Specialties

• WHOLE PERSON
  • The Whole Person
  • The Medical Patient
  • The Surgical Patient
  • The Community Patient
• CARDIORESPIRATORY
  • Cardiovascular System
  • Respiratory System
  • Haematology
• METABOLISM
  • Gastrointestinal System
  • Renal and Urinary System
  • Endocrine System
• HUMAN DEVELOPMENT
  • Obstetrics and Gynaecology
  • Child Health
  • Sexual Health and HIV
• BRAIN AND BEHAVIOUR
  • Neuroscience
  • Psychiatry
  • Ophthalmology
  • Head and Neck (ENT)
• LOCOMOTOR
  • Musculoskeletal System
  • Health Care of the Elderly
  • Dermatology

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WHOLE PERSON: The Whole Person

Index

• General Outcomes for the Whole Person

• General Outcomes for the Whole Person
  • Medical knowledge: ANATOMY
    • General Outcomes for Embryology
      1. Understand the difference between embryonic and fetal periods of development and the clinical significance to organ development and growth (11/12 Arch)
      2. Describe the major developmental steps of the human embryo between the time of implantation and 8-weeks gestation including the development of the face and heart (HD1)
      3. Know the highlights of Week 4 including closure of the neural tube, folding of the embryo, the pharyngeal arches and the beginnings of the limbs (11/12 Arch)
      4. Identify the major structures which are unique to the development of the embryo (HD1)
      5. Know the highlights of week 5 including the growth of the head, heart and kidneys (11/12 Arch)
      6. Know the highlights of week 6 including progress of the development of the limbs and the heart and start of spontaneous movements (11/12 Arch)
      7. Know the highlights of week 7 including the importance of cell death to shape the limbs and face and the growth and development of the gut (11/12 Arch)
      8. Know the highlights of week 8 including bone formation and more of the development of the gut (11/12 Arch)
    • Male Pelvis and Reproductive System
      1. Outline the development of the reproductive system (11/12 Arch)
      2. Describe the descent of the testes and the development of the inguinal canal (11/12 Arch)
      3. Describe the micro-anatomy of the internal genitalia (HD1)
      4. Identify the major structures (external and internal) of the male pelvis; describe the functional anatomical relationships between these structures (11/12 Arch)
    • Female Pelvis and Reproductive System
      1. Outline the development of the reproductive system (11/12 Arch)
      2. Identify the major structures (external and internal) of the female pelvis; describe the functional anatomical relationships between these structures (11/12 Arch)
      3. Describe the micro-anatomy of the internal genitalia (HD1)
      4. Understand pelvic measurements used in obstetrics (HD1)
      5. Understand the structure of female reproductive organs (11/12 Arch)
    • Bones, Muscles and Ligaments of the Pelvis
      1. Understand the structure of the bony pelvis and its ligaments (HD1)
      2. Identify the individual bones of the pelvis (11/12 Arch)
      3. Describe the walls of the pelvic cavity (HD1)
      4. Describe the main ligamentous attachments of the bony pelvis (11/12 Arch)
      5. Indicate the relationship of the foramina and notches to the passage of nerves, blood vessels and muscles (11/12 Arch)
      6. Describe the pelvic diaphragm (HD1)
      7. Outline the consequences of injuries to the pelvic floor leading to prolapse of the pelvic viscera (HD1)
    • Pelvic Viscera and Perineum
      1. Have knowledge of the organs of the pelvis (HD1)
      2. Describe the anatomy of the anal triangle (HD1)
      3. Describe the urogenital triangle and its pouches (HD1)
      4. Understand the structure of the pelvic viscera in the male (11/12 Arch)
      5. Describe the contents of the perineal pouches in the male and female (HD1)
    • Surface Anatomy of the Pelvis
      1. Recognise the main differences between the male and female pelvis (11/12 Arch)
    • Renal System and Urinary Tract
      1. Understand the descent of the ureters through the pelvis and the position of the bladder and urethra in the male and female (11/12 Arch)
    • Surface Anatomy - General
      1. Be able to describe basic surface anatomy, especially that relevant to general clinical examination and diagnosis
      2. Describe the body's organ systems and their location and relationship to the body's surface and skeleton (FM1)
      3. Be able to describe the body's organ systems, and their location and relationship to the body's surface and skeleton
      4. Describe basic surface anatomy especially that relevant to general clinical examination and diagnosis (FM1)
    • Muscles, Nerves and Connective Tissue
      1. Recognise the different types of connective tissue in photomicrographs (FM1, GEP/M&P)
      2. Identify common cell types found in connective tissues (FM1)
      3. Recognise nervous tissue and be able to distinguish neural and glial components (FM1)
      4. Understand differences in the make-up of the extracellular matrix between various connective tissues and how types are differently organised (FM1)
      5. Show understanding of how different cell types within nervous tissue and the organisation of the tissue contribute to its functions (FM1)
      6. Relate organisation of different types of connective tissue to their function (FM1)
      7. Recognise different types of muscle and different components of muscle tissue in photomicrographs (FM1, GEP/M&P)
    • Anatomical Positions, Planes and Movements
      1. Know the accepted anatomical language with regard to anatomical planes
      2. Understand the following anatomical planes: Axial; Transverse; Horizontal; Sagittal; Coronal (BB1, GEP/BB)
      3. Use the basic language of anatomical directions and movements (superior, inferior, anterior, posterior, proximal, distal, pronation etc) (FM1)
      4. Understand and use the basic language of anatomical directions and movements (superior, inferior, anterior, posterior, proximal, distal etc)
    • Epithelia and Glands
      1. Recognise the various epithelial cell types in photomicrographs and predict their function from their structure (FM1, GEP/M&P)
      2. Recognise glandular tissue in photomicrographs, identify the gland type and its likely function (FM1, GEP/M&P)
      3. 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 (FM1)
      4. Recognise the basement membrane and list its functions (FM1, GEP/M&P)
      5. Recognise the mucous and serous membranes in photomicrographs and be able to identify different structural components found in each of these complex tissues (FM1)
    • Bones and Joints
      1. Classify the different types of joints (FM1)
    • The Pectoral Region, Breasts and Mammary Glands
      1. Describe the anatomy and micro-anatomy of the breast (11/12 Arch)
      2. Describe the development of the breast at puberty (11/12 Arch)
    • Anatomy of the Nervous System - General
      1. Relate CNS anatomy to structures viewed in MRI, CT and X-Rays (BB1, GEP/BB)
  • Medical knowledge: PHYSIOLOGY
    • Neuropharmacology
      1. Be able to explain how neurotransmitters can produce electrical changes by activating / inhibiting receptors in the post-synaptic cell (FM1)
      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 (FM1)
      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 (FM1)
      4. Describe the major neurotransmitter systems in the central and peripheral nervous systems (FM1)
      5. Describe the role of protein kinases in transmitting the intracellular effects of second messengers (FM1)
      6. Explain how an action potential is initiated by the summation of synaptic inputs (FM1)
    • General Outcomes for Nervous System Physiology
      1. What are the membrane properties essential for excitability? Including an introduction to resting and action potentials and voltage-gated ion channels (FM1)
      2. Be able to describe the biophysical requirements for action potentials to take place (FM1)
      3. Describe how sensory nerve endings transduce and encode stimuli with examples including peripheral stretch (mechano) and thermoreceptors (FM1)
      4. Why everything depends on the Na-pump (FM1)
      5. Be able to discuss the principle characteristics of an action potential (FM1)
      6. Explain the effects of nerve fibre diameter and myelination on conduction velocity (FM1)
      7. Have an understanding of the importance of saltatory nerve conduction for activities of daily life (FM1)
      8. What is the basic mechanism of local anaesthetics (an example of pharmacological manipulation of excitability) (FM1)
      9. 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 (FM1)
      10. Describe a synapse and the role of both excitatory and inhibitory neurotransmitters with examples (FM1)
      11. Why is pre-synaptic Ca2+ important? (FM1)
      12. Understand the concept of a ligand-gated receptor (FM1)
