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 4 I&I 4: HIV & Sexual Health

• Dr Claudia Estcourt
• c.s.estcourt@qmul.ac.uk

Introduction

The aims of the HIV and Sexual Health Module are to: Help students to develop a sensitive, non-judgemental attitude to people (patients) regardless of their race, gender and sexual preference and the student’s own personal prejudices

Equip all graduating doctors to function effectively as a potential Level 1 Provider of sexual health care (National Strategy for Sexual Health and HIV, 2001) as a minimum.

Enthuse students to pursue further learning in sexual health eg by additional optional sexual health modules

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Index

• General Outcomes for Sexual Health & HIV
• Contraception
• Therapeutics in O&G
• Sexually Transmitted Infections and Pelvic Inflammatory Disease
• HIV Infection
• Genital Discharge
• Genital Ulcers and Lumps
• Pelvic Pain
• Testicular Pain

• General Outcomes for Sexual Health & HIV
  • Medical knowledge: MICROBIOLOGY and INFECTION
    • Sexually Transmitted Infections - General
      1. Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum,
      2. Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei
      3. Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis
    • General Outcomes for HIV and AIDS
      1. To be able to explain pathogenesis of HIV
    • Metabolic and Immunological Consequences of Infection
      1. Understand the relationship between HHV8, EBV and HPV in the aetiology of malignancy
  • Medical knowledge: CLINICAL FEATURES of DISEASE
    • General Outcomes for Sexually Transmitted Diseases
      1. To recognise common presentations of patients with psychosexual factors affecting sexual function and / or relationships and know where to refer them.
      2. Recognise the clinical presentations of Bechetís disease
    • Sexual Assault
      1. To know where to refer patients who have been possible survivors of sexual assault
      2. Understand the management of male and female victims of sexual assault
      3. To identify symptoms and presentations that may indicate that patients have been survivors of sexual assault
  • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH
    • HIV/AIDS and Sexually Transmitted Infections
      1. To understand the ways in which Sexual Health services are different from general medical services, including access issues and public health role
      2. To identify opportunities for sexual health promotion including opportunities for early diagnosis of HIV in related and unrelated medical contexts
  • Medical knowledge: PSYCHOLOGY
    • General Issues
      1. To appreciate how sexual wellbeing and ill health, with reference to HIV and other STIs, impact on the individual and how that may impact on psychological and physical health and recognise and describe to patients the psychological interventions available
  • Clinical skills: HISTORY and EXAMINATION
    • General
      1. Be able to obtain an appropriate sexual history, to assess risk for sexually transmitted infections and pregnancy and to communicate this risk to individual patients in a sensitive, non-judgemental manner
  • Clinical skills: DIAGNOSIS and REASONING
    • General Outcomes for Sexual Health Diagnosis
      1. Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum,
      2. Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei
      3. Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis
  • Clinical skills: PATIENT MANAGEMENT
    • Management Sexual Health Disorders (Inc. HIV) - General
      1. To manage under supervision the following medical conditions which are not immediately life threatening but which require early treatment: female lower abdominal pain, genital ulceration / discharge / lumps, testicular pain
      2. Understand the management of psychosexual disorders in male and female patients.
  • Clinical skills: PHARMACOLOGICAL THERAPY
    • Pharmacological Therapy - Sexual Health (General)
      1. To understand the efficacy, side effects, drug interactions and contraindications of drugs used in the management of STIs
  • Clinical skills: PREVENTATIVE CARE and HEALTH PROMOTION
    • Preventative care and Screening
      1. To explain principles of safer sex and risk reduction and be able to demonstrate correct condom technique
  • Professional issues: ETHICS and LAW
    • Ethics and Obstetrics and Gynaecology
      1. To understand and practice legal responsibilities of health care workers who are HIV positive
      2. To understand and practise confidentiality and be aware of current legislation concerning confidentiality with particular reference to sexual and reproductive health & HIV medicine
• Contraception
  • General Outcomes for Contraception
    1. To manage under supervision or refer as appropriate the contraceptive needs of a client presenting with a medical condition which may contraindicate the method s/he is currently using.
    2. Be able to obtain a contraceptive and reproductive health history to assess contraceptive need and to discuss contraceptive choices to enable patients to make informed decisions on those choices
    3. To describe to a client methods of emergency contraception and indications and guidance for use
    4. To explain principles of safer sex and risk reduction and be able to demonstrate correct condom technique
    5. To demonstrate basic knowledge of currently available contraceptive methods and be able to communicate to clients the mechanism of action and failure rate
• Therapeutics in O&G
  • General outcomes for therapeutics in gynaecology
    1. To demonstrate basic knowledge of currently available contraceptive methods and be able to communicate to clients the mechanism of action and failure rate
• Sexually Transmitted Infections and Pelvic Inflammatory Disease
  • General Outcomes for Pelvic Pain and Infection
    1. Understand the pathogenesis, diagnosis and management of Pelvic Inflammatory Disease
