non-competitive and physiological antagonism
    • Pharmacological Principles - General
      1. Understand and know the principles of good prescribing including the most commonly prescribed drugs.
    • Drug Absorption and Elimination
      1. Explain drug absorption with reference to the pH-partition hypothesis, as applied to aspirin
      2. Define the term apparent volume of distribution and discuss why drugs have different values for this; explain pre-systemic (first pass) metabolism
      3. Briefly describe the ways in which drugs are eliminated from the body
  • Medical knowledge: SOCIOLOGY
    • Stigma and Health
      1. Outline the processes by which medicine is involved in social control
      2. Outline the processes in producing changes in patterns of behaviour
      3. Discuss three different approaches to the idea of risk
      4. Define the concept of labelling, and describe three major effects of chronic illness
    • Child Poverty and Health
      1. Identify the main social changes that have affected the family
      2. Describe how families can affect the cause, course and outcome of illness
  • Medical knowledge: EPIDEMIOLOGY
    • Routes of Spread
      1. Define the terms: incidence; prevalence; endemic; epidemic; pandemic
      2. Discuss how pathogens are transmitted
      3. Discuss the significance, in terms of resistance to infectious diseases, of herd immunity, methods of control and immunisation
  • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH
    • Lifestyle and Disease
      1. Describe the value of prevention versus treatment and begin to apply it to all medicine for the rest of your career
  • Clinical skills: IMAGING
    • General Outcomes for Imaging
      1. Identify components of body systems and structures in several common types of medical images: ultrasound; X-Ray, CT-Scan; MRI-Scan; compared with anatomical pictures and the CAL packages
      2. Describe the uses of, and the differences between, the following medical imaging techniques: plain (X-Ray) films; computerised tomography (CT); magnetic resonance imaging (MRI).
      3. Discuss why knowledge of anatomy is vital to appreciate the applications of imaging to medicine.
      4. Discuss the use of contrast: Barium, iodine, gadolinium.
  • Clinical skills: PREVENTATIVE CARE and HEALTH PROMOTION
    • Preventative care and Screening
      1. Describe the various definitions of prevention, health education, sexual health and health promotion
  • Clinical skills: INTERACTION WITH PATIENTS
    • Interacting with Patients - General
      1. Describe a model that identifies the tasks and stages in the consultation
      2. Identify factors that act as barriers and enablers to communication
      3. Discuss the role and value of attentive listening, rapport and empathy, different question styles and summarising
      4. Demonstrate appropriate non-verbal (eg body language) and verbal skills (eg use of silence, open and closed questions and summarising) to gather information
      5. Develop skills in observation, listening, information gathering, empathy and reflective learning
    • Cultural Issues
      1. Discuss variation in social relations and the effect on communication with health-care workers
      2. Identify potential effects of culture, age, gender, ethnicity, religion, socio-economic status and environment on communication.
      3. Discuss how health beliefs affect interactions with health-care workers and services
      4. Recognise the importance of not making assumptions.
      5. Discuss the role of health advocates in overcoming barriers to communication and enabling access to health-care
      6. Develop skills in listening, information gathering, empathy and respect.
    • Non-verbal Communication
      1. Describe the importance of non-verbal communication and body language in medical encounters
  • Professional issues: LEARNING
    • Using Information Technology (I.T.)
      1. Explain why you would search a database
      2. Know the difference between a citation, abstract and full text
      3. Know how to use internet searches to identify and explore health-related websites to identify current national guidelines relating to diabetes and obesity
      4. Know the structure of a bibliographic citation: author; title; source; pagination; year of publication
      5. Be able to find and know the usefulness of a Library Database list
      6. Understand authentication (ie ATHENS personal usernames and passwords)
      7. Know the availability of three major databases for medics; have ability to find answers to problems eg using Medline, PubMed, Web of Science, Cochrane, NeLH
      8. Know how to use author, journal and subject facility; be able to apply Boolean oerators to search strategy AND/OR; be able to apply limits to search results; be able to combine search strategies
      9. Demonstrate the ability within the Web of Science, to use cited reference searching
      10. Be able to display and email search results within a database
    • Attitudes to Learning
      1. Be able to give examples of what is and is not plagiarism; know the consequences of plagiarising and implement procedures to avoid plagiarising
  • Professional issues: MEDICAL PROFESSIONALISM
    • General Outcomes for Medical Professionalism
      1. Specify why the privileges associated with being a medical student carry with them the responsibility to respect the rights and dignity of patients
  • Professional issues: ETHICS and LAW
    • Confidentiality
      1. Evaluate the importance of privacy in personal life, and why this might entail a right to confidentiality
      2. Outline why respect for confidentiality is such an important component of successful clinical relationships and of the key tenets policy.
      3. Describe the specific duties of medical students as regards confidentiality, and typical dangers of breaching it.
      4. Discuss arguments for and against the belief that confidentiality should be broken in the public interests, including the confidentiality of the clinical relationship
    • Informed Consent
      1. Explain why obtaining consent is an integral part of successful clinical relationships and the key tenets of GMC policy
      2. Differentiate between explicit and applied consent, indicating when each is important
• General Outcomes for Community Care
  • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH
    • General Outcomes for Public Health
      1. List the overall aims and objectives of the year 1 Medicine in society course and describe the process by which they will be assessed
      2. Recognise that health promotion and public health measures have an impact on the health of the population.
• Bronchiectasis and Cystic Fibrosis (Priority 3)
  • General
    1. Cystic Fibrosis, Pseudomonas Aeruginosa, Staphylococcus Aureus, Physiotherapy, Ciproflaxacin, Flucloxacilin, DNAase, CFTR

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