    • Autonomic Nervous System
      1. Compare and contrast the SNS with the autonomic nervous system (ANS) (FM1)
      2. Draw labelled diagrams to show the general arrangement of motor and somatic reflexes (FM1)
      3. Name the divisions of the ANS, and describe the segmental organisation of the sympathetic and parasympathetic nervous systems (FM1)
      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 (FM1)
      5. Describe how the adrenal medulla acts as a modified post-ganglionic cell (FM1)
      6. Briefly describe how the enteric nervous system can control gut function (FM1)
    • Homeostasis
      1. Be able to apply the principles of homeostasis to one human physiological system - body temperature; blood glucose concentration; body fluid volume (FM1)
      2. Be able to define homeostasis in relation to the physiological systems (FM1)
      3. Be able to discuss the contribution of negative feedback, positive feedback and positive feed-forward to the process of body homeostasis (FM1)
    • Acid-Base Balance
      1. Be able to define the term buffer system and explain how it resists changes in pH (FM1)
      2. Be able to state the normal pH and hydrogen concentration of human blood plasma and the ranges compatible with life (FM1)
      3. Be able to cite a common clinical example of acid-base becoming unbalanced (FM1)
    • Body Fluids
      1. Be able to describe how water and ions enter and leave the body in a controlled way (FM1)
      2. Be able to describe the process of osmosis and distinguish between exudates and transudates (FM1)
      3. Be able to discuss the contributions of ion pumps to cellular function (FM1)
    • Gastrointestinal Physiology - General
      1. Analyse how the gut handles carbohydrate (FM1)
      2. Describe the hormonal control of blood glucose (FM1)
    • Function of the GI Tract
      1. Distinguish between the handling of simple and complex carbohydrates (FM1)
    • Male Reproductive Physiology
      1. Describe the normal process of oogenesis and spermatogenesis (11/12 Arch)
    • Female Reproductive Physiology
      1. Describe the normal process of oogenesis and spermatogenesis (11/12 Arch)
      2. Understand the normal process of ovulation (HD1)
      3. Outline how normal menstrual function is related to conception (HD1)
      4. Understand that ovarian and menstrual cycles are closely linked (HD1)
    • Physiology of Growth and Puberty
      1. Describe the regulation of normal growth (HD1)
      2. Understand the normal physiological and anatomical changes at puberty (HD1)
      3. Identify the stages of puberty in boys and girls (HD1)
      4. Understand the relationships between growth and the onset of puberty (HD1)
      5. Understand the techniques of measuring children of all ages and be able to plot and interpret measurements on a growth chart (HD1)
      6. Understand the biological features influencing normal growth patterns (HD1)
    • The Hormones of Reproduction
      1. Understand the use of antibodies in analytical methods (HD1)
      2. Understand the principles of sensitivity and specificity of analytical methods (HD1)
      3. Recognise testing anomalies (HD1)
      4. Explain the importance of the structure of glycoproteins (HD1)
      5. Outline the role of the main glycoproteins involved in reproductive physiology incuding maternal recognition and maintainance of pregnancy (HD1)
      6. Understand the changes in levels of the main glycoproteins at the menopause (11/12 Arch)
      7. Recognise that molecules can be produced ectopically (HD1)
    • Muscle Function and the Neuromuscular Junction
      1. Know the anatomy, physiology and pharmacology relating to the neuromuscular junction (LOC1)
    • Adaptation of Fetus to Neonate - General
      1. Understand the circulatory changes at birth and the neonatal transitional circulation (HD1)
      2. Understand the changes in pulmonary physiology at birth (HD1)
      3. Describe the basic metabolic adaptations which take place in the neonate (HD1)
    • Physiology of Ageing - General
      1. Outline the patterns of body and organ growth during normal human development (11/12 Arch)
      2. Explain how age, metabolic rate, weight and surface area change during normal human development (11/12 Arch)
      3. Briefly outline the patterns of disease noted in human development and diseases of premature ageing (11/12 Arch)
    • Labour, Delivery and Puerperium (inc. Lactation)
      1. Describe the nature and control of processes associated with lactation (11/12 Arch)
    • Physiology of Pregnancy - General
      1. Describe the physiological changes in preparation for lactation (HD1)
  • Medical knowledge: BIOCHEMISTRY (inc. Metabolism)
    • Biochemistry - General
      1. Be able to define and describe with examples, the volume of distribution, clearance and elimination half life (GEP/BB)
      2. To define and explain drug absorption (GEP/BB)
  • Medical knowledge: CELL BIOLOGY
    • Sugars and Polysaccharides
      1. Distinguish between the terms monosaccharide, disaccharide and polysaccharide and name a physiologically important example of each group (FM1)
      2. Define the terms: glycosidic bond; sugar esterification (phosphates + sulphates); amino sugar, giving a physiologically relevant example of each one (FM1)
      3. Define the mechanism and biological importance of protein glycosylation (FM1)
      4. Outline the structures and biological roles of glycogen, heparin, proteoglycan and bacterial lipo-polysaccharide (FM1)
    • Membrane Function
      1. Understand the functions of biological membranes and associated proteins including adhesion, transport and communication (FM1)
      2. Be able to describe the function of membrane proteins (FM1)
      3. Distinguish between passive diffusion, facilitated diffusion, secondary active transport, and active transport giving examples of each in human tissues (FM1)
      4. Relate specialisations of the plasma membrane to its function (FM1)
      5. Describe how deficiencies in folding, trafficking and function of the CFTR protein cause cystic fibrosis (FM1)
    • 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 (FM1)
      2. Outline the common structural features of the amino-acids and the roles of their side chains in protein structure and function (FM1)
      3. Describe the structure of proteins and the stabilising forces of the a-helix, b-pleated sheet and collagen triple helix (FM1)
      4. Comprehend the problems of protein folding in vivo and the role of molecular chaperones in dealing with this (FM1)
      5. Explain how post translational modifications can be important for stability and modulation of function (FM1)
    • Enzymes
      1. Define the following terms in relation to enzyme catalysis: substrate specificity; active site; activation energy; cofactor and co-enzyme; proenzyme (FM1)
      2. Explain by reference to the Michaelis-Menten equation how the rate of enzyme catalysed reaction depends on enzyme concentration and substrate concentration (FM1)
      3. Enzyme activity assays (FM1)
      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 (FM1)
      5. Define the term isoenzymes and their value in diagnostic enzymology (FM1)
    • Lipids and Membranes
      1. Understand the architecture and components of the currently accepted view of biological membranes (FM1)
      2. Describe the general structural features, properties and biological roles of triglycerides (triacylglycerols); phospholipids; glycolipids; cholesterol and steroids (FM1)
      3. Distinguish between essential and non-essential fatty acids (FM1)
      4. Relate the lipid and protein composition of biological membranes to the membrane's properties (FM1)
    • Biological Energy
      1. Define the principal energy stores in human cells (FM1)
      2. Describe the principal biological roles of ATP in relation to biosynthesis reactions, transport and motility (FM1)
      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 (FM1)
      4. Explain the significance of B-group vitamins in terms of coenzyme structure and function (FM1)
    • Cell and Tissue Structure
      1. Identify the organelles and ultrastructural features of cells; describe organisation and functions of the following and, where applicable, relate to human disease (FM1)
      2. Understand the functions of the principal components of the extracellular matrix and relate to cell function and disease (FM1)
      3. nucleus; mitochondrion; endoplasmic reticulum (rough and smooth); Golgi complex; lyosomes; peroxisomes; cytoskeleton; plasma membrane (FM1)
      4. 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 (FM1)
      5. Relate the specialised structure of the cell surface (microvilli, cilia, pseudopodia) to the functions of the tissues and cells concerned (FM1)
    • Cell Differentiation and Cell Death
      1. Define programmed cell death (FM1)
      2. Visualisation of cell behaviour including movement, cell division and death (FM1)