• HIV Infection
  • Infections and Disorders Associated with HIV
    1. To recognise the presentations of HIV infected patients with Pneumocystis pneumonia, Candidiasis, Toxoplasmosis, Cryptococcosis, Tuberculosis, Cytomegalovirus, Kaposiís Sarcoma, Lymphoma, Hepatitis B and C
    2. Describe the spectrum of clinical problems associated with HIV infection: asymptomatic HIV infection, persistent generalised lymphadenopathy, symptomatic HIV infection and Acquired Immunodeficiency Syndrome
    3. List the opportunistic infections that commonly cause clinical disease in HIV infection
  • General Outcomes for HIV Infection
    1. Understand the pathogenesis, diagnosis, management and prevention of the following in the context of HIV: Pneumocystis jiroveci, Cryptococcus neoformans, Candidia albicans, Toxoplasma gondii, Cryptosporidium parvum, Mycobacterium tuberculosis, atypical My
    2. Demonstrate knowledge of the CDC classification system for HIV infection
    3. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case
    4. To describe principles of partner notification for STIs and HIV
    5. To recognise medical presentations of primary or established HIV infection
    6. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case
    7. To understand the basic epidemiology of STIs and HIV and public health issues for control of spread of infection locally and globally
    8. Understand the pathogenesis, diagnosis and management of HIV infection
    9. Describe the management of a person who has sustained a needlestick injury from a known HIV positive source
    10. Recognise the significance and list possible causes for the following symptoms in an HIV infected person: Generalised seizures, loss of vision, focal neurological deficit, change in affect, shortness of breath, rash
    11. To outline national screening programs relevant to sexual and reproductive health and HIV (currently cervical screening, Chlamydia screening and antenatal HIV testing)
    12. To assess risk of HIV transmission in individual presenting after occupational and non-occupational potential exposure to HIV
    13. Correlate the changes in the immune system at a cellular level with the clinical consequences for the patient with HIV infection
    14. To describe available Post Exposure Prophylaxis regimens for HIV and how best to access these regimens
    15. Describe the spectrum of clinical problems associated with HIV infection: asymptomatic HIV infection, persistent generalised lymphadenopathy, symptomatic HIV infection and Acquired Immunodeficiency Syndrome
    16. To understand and practise legal responsibilities relevant to sexual activity and sexual health and HIV care (e.g. issues of consent, disclosure, providing care for minors, people with learning difficulties, suspected abuse, rape)
    17. To be able to explain pathogenesis of HIV
    18. Understand the pathogenesis, diagnosis and management of the following in the context of HIV: Kaposi’s sarcoma, Non-Hodgkin’s B cell Lymphoma, Primary cerebral lymphoma, Burkitt’s lymphoma and squamous cell carcinoma
    19. Be able to engage in relevant HIV pre-test discussions to assess relative risk of infection and enable patients to make an informed decision on testing
    20. List the opportunistic infections that commonly cause clinical disease in HIV infection
  • Treatment of HIV Infection
    1. To manage under supervision or refer as appropriate the presentations of HIV positive patients with Pneumocystis pneumonia, Candidiasis, Toxoplasmosis, Cryptococcosis, Tuberculosis, Cytomegalovirus, Kaposi’s Sarcoma, Lymphoma, Hepatitis B and C
    2. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case
    3. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case
    4. Understand the pathogenesis, diagnosis and management of HIV infection
    5. To describe the basic principles of anti-HIV therapy, including major side-effects and interactions of therapy
    6. Explain the rationale for risk assessment and the use of antiretroviral agents for prophylaxis following sexual intercourse with a known or suspected HIV positive person
  • Malignancies Associated with HIV Infection
    1. To manage under supervision or refer as appropriate the presentations of HIV positive patients with Pneumocystis pneumonia, Candidiasis, Toxoplasmosis, Cryptococcosis, Tuberculosis, Cytomegalovirus, Kaposi’s Sarcoma, Lymphoma, Hepatitis B and C
    2. Explain why HIV infection predisposes to certain malignancies
    3. Understand the pathogenesis, diagnosis and management of the following in the context of HIV: Kaposi’s sarcoma, Non-Hodgkin’s B cell Lymphoma, Primary cerebral lymphoma, Burkitt’s lymphoma and squamous cell carcinoma
• Genital Discharge
  • General Outcomes for Genital Discharge
    1. List a differential diagnosis for a female patient presenting with vaginal and or rectal discharge
    2. List a differential diagnosis for a male patient presenting with urethral and or rectal discharge
• Genital Ulcers and Lumps
  • General Outcomes for Genital Ulcers and Lumps
    1. List a differential diagnosis for a male and female patient presenting with genital lumps
    2. List a differential diagnosis for a male and female patient presenting with genital ulceration
• Pelvic Pain
  • General Outcomes for Pelvic Pain
    1. List a differential diagnosis for a female patient presenting with acute and or chronic pelvic pain
  • Pelvic Inflammatory Disease (PID)
    1. Understand the pathogenesis, diagnosis and management of Pelvic Inflammatory Disease
• Testicular Pain
  • Testicular Torsion
    1. Describe the presenting features and referral pathway for testicular torsion
  • General Outcomes for Testicular Pain
    1. List a differential diagnosis for a patient presenting with acute or chronic testicular pain
  • Epididymitis
    1. Understand the pathogenesis, diagnosis and management of epididymitis

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