Specialties
- WHOLE PERSON
- CARDIORESPIRATORY
- METABOLISM
- HUMAN DEVELOPMENT
- BRAIN AND BEHAVIOUR
- LOCOMOTOR
HUMAN DEVELOPMENT: Sexual Health and HIV
Index
- General Outcomes for Sexual Health & HIV
- HIV Infection
- Genital Discharge
- Genital Ulcers and Lumps
- Pelvic Pain
- Testicular Pain
- General Outcomes for Sexual Health & HIV
- Medical knowledge: PHYSIOLOGY (TD 8.2)
- Male Reproductive Physiology
- Medical knowledge: MICROBIOLOGY and INFECTION (TD 8.9)
- General Outcomes for HIV and AIDS
- Sexually Transmitted Infections - General
- Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis (I&I 4)
- Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei (I&I 4)
- Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum, (I&I 4)
- List the major routes of transmission of HIV (I&I 4)
- Sources of Infection and Routes of Transmission
- Medical knowledge: PHARMACOLOGY (TD 8.10)
- Contraception and HRT
- Describe to a patient methods of emergency contraception, indications and guidance for use (I&I 4)
- Demonstrate basic knowledge of currently available contraceptive methods and be able to communicate to patients the mechanisms of action and failure rate (I&I 4)
- Manage under supervision or refer as appropriate the contraceptive needs of a patient presenting with a medical condition which may contraindicate the method s/he is currently using (I&I 4)
- Contraception and HRT
- Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
- HIV Infection
- Sexual Assault
- Understand the management of male and female victims of sexual assault (I&I 4)
- To know where to refer patients who have been possible survivors of sexual assault (I&I 4)
- Identify symptoms and presentations that may indicate that patients have been survivors of sexual assault (I&I 4)
- Recognise presentations of Domestic Abuse and be able to refer appropriately (I&I 4)
- Identify and understand Female Genital Mutilation and be able to refer appropriately (I&I 4)
- Be aware of non-consensual sexual intercourse in male and females and appropriate referral pathways for further management and support (I&I 4)
- General Outcomes for Sexually Transmitted Diseases
- Recognise the clinical presentations of Bechetís disease
- Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum (I&I 4)
- Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei (I&I 4)
- Recognise common presentations of patients with psychosexual factors affecting sexual function and / or relationships and know where to refer them. (I&I 4)
- 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 (I&I 4)
- Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoea, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis (I&I 4)
- Recognise the clinical presentations of primary HIV infection (seroconversion) and describe the management of a suspected case (I&I 4)
- Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH (TD 11 a-j)
- HIV/AIDS and Sexually Transmitted Infections
- Explain the principles of safe sex and risk reduction, and identify at risk groups (I&I 4)
- To understand the ways in which Sexual Health services are different from general medical services, including access issues and public health role
- To understand the process when a patient attends a GUM clinic (I&I 4)
- To identify opportunities for sexual health promotion including opportunities for early diagnosis of HIV in related and unrelated medical contexts (I&I 4)
- Lifestyle and Disease
- HIV/AIDS and Sexually Transmitted Infections
- Medical knowledge: PSYCHOLOGY (TD 9 a-g)
- Bio-Psycho-Social Issues
- To appreciate the concerns a patient may have attending a GUM clinic and list three ways you might put patients at ease (I&I 4)
- Describe the stresses and psychological reactions associated with actual or perceived HIV infection, Hepatitis B and C or STDs, and the buffering effects of adaptive coping skills and social support (I&I 4)
- General Issues
- Bio-Psycho-Social Issues
- Clinical skills: HISTORY (TD 13 a-b)
- General
- List the required competencies in The Fraser Ruling (I&I 4)
- 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 (I&I 4)
- Understand some of the difficulties patients might have in discussing issues regarding sex, sexuality and sexual practices and problems (I&I 4)
- Understand causes of genital warts and difference between low-risk and high-risk HPV types (I&I 4)
- To understand how to take a sexual history (I&I 4)
- Take a brief alcohol and recreational drug history and understand the relevance to high risk sexual behaviours (I&I 4)
- To gain an appreciation of some of the different types of sexual practices (I&I 4)