      3. Explain the difference between stem cells and differentiated cells (FM1)
      4. Describe the role of stem cells in cancer (FM1)
      5. Explain the changes that occur with ageing at the cellular and tissue levels (FM1)
  • Medical knowledge: MOLECULAR BIOLOGY and GENETICS
    • RNA Structure and Synthesis
      1. Describe the Central Dogma and the basic structure of a gene (FM1)
      2. Describe the process of transcription and explain the function of RNA polymerase (FM1)
      3. Explain what a promoter is and its role in transcription (FM1)
      4. How is RNA modified before leaving the nucleus? (FM1)
      5. Describe the different types of RNA and their role in translation (FM1)
      6. Describe how antibiotics can interfere in the process of transcription (FM1)
    • DNA Structure and Synthesis
      1. Describe, using simple diagrams, the structure of DNA and its organisation into nucleosomes and chromatin (FM1)
      2. Describe the organisation of human genes, both internally and into gene families (FM1)
      3. Outline the mechanism of DNA synthesis (replication) and describe how some antibiotics interfere in this process (FM1)
      4. Explain the very low level of mistakes in the DNA replication process (FM1)
      5. Outline methods of DNA repair, with an example of the clinical consequence of a defective repair mechanism (FM1)
    • Forensic Molecular Pathology
      1. Appreciate the difference in requirements when analysing DNA for medical and criminal justice purposes (FM1)
      2. Gain an understanding of what is meant by a DNA Profile (FM1)
      3. Learn about how different parts of the human genome provide molecular tools that are used for intelligence and crime-fighting purposes (FM1)
    • Cell Division and its Control
      1. Describe the main features of the cell cycle (FM1)
      2. Describe the main mechanisms and biological functions of mitosis and meiosis (FM1)
      3. Discuss the role of genes in co-ordinating the cell cycle (FM1)
      4. Give examples of human diseases associated with mutations in these genes (FM1)
      5. Explain how some chemotherapeutic drugs may inhibit cell division in cancer cells (FM1)
    • Protein Synthesis
      1. Outline the key features of the genetic code (FM1)
      2. What are the essential RNA species for translation (FM1)
      3. Describe the events and regulation in the ribosome cycle of protein synthesis (FM1)
      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) (FM1)
      5. How does viral and bacterial interference effect protein translation (FM1)
      6. Know that antibiotics are used to target ribosomes (FM1)
      7. Outline protein synthesis defects in inherited disease (FM1)
    • Control of Gene Expression
      1. Understand the basic processes involved in eukaryotic gene expression (11/12 Arch)
      2. Describe, with examples, the various levels at which eukaryotic gene expression can be controlled (11/12 Arch)
      3. Discuss the interaction of protein factors and DNA regulatory elements in the control of transcription in eukaryotic cells (11/12 Arch)
      4. Know how drugs / hormones can influence gene expression (11/12 Arch)
    • The Human Genome
      1. Describe in outline the structure and organisation of the human genome (FM1)
      2. Understand the differences between coding and non-coding the DNA-sequences, introns and exons, pseudogenes, control elements and repetitive sequences (FM1)
      3. Compare the different ways in which we can access the human genome (FM1)
    • Genetic Variation
      1. Define the terms rare and polymorphic genetic variation (FM1)
      2. Discuss how DNA polymorphisms can be detected and how they may be used to identify individuals (FM1)
      3. Understand the basic principles of population genetics with reference to allele frequencies and the Hardy-Weinberg equilibrium (FM1)
      4. Explain how genetic variation contributes to common disease (FM1)
    • Genetics of Antibiotic Resistance
      1. Be able to describe the key features of plasmids, insertion sequences, transposons and integrons and understand their role in mobility of antibiotic resistance genes. (CSP3)
      2. Be able to understand the differences between bacterial and eukaryotic genes (CSP3)
      3. Be able to outline the mechanism of transfer of DNA between bacterial cells; conjungation, transformation and transduction (CSP3)
      4. Know the major biochemical mechanisms of resistance - destruction of drug, modification of drug, drug impermeability or efflux, target modification, target bypass (CSP3)
      5. Understand that resistance can disseminate by spread of resistant strains, spread of mobile genetic elements and spread of resistance genes (CSP3)
      6. Understand the potential sources of antibiotic resistance genes and the significance of horizontal gene transfer in the evolution and spread of antibiotic resistance among pathogenic bacteria (CSP3)
    • Genetics of Autoimmune Disease
      1. Understand how genetic risk variants predisposing to human disease can be identified (CSP3)
      2. Understand the spectrum of risk variants (common, rare, SNPs, structural variants) (CSP3)
      3. Understand risk variants for selected chronic immune disease eg Type 1 Diabetes, Coeliac Disease, Crohn's Disease (CSP3)
      4. Role of HLA variants and immune disease risk: coeliac disease, ankylosing spondylitis as examples (CSP3)
      5. Role of new technologies: exome and whole genome sequencing. (CSP3)
      6. Taking risk variants forward for patient benefit: diagnosis, prognosis, new therapeutics (CSP3)
    • Genetics - General Outcomes
      1. PCR and its uses in pre-natal diagnosis / pre-implantation genetic diagnosis (FM1)
      2. How is pre-natal diagnosis and PGD performed (11/12 Arch)
      3. Evaluate the contribution of genetic and environmental factors to normal human variation and to disease (FM1)
      4. To be able to define the differences between monogenic and complex genetic diseases (CSP3)
      5. To have some knowledge of the methods used to map genes causing complex genetic diseases, for example the basics of linkage analyses and association studies (CSP3)
      6. Describe the basic principles of Mendelian inheritance and understand the difference between monogenic, multigenic and multifactorial disorders (FM1)
      7. Evaluate the likelihood of genotype specific drugs / therapies (11/12 Arch)
      8. Use of high density single nucelotide polymorphism (SNP) arrays of disease gene mapping and cancer diagnostics (FM1)
      9. Understand the role of cytogenetics and molecular genetics in clinical diagnosis (FM1)
      10. To know some examples of complex gene traits where new genes have been mapped and what has been found and why it is important (CSP3)
      11. Think about the ethical issues with respect to personal genome sequencing (11/12 Arch)
      12. Old and new sequencing: how to sequence your genome for £2000 (FM1)
    • Epigenetics
      1. Define the term epigenetics (FM1)
      2. Describe the role of epigenetic markers in controlling gene expression (FM1)
      3. Understand the extent to which epigenetics impacts on human disease (FM1)
    • Chromosomal Genetics
      1. Describe the normal human karyotype and common methods used to identify individual chromosomes; explain benign copy-number-variation (11/12 Arch)
      2. Define the terms used to denote variation in chromosome number: haploid, diploid, polyploid, aneuploid, monosomy, trisomy; list common aneuploidy syndromes, incidence, clinical picture and methods for pre-natal diagnosis (11/12 Arch)
      3. Explain the three causes of Down's syndrome phenotype: classical trisomy 21; 14:21 Robertsonian translocation and somatic mosaicism (11/12 Arch)
      4. Define the terms used to denote variation in chromosome structure: deletion; duplication; inversion; translocation; ring chromosome. Explain the importance of acquired chromosomal changes in cancer (11/12 Arch)
      5. Define the functions of the X and Y chromosomes and the significance of Lyonisation in females (11/12 Arch)
    • The Genome and Drug Discovery
      1. Be able to describe the main approaches and tools used to identify genes for common disease and drug response and safety (CSP3)
      2. Be able to give some examples of where genetic makeup affects drug effectiveness and safety; understand how this may contribute to drug discover (CSP3)
      3. Understand some of the ethical issues around genetic data and potential risks to the individual (CSP3)
    • 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 (FM1)
      2. Describe, with examples, the different patterns of inheritance of single gene disorders (FM1)
      3. Describe the different types of gene mutation and their consequences (FM1)
      4. Describe how mutations in different genes can result in the same clinical disorder (FM1)
  • Medical knowledge: PATHOLOGY
    • General Pathology
      1. The graduate will be able to apply to medical practice biomedical scientific principles, method and knowledge relating to: (click to see list) (YR5intro)
      2. Describe how the basic tissue types are organised in the skin and the colon (FM1)
      3. Describe the types of investigations that can provide tissue for histological analysis, and discuss the clinical value of such analysis (FM1, GEP/M&P)
      4. Describe the morphological changes undergone by cancer cells as seen in a photomicrograph (FM1, GEP/M&P)
  • Medical knowledge: CANCER
    • Neoplasia
      1. Describe the principles of cancer diagnosis and the classification of malignant neoplasms (CSP3)
      2. Revise the principles behind the classification of malignant neoplasms (FM1)
      3. Define the terms: tumour, neoplasm, benign, malignant, histogenesis, differentiation, metastasis (FM1)
      4. Describe the behaviour and pathological features of malignant neoplasms (FM1)
      5. Give a brief classification of benign and malignant neoplasms according to their cell of origin (FM1)
      6. Classify common malignant neoplasms according to their cell of origin (CSP3)
      7. Describe the behaviour and pathological characteristics of malignant neoplasms (CSP3)
      8. Name the aetiological agents that have been linked to the development of some malignant neoplasms (FM1)
      9. Compare and contrast the pathological features of benign and malignant neoplasms (FM1)
      10. Describe the effects of a neoplasm on the host (FM1)
      11. Define the term Paraneoplastic Syndrome and give some examples (FM1)
    • Cancer and Genetic Disease
      1. Discuss the types of genetic changes that occur during cancer development (FM1)
      2. Account for the fact that cancer risk can be inherited (FM1)
      3. Define a tumour suppressor gene and an oncogene (FM1)
  • Medical knowledge: IMMUNOLOGY and INFLAMMATION
    • The Immune Response in Health
      1. Know that many pathogens invade the spaces between cells eg extra-cellular bacteria (FM1)
      2. List the physical defence barrier components of the innate immune system (skin etc), and link them with the mechanisms by which they are breached (CSP3)
      3. Know how bacteria are eliminated using the humoral immune response (FM1)
      4. Know what an antibody is (FM1)
      5. Know how phagocytes (eg neutrophils) interplay with antibodies (FM1)
      6. Understand complement and know its function (FM1)
    • Immunology - General Outcomes
      1. Indicate the development of the immune system, including the function of lymphocytes (HD1)
      2. Understand that immunology is related to disease including infections, autoimmunity and allergy (hypersensitivity) (FM1)
      3. Understand cytokines and their function (FM1)
      4. 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 (FM1)
      5. 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 (FM1)
      6. Know that the immune system is an agent of harm in the modern age (FM1)
      7. Appreciate that communication between cells is critical (FM1)
      8. Explain the immunological processes enabling protection against disease to take place (HD1)
      9. Realise the importance of long term immunological memory (FM1)
    • Recognition and Response to Antigens
      1. Understand that some pathogens live inside cells - this includes all viruses, or bacteria such as TB (FM1)
      2. What is an antigen? (FM1)
      3. List the cellular components of the innate immune system: macrophages / monocytes; neutrophils; eosinophils; basophils / mast cells; and link them with their antigen T receptors (where known: TLRs, NOD) (CSP3)
      4. How are these eliminated by the cell-mediated immune response including macrophages, cytotoxic T cells, NK cells and yd cells (FM1)
      5. Know how the immune system recognises antigens (FM1)
      6. State how phagocytes move and kill (together with defects), and state the structures and molecules that they interact with: endothelial cells, adhesion molecules, matrix (CSP3)
      7. What is the MHC and its role in presenting antigens in a form that T cells can see. (FM1)
      8. Introduce the idea that TCRs and BCRs are made with random antigen recognition capacities (FM1)
      9. List the cells of the adaptive immune system (B-cells, different kinds of T-cells etc), and state the roles they play. List the different classes of antibody (CSP3)
      10. Distinguish between Th1 and Th2 responses and list the cytokines involved in each stating the cells that secrete them (CSP3)
      11. Delineate the mechanism of septic shock (CSP3)
    • Communication between Immune Cells and Tissues
      1. Know that Th1 cells drive cell-mediated immunity (FM1)
      2. Know that Th2 cells drive humoral immunity (FM1)
      3. Know that Th17 cells drive responses to extracellular bacteria (FM1)
      4. Know that T-reg cells retrain immune responses (FM1)
      5. Know that memory T-cells remember our infection history (FM1)
      6. Appreciate that CD4 or helper T-cells orchestrate adaptive immun responses (FM1)
  • Medical knowledge: MICROBIOLOGY and INFECTION
    • General Outcomes for Microbiology
      1. Be able to distinguish between the different groups of pathogens (FM1)
      2. List the basic characteristics of viruses and the criteria by which they are classfied (FM1)
      3. Outline the structure of bacteria, emphasising differences from eukaryotic cells (FM1)
      4. Describe the structure of viruses, defining the terms: capsid; capsomeres; genome; nucleocapsid, envelope (FM1)
      5. Describe how bacteria can be classified on the basis of staining properties and morphology (FM1)
      6. Describe how viruses replicate (FM1)
      7. List those parts of the body which should be sterile and those which have a normal flora (FM1)
    • Pathogenesis
      1. Describe portals of entry of pathogens and their adherence mechanisms (FM1)
      2. Discuss major infectious disease problems; case studies of bacteria; lessons from history (public health, pathology, pathogenesis)
      3. For viruses, list their mechanisms of persistence, and explain their harmful effects (killing cells, alter functions of cells, giant cell formation, malignant change, hypersensitivity) (FM1)
      4. 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) (FM1)
      5. Describe how pathogens are disseminated through host organs and how they exit from the host (FM1)
    • Retroviruses
      1. List the three sets of genes in retroviruses (Gag, Pol, Env), their order and what they encode (CSP3)
      2. Draw the retroviral life cycle, naming the enzymes involved (CSP3)
      3. List the retroviruses that cause disease in humans and the diseases they cause (CSP3)
      4. Account for HTLV1 causation of Adult T-cell Leukaemia and Myelopathy, including Tax gene; describe these conditions and their treatment (CSP3)
      5. Describe Human Endogenous Retroviruses (CSP3)
    • Antivirals and Viral Infections
      1. Know the concept of inhibition of virus specific enzymatic activities (FM1)
      2. List the stages in the viral replication cycle from virus entry into the cell to virus release (CSP3)
      3. How to inhibit cellular factors important for virus replication (FM1)
      4. What are the treatment strategies and side effects (FM1)
      5. List the drugs that can inhibit each stage of the viral life cycle (CSP3)
      6. List the stages of the influenza life cycle that can be inhibited by drugs and the drugs concerned (CSP3)
    • Antimicrobials and Bacterial Infections
      1. Describe the principle of selective toxicity (FM1)
      2. Describe the structure and function of targets in microbes that differ from their counterparts in the host (FM1)
      3. Discuss mechanisms and implications of microbial resistance (FM1)
    • Terminology used in Microbiology
      1. Be familiar with terminology relating to helminth and protozoal diseases
      2. Define the terms pathogen; commensal; opportunistic pathogen; carriage; colonisation resistance; virulence (FM1)
    • Sources of Infection and Routes of Transmission
      1. Define the terms: incidence; prevalence; endemic; epidemic; pandemic (FM1)
      2. Discuss how pathogens are transmitted (FM1)
      3. Discuss the significance, in terms of resistance to infectious diseases, of herd immunity, methods of control and immunisation (FM1)
    • General Outcomes for HIV and AIDS
      1. List the phases of the HIV replication cycle that can be inhibited by drug treatment (CSP3)
  • Medical knowledge: CLINICAL FEATURES of DISEASE
    • Tropical Haematological Disorders
      1. Know the common presentations of neglected tropical disease: viral, protozoal, helminth and bacterial
  • 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 (FM1)
      2. Focus main learning about drugs ie pharmacology / prescribing (BRAINS&AIMS) around the top 100 Drugs you are most likely to prescribe as a junior doctor (11/12 Arch)