- Take a sexual history with regard to sexual preference, practice, and problems that is respectful of individual lifestyles and sensitive to social and cultural issues (I&I 4)
- 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-judgmental manner (I&I 4)
- General
- Clinical skills: PHYSICAL EXAMINATION (TD 13 c)
- Examining the Patient
- Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
- Sexual Health Investigations
- Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
- General Outcomes for Sexual Health Diagnosis
- Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis (I&I 4)
- Understand approach to diagnosing genital sores (history and examination) (I&I 4)
- Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei (I&I 4)
- Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum, (I&I 4)
- List the diagnostic tests used for genital sores (Dark ground, PCR) (I&I 4)
- List a differential diagnosis for a male and female patient presenting with genital ulceration, focussing on Herpes Simplex and Syphilis infection (I&I 4)
- Recognise the clinical presentations of non-infective genital ulceration (eg Bechet’s disease) (I&I 4)
- With reference to HIV, Hepatitis B and C and STDs the student should be able to: a) Identify the skills, roles and responsibilities of the health care team; b) To understand that a patient needs to give consent for an HIV test and that pre-test/post-test counselling are no longer performed routinely in order to reduce the stigma associated with HIV. (I&I 4)
- Be able to explain asymptomatic shedding of HSV (I&I 4)
- Be able to explain incubation periods and transmission (I&I 4)
- Explain other aspects of management – e.g. Patient Information, Partner Notification issues, condom use (I&I 4)
- Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
- To have an introduction to Sexually Transmitted Infection (STI) and their treatments (I&I 4)
- General Outcomes for Sexual Health Diagnosis
- Clinical skills: DIAGNOSTIC PROCEDURES (TD 18 a)
- Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
- Management Sexual Health Disorders (Inc. HIV) - General
- 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
- Understand the management of psychosexual disorders in male and female patients. (I&I 4)
- List treatment options for genital warts (I&I 4)
- List treatments for NGU, Chlamydia, Gonorrohea and LGV (I&I 4)
- With reference to HIV, Hepatitis B and C and STDs the student should be able to: a) Identify the skills, roles and responsibilities of the health care team; b) To understand that a patient needs to give consent for an HIV test and that pre-test/post-test counselling are no longer performed routinely in order to reduce the stigma associated with HIV. (I&I 4)
- Offer STI & HIV testing as part of genital wart management (I&I 4)
- To understand the efficacy, side effects, drug interactions and contraindications of drugs used in the management of STIs (I&I 4)
- Offer STI & HIV testing as part of management (I&I 4)
- List treatments for HSV and Syphilis (I&I 4)
- Explain other aspects of management – eg Patient Information, Partner Notification issues, condom use (I&I 4)
- Offer STI & HIV testing as part of genital sores management (I&I 4)
- Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
- To have an introduction to Sexually Transmitted Infection (STI) and their treatments (I&I 4)
- Explain other aspects of management – eg Patient Information, Partner Notification issues, condom use (I&I 4)
- To appreciate the importance of contact tracing and partner notification (I&I 4)
- Management of general O&G problems
- Management Sexual Health Disorders (Inc. HIV) - General
- Clinical skills: SUPPORTING PATIENTS and IDENTIFYING ABUSE and NEGLECT (TD 14 h-i)
- Preventative care and Screening
- General Outcomes for Integrated Health
- Clinical skills: INTERACTION WITH PATIENTS (TD 15 a-b)
- Clinical skills: PRESCRIBING DRUGS SAFELY AND EFFECTIVELY (TD 17 a-h)
- Pharmacological Therapy - Sexual Health (General)
- Professional issues: WORKING IN TEAMS (TD 22 a-c)
- Multi-disciplinary Team Work (MDT)
- Professional issues: ETHICS and LAW (TD 20 a-g)
- Ethics in Obstetrics and Gynaecology
- Legal, Moral, Ethical Responsibilities of Patient Care
- Professional issues: RISK MANAGEMENT and PATIENT SAFETY (TD 23 d)
- Human Factors
- Principles of Risk Management
- Medical knowledge: PHYSIOLOGY (TD 8.2)
- HIV Infection
- General Outcomes for HIV Infection
- Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
- Describe the spectrum of clinical problems associated with HIV infection: primary HIV infection, asymptomatic HIV infection, persistent generalised lymphadenopathy, symptomatic HIV infection and Acquired Immunodeficiency Syndrome (I&I 4)