      3. Recall and describe what BRAINS&AIMS stands for and use the format when presenting a drug.
      4. Learn about key features of other drugs eg interesting mechanisms that help understand underlying physiology; dangerous drugs that may have been prescribed by someone else and affect your patients (11/12 Arch)
      5. Keep a portfolio of all the drugs you have learnt about / seen being used in a patient; it takes a long time to build up a good knowledge base so start now and keep revising and building; accept minor modifications if the list changes over time (11/12 Arch)
      6. Understand the principles of prescribing (CSP3)
      7. Manage the above through a series of worked examples (CSP3)
      8. Guidelines and policies for antimicrobial prescribing in general (CSP3)
    • Adverse Drug Reactions
      1. Be able to inform the patient of common and serious adverse effects and advise them on what to do. (CSP3)
      2. Be able to monitor for adverse drug reactions: subjective - symptomatic side effects; objective - blood tests, therapeutic drug monitoring (CSP3)
      3. Be able to prevent adverse drug reactions (ADR's). Using the BNF, learn common and serious ADRs for key drugs prescribed by FY1's; avoid harmful interactions; use prophylaxis if necessary; be aware of susceptible patients; use the appropriate dose regimen (CSP3)
      4. Know and identify which patients / patient groups have increased susceptibility to adverse effects of certain drugs (A SAD GAP - Age, Sex, Diseases, Genetic, Altered Physiology, pregnancy); take necessary precautions, avoid such drugs or adjust doses (CSP3)
      5. Know how to classify adverse drug reactions using DOTS - Dose - dependent (Type A); independent (Type b); Time dependent; Independent; Susceptible patients (CSP3)
      6. Know how to diagnose an adverse drug reaction (ADR) and be able to differentiate a suspected ADR from known common and serious ADRs (CSP3)
      7. Know how to treat adverse drug reactions (ADR): stop drug; supportive and /or specific treatments if indicated eg for anaphylaxis (CSP3)
      8. Know which adverse reactions (ADRs) to report and how. (CSP3)
    • Pharmacokinetics and Pharmacodynamics
      1. Describe drug binding sites giving examples of both site and drug that attaches to it. (FM1)
      2. Be able to define and discuss the following: affinity; full agonist; partial agonist; neutral agonist; inverse agonist; pure antagonist; potency; efficacy; selectivity; specificity; reversible; irreversible; competitive; non-competitive (CSP3)
      3. Note G-protein-coupled receptors (GPCRs) compose largest group of drug binding sites (FM1)
      4. Be able to define pharmacokinetics and pharmacodyamics (CSP3, GEP/BB)
      5. Discuss selectivity of drug action (FM1)
      6. Distinguish and define pharmacokinetics /pharmacodynamics; liberation; absorption; volume of distribution; distribution; exretion; metabolism; clearance; half life (CSP3)
      7. Understand what is meant by structure-action relationships (FM1)
      8. Distinguish and define half life; narrow / wide therapeutic window; zero order kinetics; first order kinetics; peak levels; trough levels; bioavailability; loading dose, maintenance dose (CSP3)
      9. Compare and contrast routes of drug administration (FM1)
      10. Define absorption and the various mechanisms (CSP3)
      11. Understand what is meant by pharmacokinetics (FM1)
      12. Describe various methods of drug formulation resulting in its liberation (CSP3)
      13. Discuss the factors influencing pharmacokinetics (CSP3)
      14. Understand how and where drugs act - give examples (CSP3)
    • Pharmacological Principles - General
      1. Know what is meant by the term selective toxicity and distinguish between an antibiotic and antimicrobial agent (CSP3)
      2. List sites of action of antimicrobials with examples (CSP3)
      3. List mechanisms of resistance and factors predisposing to increased resistance (CSP3)
      4. Know about the increasing importance of antifungals in medicine and some examples of these agents (CSP3)
    • Drug Interactions
      1. Define pharmacodynamic interactions ie what drugs do to the body. (CSP3)
      2. Define pharmacokinetic interactions ie what the body does to the drug - absorption, distribution, metabolism, excretion (CSP3)
      3. Know how to avoid harmful (adverse) interactions (CSP3)
      4. Know how to identify potential or actual interactions by looking up in Appendix I in the BNF and learning common and important interactions by understanding the mechanisms (CSP3)
      5. Know key drugs that modify pharmacokinetic processes (CSP3)
      6. Use beneficial interactions (CSP3)
      7. Give examples of antimicrobial side effects and interactions (CSP3)
    • Evidence Based Pharmacology
      1. Be aware of the various milestones and pitfalls in drug development (FM1)
      2. Be able to describe the levels of evidence and recommendations for drug therapeutic strategies (CSP3)
      3. Be able to describe, discuss and assess harm:benefit ratio (CSP3)
      4. Be able to define the following: Randomised trial; double blind; multi-centre; placebo-controlled; cohort study; case control study; systematic review/meta-analysis; case-series; risk:benefit ratio; phase 1,2,3,4 trials (CSP3)
      5. Understand the limitations of using information from clinical trials eg extrapolating results to individual patients (CSP3)
      6. Use evidence obtained from studies to guide drug selection (CSP3)
      7. Use sources such as BNF, NICE Guidelines, Clinical Evidence, Cochrane Database, medical journals, PubMed to guide drug selection (CSP3)
    • Drug Receptor Interactions
      1. Define the terms: agonist, antagonist, EC50, efficacy and potency (FM1)
      2. Draw idealised concentration vs response curves to distinguish between drugs of high and low potency and/or high and low efficacy (FM1)
      3. Describe, with a clinical example, the characteristics of competitive antagonism (FM1)
      4. Distinguish competitive antagonism from non-competitive and physiological antagonism (FM1)
    • Drug Absorption and Elimination
      1. Explain drug absorption with reference to the pH-partition hypothesis, as applied to aspirin (FM1)
      2. Define the term apparent volume of distribution and discuss why drugs have different values for this; explain pre-systemic (first pass) metabolism (FM1)
      3. Briefly describe the ways in which drugs are eliminated from the body (FM1)
    • Prescribing for the Elderly
      1. Outline how the body composition and organ metabolic changes impact on pharmacology (11/12 Arch)
  • Medical knowledge: SOCIOLOGY
    • Child Poverty and Health
      1. Identify the main social changes that have affected the family (FM1)
      2. Describe how families can affect the cause, course and outcome of illness (FM1)
    • Health Inequality
      1. Apply social science principles, method and knowledge to medical practice (click to see list) (YR5intro)
      2. Understand and describe what is meant by class, relative poverty and social exclusion. (GEP/HSPH)
      3. Describe the key ways in which social structure and health are related. (GEP/HSPH)
      4. Offer valid explanations for the existence of noted health inequalities. (GEP/HSPH)
      5. Outline the implications of inequality for health policy and medical practice. (GEP/HSPH)
    • Gender and Health
      1. Describe the changing relationship between social structure and gender. (GEP/HSPH)
      2. Be aware of differential patterns of morbidity and mortality related to gender. Consider different causes for these patterns. (GEP/HSPH)
      3. Discuss key health concerns for men and women. (GEP/HSPH)
      4. Outline the implication of considerations related to gender on medical provision. (GEP/HSPH)
    • Death and Dying
      1. Outline current trends in life expectancy (CSP3)
      2. Explore definitions and experiences of dying including the good death (CSP3)
      3. Examine different dying trajectories and the role of palliative medicine (CSP3)
      4. Demonstrate an understanding of the processes involved in normal grief and bereavement (CSP3)
      5. Discuss experiences of health professionals working with dying patients and their relatives (CSP3)
    • Stigma and Health
      1. Outline the processes by which medicine is involved in social control (FM1)
      2. Outline the processes in producing changes in patterns of behaviour (FM1)
      3. Discuss three different approaches to the idea of risk (FM1)
      4. Define the concept of labelling, and describe three major effects of chronic illness (FM1)
    • Chronic Illness and Disability
      1. Explain how people typically cope with developing a chronic illness and their adaptation strategies. (GEP/HSPH)
  • Medical knowledge: EPIDEMIOLOGY
    • Trials & Research
      1. Explain the Bradford Hill criteria for causality and give examples of each. (GEP/HSPH)
      2. Interpret ‘means’, ‘standard deviations’ and ‘standard errors’. (GEP/HSPH)
      3. Describe the essential structure of cohort and case-control studies. (GEP/HSPH)
      4. Interpet ‘medians’ and ‘interquartile ranges’. (GEP/HSPH)
      5. Identify potential biases in case-control and cohort studies. (GEP/HSPH)
      6. Understand the nature of bias. (GEP/HSPH)
      7. Detail when each of case-control, cohort and randomised controlled trials are appropriate research studies. (GEP/HSPH)
      8. Explain the basic characteristics of a Normal Distribution. (GEP/HSPH)
      9. Explain how confounding occurs. (GEP/HSPH)
      10. Define a reference range. (GEP/HSPH)
      11. Interpret unadjusted and adjusted results and be able to explain when each is valid. (GEP/HSPH)
      12. Be able to give examples of important case-control and cohort studies. (GEP/HSPH)
    • Pandemics
      1. Pandemic Influenza: 1918 pandemic; virology of infectious disease; emerging viral infections; pandemics past and future
    • Routes of Spread
      1. Define the terms: incidence; prevalence; endemic; epidemic; pandemic (FM1)
      2. Discuss how pathogens are transmitted (FM1)
      3. Discuss the significance, in terms of resistance to infectious diseases, of herd immunity, methods of control and immunisation (FM1)
  • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH
    • Infectious Diseases
      1. Be familiar with and understand the causes of recent infectious disease outbreaks in London (Tuberculosis; Anthrax; Hepatitis A outbreak in the orthodox jewish community)
    • General Outcomes for Public Health
      1. Apply to medical practice the principles, method and knowledge of population health and the improvement of health and healthcare (click to see list) (YR5intro)
    • Vaccination and Immunisation
      1. Know the normal immunisation programme (HD1)
      2. Understand the dangers to the individual and the herd of not immunising (HD1)
      3. Relate experience in the UK to worldwide programmes of protection using immunisation (HD1)
    • 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 (FM1)
      2. Explain the key driving factors behind current health policy as regards management of chronic illness. (GEP/HSPH)
  • Medical knowledge: PSYCHOLOGY
    • Normal Behaviour and Emotional Development
      1. Apply psychological principles, method and knowledge to medical practice (click to see list) (YR5intro)
  • Clinical skills: HISTORY and EXAMINATION
    • Taking a History
      1. Take and record a patient's medical history, including family and social history, talking to relatives or other carers where appropriate. (YR5intro)
      2. Perform a mental-state examination. (YR5intro)
    • Examining the Patient
      1. Perform a full physical examination. (YR5intro)
  • 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 (FM1)
  • Clinical skills: PATIENT MANAGEMENT
    • Basic Life Support
      1. Provide immediate care in medical emergencies (click to see list) (YR5intro)
    • General Principles of Patient Management
      1. Diagnose and manage clinical presentations (click to see list) (YR5intro)
  • Clinical skills: THERAPEUTIC PROCEDURES
    • General
      1. Carry out practical procedures safely and effectively (click to see list) (YR5intro)
  • Clinical skills: PHARMACOLOGICAL THERAPY
    • General Principles
      1. Prescribe drugs safely, effectively and economically (click to see list) (YR5intro)
  • 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 (FM1)
  • Clinical skills: INTEGRATED HEALTH and COMPLIMENTARY THERAPIES
    • General Outcomes for Integrated Health
      1. Demonstrate awareness of popular forms of Complementary and Alternative Medicine (CAM). (GEP/HSPH)
      2. Understand the different means of establishing evidence to support the effectiveness of complementary medicine. (GEP/HSPH)
      3. Appreciate arguments for and against using complementary and alternative medicine in the NHS. (GEP/HSPH)
  • Clinical skills: INTERACTION WITH PATIENTS
    • Interacting with Patients - General
      1. Describe a model that identifies the tasks and stages in the consultation (FM1)
      2. Communicate effectively with patients and colleagues in a medical context (click to see list) (YR5intro)
      3. Elicit patients’ questions, their understanding of their condition and treatment options, and their views, concerns, values and preferences. (YR5intro)
      4. Provide explanation, advice, reassurance and support. (YR5intro)
      5. Demonstrate appropriate respect to patients in relation to dress, greetings, verbal and non-verbal behaviour
      6. Identify factors that act as barriers and enablers to communication (FM1)
      7. Be able to negotiate patient's consent to interview; begin and end an interview
      8. Discuss the role and value of attentive listening, rapport and empathy, different question styles and summarising (FM1)
      9. Be able to explore the impact of ill health on a patient's life (physical, social and psychological)
      10. Demonstrate appropriate non-verbal (eg body language) and verbal skills (eg use of silence, open and closed questions and summarising) to gather information (FM1)
      11. Develop skills in observation, listening, information gathering, empathy and reflective learning (FM1)
    • Cultural Issues
      1. Identify potential effects of culture, age, gender, ethnicity, religion, socio-economic status and environment on communication (11/12 Arch)
      2. Discuss variation in social relations and the effect on communication with health-care workers (FM1)
      3. Recognise the importance of not making assumptions (11/12 Arch)
      4. Discuss how health beliefs affect interactions with health-care workers and services (FM1)
      5. Discuss the role of health advocates in overcoming barriers to communication and enabling access to health-care (FM1)
      6. Develop skills in listening, information gathering, empathy and respect (11/12 Arch)
    • Non-verbal Communication
      1. Describe the importance of non-verbal communication and body language in medical encounters (FM1)
  • Clinical skills: WORKING IN TEAMS
    • General Outcomes for Working in Teams
      1. Learn and work effectively within a multi-professional team (click to see list) (YR5intro)
  • Clinical skills: MANAGING INFORMATION
    • General Outcomes for Managing Information
      1. Use information effectively in a medical context (click to see list) (YR5intro)
  • Professional issues: LEARNING
    • Strengths and Limitations
      1. Be able to identify one's own learning needs (YR1intro)
      2. Recognise own personal and professional limits and seek help from colleagues and supervisors when necessary. (YR5intro)
      3. Continues to recognise limitations of current personal understanding and capabilities, identifies areas needing refreshing or extending and uses research skills to address these areas and influence own practice
      4. Have the ability to manage own learning needs (Yr2intro)
      5. Be able to adapt to the clinical learning environment and learn autonomously (YR3intro)
      6. Recognise personal and professional limits and seek help from colleagues and supervisors when necessary (YR1intro)
      7. Is confident to practise as an FY1 Doctor
    • Using Information Technology (I.T.)