- Recognise the major clinical presentations of neurological complications of HIV (I&I 4)
- Epidemiology HIV worldwide
- Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
- 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
- To describe available Post Exposure Prophylaxis regimens for HIV and how best to access these regimens
- To be able to explain pathogenesis of HIV
- Recognise the significance and list possible causes for the following symptoms in an HIV infected person: Generalised seizures; Loss of consciousness; Focal neurological deficit; Change in affect; Shortness of breath; Rash; Fever (I&I 4)
- 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 (I&I 4)
- 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
- Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
- To recognise medical presentations of primary or established HIV infection
- Be aware of, and have an understanding of a patient's feelings when diagnosed with HIV / AIDS
- 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
- 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)
- List the opportunistic infections that commonly cause clinical disease in HIV infection
- Engage in relevant HIV pre-test discussions to assess relative risk of infection and enable patients to make an informed decision on testing (both in GU setting and outside of GU) (I&I 4)
- To understand the basic epidemiology of STIs and HIV and public health issues for control of spread of infection locally and globally (I&I 4)
- To outline national screening programs relevant to sexual and reproductive health and HIV (currently cervical screening, Chlamydia screening and antenatal HIV testing)
- Understand the changing significance neurological complications of HIV, in particular, HIV-associated neurocognitive disease (I&I 4)
- Assess risk of HIV transmission in individual presenting after occupational and non-occupational potential exposure to HIV (I&I 4)
- Explain the functions of the various parts of the HIV virus particle (I&I 4)
- Understand the concept of opt-out testing and the settings in which opt-out testing are conducted. (I&I 4)
- Demonstrate knowledge of the CDC classification system for HIV infection (I&I 4)
- Know the mode of transmission of HIV, AIDS
- To describe principles of partner notification for STIs and HIV (I&I 4)
- Identify neurological clinical presentations that may indicate undiagnosed HIV infection (I&I 4)
- Describe the genome of HIV with reference to the regulatory proteins produced and their functions. (I&I 4)
- Correlate the degree of immunosuppression of an individual patient with the likely clinical problems (I&I 4)
- Identify barriers to testing (from patients and healthcare professionals) (I&I 4)
- Formulate a plan for the treatment and prevention of neurological disease in HIV (I&I 4)
- Describe available PEP regimens and how best to access these regimen (I&I 4)
- Understand a range of testing methods (I&I 4)
- Describe the tests used in the diagnosis and monitoring of HIV infection including: tests for antibodies to HIV-1 and HIV-2; Tests for the virus itself (viral antigen, viral DNA and RNA, viral subtypes and genetic analysis for resistance mutations); Tests of the immune system (lymphocyte subsets) (I&I 4)
- Understand the circumstances in which HIV testing can be performed with out the patient’s consent (I&I 4)
- Critically evaluate the utility of individual tests in specific clinical situations including: Diagnosis in chronically infected individual; HIV seroconversion; pregnancy; neonates and children less than 2 years old; patients on antiretroviral therapy (I&I 4)
- Describe how widespread HIV is; know what is meant by clades (CSP3)
- Demonstrate the events that occur at a cellular level during acute HIV infection (I&I 4)
- Describe the management of a person who has sustained a needlestick injury from a known HIV positive source (I&I 4)
- Be able to explain the events within the immune system which result from HIV infection (I&I 4)
- Describe the specific immune responses to HIV (I&I 4)
- Correlate the changes in the immune system at a cellular level with the clinical consequences for the patient with HIV infection (I&I 4)
- Explain the factors that may confer resistance to HIV (I&I 4)
- Define the term long-term non progressor (I&I 4)
- Describe the potential uses of vaccination and immunotherapy in HIV (I&I 4)
- Infections and Disorders Associated with HIV
- Describe the epidemiology and natural history of Hepatitis A, B, C and D (I&I 4)