      1. Be aware of the IT facilities across the College (YR1intro)
      2. Explain why you would search a database (FM1)
      3. Recognise constituent parts of a URL address (YR1intro)
      4. Confidently start applications on a PC, switch on; reboot; use username and password to connect to network; use mouse to point and click (YR1intro)
      5. Know the difference between a citation, abstract and full text (FM1)
      6. Know the structure of a bibliographic citation: author; title; source; pagination; year of publication (FM1)
      7. Be able to start File Manager; confidently locate and open available software, eg, webmail, web browser, microsoft suite (YR1intro)
      8. Know how to use internet searches to identify and explore health-related websites to identify current national guidelines relating to diabetes and obesity (FM1)
      9. Be able to find and know the usefulness of a Library Database list (FM1)
      10. Carry out basics of print management - accounting for and adding print credit (YR1intro)
      11. Be informed about remote access; authentication and availability of wireless network (YR1intro)
      12. Understand authentication (ie ATHENS personal usernames and passwords) (FM1)
      13. 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 (FM1)
      14. Be aware of the need for evaluation of resources particularly web, authority, motivation, date, verification of evidence, bias etc (See BMA website - tips for professionals) (YR1intro)
      15. Locate specific sites supporting the course; SMD Blackboard; QM Library Medical and Dental site (YR1intro)
      16. 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 (FM1)
      17. Be aware that search skills are transferable skills involving effective questioning and effective time-management (YR1intro)
      18. Demonstrate the ability within the Web of Science, to use cited reference searching (FM1)
      19. Accept the need to comply with College regulations regarding IT, plagiarism and copyright (YR1intro)
      20. Be able to display and email search results within a database (FM1)
      21. Demonstrate the ability to navigate a web browser; scroll bar; back/forward/stop; home; URL box; hypertext links; bookmarks; go etc (YR1intro)
    • Attitudes to Learning
      1. Acquire, assess, apply and integrate new knowledge and learn to adapt to changing circumstances (Yr2intro)
      2. Respond constructively to the outcomes of appraisals, performance reviews and assessments. (YR5intro)
      3. Establish the foundations for lifelong learning and continuing professional development, including a professional development portfolio containing, reflections, achievements and learning needs (YR5intro)
      4. Be able to give examples of what is and is not plagiarism; know the consequences of plagiarising and implement procedures to avoid plagiarising (FM1)
    • Learning - General
      1. Acquire, assess, apply and integrate new knowledge, learn to adapt to changing circumstances and ensure that patients receive the highest level of professional care. (YR5intro)
  • Professional issues: TEACHING
    • Medical Students as Teachers
      1. Function effectively as a mentor and teacher including contributing to the appraisal, assessment and review of colleagues, giving effective feedback, and taking advantage of opportunities to develop these skills (YR5intro)
  • Professional issues: REFLECTION and MENTORING
    • Development of the Ability to Reflect
      1. Respond constructively to the outcome of appraisal, performance review and assessment (Yr2intro)
    • Reflection and Mentoring - General
      1. Continually and systematically reflect on practice and, whenever necessary, translate that reflection into action, using improvement techniques and audit appropriately − for example, by critically appraising the prescribing of others. (YR5intro)
  • Professional issues: EVIDENCE BASED MEDICINE
    • Evidence Based Medicine - General
      1. Locate and access resources for medical professionalseg OMNI; NeLH, MEDLINE-Plus. Demonstrate the ability to find answers to problems using these resources (YR1intro)
  • Professional issues: PERSONAL ATTITUDES and SELF CARE
    • General Outcomes for Personal Attitudes and Self Care
      1. Recognise own personal health needs, consult and follow the advice of a suitably qualified professional, and protect patients from any risk posed by own health. (YR5intro)
    • Self Care
      1. Manage time and prioritise tasks, and work autonomously when necessary and appropriate (YR1intro)
      2. Recognise personal health needs, consult and follow the advice of a suitably qualified professional, and protect patients from any risks posed by personal health (YR1intro)
  • Professional issues: MEDICAL PROFESSIONALISM
    • Caring for Patients
      1. Demonstrate awareness of clinical responsibilities and role of the doctor making the care of the patient the first concern (YR3intro)
      2. Determine the extent to which patients want to be involved in decision-making about their care and treatment. (YR5intro)
      3. Maintain confidentiality and respect patients' dignity and privacy and understand the importance of appropriate consent (YR1intro)
      4. Place patients’ needs and safety at the centre of the care process. (YR5intro)
      5. Assess a patient’s capacity to make a particular decision in accordance with legal requirements and the GMC’s guidance. (YR5intro)
      6. Demonstrate awareness of the clinical responsibilities and role of the doctor, making the care of the patient the first concern. Recognise the principles of patient-centred care, including self-care, and deal with patients’ healthcare needs in consultat (YR5intro)
      7. Recognise the principles of patient centered care, including self care, dealing with patients' healthcare needs in consultation with them and, where approriate, their relatives or carers (YR3intro)
    • General Outcomes for Medical Professionalism
      1. Deal effectively with uncertainty and change. (YR5intro)
      2. Specify why the privileges associated with being a medical student carry with them the responsibility to respect the rights and dignity of patients (FM1)
      3. Recognise the rights and the equal value of all people and how opportunities for some people may be restricted by others’ perceptions. (YR5intro)
      4. Respect patients' rights to hold religious or other beliefs and take these into account when relevant to treatment options (Yr2intro)
  • Professional issues: INTER-PROFESSIONAL TEAMS
    • Working in Teams
      1. Understand the roles and expertise of health and social care professionals including doctors in the context of working and learning as a team as well as in policy and practice development (Yr2intro)
      2. Work with colleagues in ways that best serve the interests of patients, passing on information and handing over care
  • Professional issues: RISK MANAGEMENT and PATIENT SAFETY
    • Principles of Risk Management
      1. Promote, monitor and maintain health and safety in the clinical setting, understanding how errors can happen in practice and applying the principles of quality assurance, clinical governance and risk management to medical practise
      2. Promote, monitor and maintain health and safety in the clinical setting, understanding how errors can happen in practice, applying the principles of quality assurance, clinical governance and risk management to medical practice, and understanding responsi (YR5intro)
      3. Place the patient's needs and safety at the centre of the care process (YR3intro)
    • Infection Control
      1. Understand the importance of, and the need to keep to, measures to prevent the spread of infection, and apply the principles of infection prevention and control. (YR5intro)
      2. Understand the importance of, and the need to adhere to, measures to prevent the spread of infection (YR3intro)
  • Professional issues: ETHICS and LAW
    • Ethics and Organ Transplantation / Donation
      1. Describe the evolution of transplant ethics since 1968. (CSP4b)
      2. Describe the causes of the organ crisis
      3. Argue the pros and cons of a regulated market in organs
      4. Suggest non-commercialist solutions for the organ crisis
      5. Argue pros and cons of a policy of implied consent (opt-out), for organ donation upon death
      6. Argue pro and con a regulated market in organs. (CSP4b)
      7. Argue pro and con a policy of implied consent (opt-out) for organ donation upon death. (CSP4b)
      8. Explain why altruistic living unrelated donation (LURD) is a legal FICTION (CSP4b)
    • End of Life (inc. Do Not Resuscitate Orders)
      1. Give arguments for and against hastening death of patients in various circumstances (CSP3)
      2. Outline the duties and prerogatives of doctors and the rights of competent patients in relation to the hastening of death and specify the circumstances where they apply (CSP3)
      3. Outline the difference between various forms of hastening death and distinguish between the ethico-legally acceptable ones from those which are unacceptable (CSP3)
      4. Specify the provisions of acceptable Advance Directives, action based on the rule of double effect, DNAR orders, withdrawal of life-saving treatment and non-treatment decisions (CSP3)
      5. Explain the role of relatives in relation to withdrawal of treatment in incompetent adults (CSP3)
    • Legal, Moral, Ethical Responsibilities of Patient Care
      1. Recognise the duty to take action if a colleague’s health, performance or conduct is putting patients at risk. (YR5intro)
      2. Understand and accept the legal, moral and ethical responsibilities involved in protecting and promoting the health of individual patients, their dependants and the public − including vulnerable groups such as children, older people, people with learnin (YR5intro)
      3. Describe the harm principle and the limits to autonomy (CSP3)
      4. Respect all patients, colleagues and others regardless of their age, colour, culture, disability, ethnic or national origin, gender, lifestyle, marital or parental status, race, religion or beliefs, sex, sexual orientation, or social or economic status. G (YR5intro)
      5. Be polite, considerate, trustworthy and honest, act with integrity, maintain confidentiality, respect patients’ dignity and privacy, and understand the importance of appropriate consent. (YR5intro)
      6. Identify the conflict between the individual and society in the context of risk to others (CSP3)
      7. Outline the steps a doctor should take to ensure that the DVLA is informed about dangerous drivers (CSP3)
    • Medical Negligence and Malpractice
      1. Describe the duty of care and who has it (CSP3)
      2. Outline the legal conditions for negligence to be established (CSP3)
      3. Explain the Bolitho modification of the Bolam test (CSP3)
      4. Describe situations or res ipsa loquitur (CSP3)
      5. Explain the legal standard of evidence in negligence cases (CSP3)
    • Ethics and Obstetrics and Gynaecology
      1. Argue pro and con termination of pregnancy. (CSP4b)
      2. Know about and keep to the GMC’s ethical guidance and standards including Good Medical Practice, the ‘Duties of a doctor registered with the GMC’ and supplementary ethical guidance which describe what is expected of all doctors registered with the G (YR5intro)
      3. Understand and accept the legal, moral and ethical responsibilites involved in protecting and promoting the health of individual patients, their dependants, the public and vulnerable groups such as children, older people and people with mental illness (YR1intro)
      4. Know and comply with GMCs ethical guidance and standards including Good Medical Practice; Duties of a Doctor Registered with the GMC, and supplementary ethical guidance which describes what is expected of all doctors registered with the GMC (YR1intro)
      5. Demonstrate knowledge of laws, and systems of professional regulation through the GMC and others, relevant to medical practice, including the ability to complete relevant certificates and legal documents and liaise with the coroner or procurator fiscal wh (YR5intro)
      6. Describe the legal status of the foetus. (CSP4b)
      7. Demonstrate knowledge of laws and systems of professional regulation through the GMC and others relevant to medical practice; including the ability to complete relevant certificates/legal document and liaise with the coroner / procurator fiscal
      8. Understand some of the ethical issues around genetic data and potential risks to the individual (CSP3)
      9. Explain the concept of personhood and describe its relation to the morality of abortion. (CSP4b)
      10. Describe the legal conditions of lawful abortion as outlined in the Abortion Act 1967 (1990). (CSP4b)
      11. Explain the legal status of the woman and of her husband/partner regarding abortion. (CSP4b)
      12. Describe the duties and rights of the doctor in relation to abortion. (CSP4b)
      13. Outline the principles of the HFEA 1990 concerning research on embryos. (CSP4b)
      14. Identify legal and ethical issues in reproductive medicine, prenatal screening and genetic counselling. (CSP4b)
    • Moral Theories
      1. Understand the nature and outline the various forms of an ethical problem; identify examples of ethical problems in medicine
      2. Explain the interface between medical ethics and medical law
      3. Outline the major moral theories and their criteria of identifying goodness
      4. Give examples of how each of these theories could be applied in medico-ethical decision making
      5. Describe the shortcomings of moral theories and suggest how they could be overcome
    • Confidentiality
      1. Evaluate the importance of privacy in personal life, and why this might entail a right to confidentiality (FM1)
      2. Outline why respect for confidentiality is such an important component of successful clinical relationships and of the key tenets policy. (FM1)
      3. Describe the specific duties of medical students as regards confidentiality, and typical dangers of breaching it. (FM1)
      4. Discuss arguments for and against the belief that confidentiality should be broken in the public interests, including the confidentiality of the clinical relationship (FM1)
    • Research Ethics
      1. Describe some classical examples of abuse in biomedical research and specify why they are abuses. (CSP3)
      2. Explain the change in ethics and law that has occured in the last four decades (CSP3)
      3. Outline the key international and national codes that currently regulate acceptable research (CSP3)
      4. Describe the work of research ethics committees and the structure of a research protocol. (CSP3)
      5. Identify common moral faults in the design of research protocols and explain why they are faults (CSP3)
      6. Describe the standards of confidentiality in relation to the publication of research outcomes (CSP3)
      7. State the circumstances in which biomedical research could be, or ought not to be, conducted on vulnerable individuals (minors and mentally incapacitated patients) (CSP3)
    • Truth Telling
      1. Explain in what respects truth-telling is important both to patient and doctor/student. (CSP3)
      2. Give classical justifications for and against deception and assess the strengh and weaknesses of both. (CSP3)
      3. Specify the potential ethico-legal consequences of lying to patients. (CSP3)
      4. Describe circumstances within medicine and surgery in which it would be appropriate to be economical with the truth (CSP3)
      5. Specify the moral and legal problems of respecting a patient's right not to be told the truth. (CSP3)
      6. Anticipate and appropriately respond to situations where patients ask you as a medical student (or doctor) to be truthful about their condition, treatment and prognosis (CSP3)
      7. Outline good policies on breaking bad news (CSP3)
    • Ethics and Paediatrics (inc. abuse/neglect)
      1. Identify three distinct groups of minors in relation to mental capacity, consent and refusal of treatment. (CSP4b)
      2. Describe the medical law pertaining to minors and the tension reflected therein between respect for their autonomy and acting in their best interests. (CSP4b)
      3. Explain the legal concept of parental responsibility and its relevance to the consent question. (CSP4b)
      4. Explain how conflicts between the interests of minors and their guardians ought to be resolved. (CSP4b)
    • Informed Consent
      1. Explain why obtaining consent is an integral part of successful clinical relationships and the key tenets of GMC policy (FM1)
      2. Differentiate between explicit and applied consent, indicating when each is important (FM1)
    • Elective Ethics
      1. Understand the sustainability of delivering healthcare in resource poor settings
      2. Be aware of the importance of local culture, language and prevalence of local diseases and determinants of health
      3. Familiarise yourself with different ethical scenarios; be able to describe an appropriate response to common ethical scenarios when working abroad
    • Ethics and Mental Illness
      1. Describe the three sections of involuntary admission as outlined in the Mental Health Act 1983 (2007). (CSP4b)
      2. Outline the conditions that need to be met for involuntary admission. (CSP4b)
      3. Explain the ethical-legal difference between formal and informal patients and between patients with mental illness and those who suffer from organic brain syndromes. (CSP4b)
  • Professional issues: GOVERNANCE and AUDIT
    • Governance and Audit - General
      1. Understand and have experience of the principles and methods of improvement including audit, adverse incident reporting and quality improvement and how to use the results of audit to improve practice (CSP4a)
      2. Understand the framework in which medicine is practised in the UK, including: the organisation, management and regulation of healthcare provision;the structures, functions and priorities of the NHS; and the roles of, and relationships between, the agencie (YR5intro)
      3. Understand and have experience of the principles and methods of improvement, including audit, adverse incident reporting and quality improvement, and how to use the results of audit to improve practice. (YR5intro)
  • Professional issues: MEDICAL LEADERSHIP and MANAGEMENT
    • Medical Leadership and Management - General
      1. Demonstrate awareness of the role of doctors as managers, including seeking ways to continually improve the use and prioritisation of resources. (YR5intro)
      2. Recognise the duty to take action if a colleague's health, performance or conduct is putting patients at risk (GMC) (CSP4a, GEPintro, YR1intro, Yr2intro, YR3intro, YR5intro)
      3. Demonstrate awareness of the role of doctor as manager, including seeking ways to continually improve the use and prioritisation of resources (Yr2intro)
      4. Demonstrate the ability to play various team roles including leadership; deal effectively with uncertainty and change
      5. Understand the framework in which medicine is practised in the UK including the organisation, management and regulation of healthcare provision and the structure and functions of the NHS (Yr2intro)

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