- List the fungi and protozoa that commonly cause clinical disease in the context of HIV infection (I&I 4)
- To recognise the presentations of HIV infected patients with Pneumocystis pneumonia, Candidiasis, Toxoplasmosis, Cryptococcosis, Tuberculosis, Cytomegalovirus, Kaposiís Sarcoma, Lymphoma, Hepatitis B and C
- List the opportunistic infections that commonly cause clinical disease in HIV infection
- Describe the spectrum of clinical problems associated with HIV infection: primary HIV infection, asymptomatic HIV infection, persistent generalised lymphadenopathy, symptomatic HIV infection and Acquired Immunodeficiency Syndrome (I&I 4)
- Understand the effect of co-infection with HIV and Hepatitis B and C on the natural history of HIV and Hepatitis B and C (I&I 4)
- List the bacteria and viruses that commonly cause clinical disease in the context of HIV infection (I&I 4)
- Describe the methods of diagnosis and monitoring of Hepatitis B and C infection (I&I 4)
- Recognise the major clinical presentations of: Pneumocystis jiroveci; Cryptococcus; Candidiasis; Toxoplasmosis; Cryptosporidium; Herpes viruses (Herpes Simplex, Herpes Zoster, Cytomegalovirus); Human papilloma virus; Papovavirus; Salmonella; Mycobacteria; Haemophilus; Pneumococcus (I&I 4)
- Describe the investigation of abnormal liver function tests / hepatomegaly in an HIV-infected individual (I&I 4)
- Describe the treatment of Hepatitis B and C and how this differs in the context of HIV co-infection (I&I 4)
- Describe prevention strategies, including vaccination, for Hepatitis A, B and C (I&I 4)
- Describe the spectrum of renal disease in HIV (I&I 4)
- Describe the investigation and management of abnormal renal function in an HIV-infected individual (I&I 4)
- Treatment of HIV Infection
- To describe the basic principles of anti-HIV therapy, including major side-effects and interactions of therapy (I&I 4)
- Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
- Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
- 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
- Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
- Describe the management of a person who has sustained a needlestick injury from a known HIV positive source (I&I 4)
- Describe the different groups of antiretroviral drugs and their mode of action (I&I 4)
- 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 (I&I 4)
- Describe examples of the most commonly prescribed antiretroviral drugs including major side-effects and interactions of therapy (I&I 4)
- Demonstrate the life cycle of HIV, with particular reference to the areas that have implications for therapeutic interventions (I&I 4)
- Describe why adherence to ARVs is important (I&I 4)
- Describe the principles of diagnosis, management and prevention of opportunistic fungi and protozoa (I&I 4)
- Review the specific details of development of ARV resistance (I&I 4)
- Describe the principles underpinning the diagnosis, management and prevention of opportunistic bacterial and viral infection in HIV infected patients (I&I 4)
- Formulate a plan for the treatment and prevention of opportunistic bacterial and viral pathogens (I&I 4)
- Consider specific difficulties associated with ARVs that have an impact on adherence and resistance including: bioavailability; side-effects (short and long-term); confidentiality; interactions (I&I 4)
- Describe how antiretroviral therapy may be used to prevent HIV transmission including: Mother to child transmission; Post-exposure prophylaxis (PEP / PEPSE); Pre-exposure prophylaxis (PrEP); Treatment as Prevention (TAsP) strategies including “test and treat” initiatives in high prevalence settings (I&I 4)
- Describe the potential uses of vaccination and immunotherapy in HIV (I&I 4)
- Malignancies Associated with HIV Infection
- 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
- 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
- Explain why HIV infection predisposes to certain malignancies (I&I 4)
- Understand the relationship between HHV8, EBV and HPV in the etiology of malignancy (I&I 4)
- List the presenting clinical features of Kaposi’s sarcoma, non-Hodgkin’s B cell lymphoma and squamous cell carcinoma in HIV infection (I&I 4)
- Consider appropriate differential diagnoses for each condition (I&I 4)
- Discuss potential management strategies for each type of malignancy (I&I 4)
- General Outcomes for HIV Infection
- Genital Discharge
- General Outcomes for Genital Discharge
- List a differential diagnosis for a female patient presenting with vaginal and or rectal discharge
- Understand approach to diagnosing dysuria & discharge (history and examination) (I&I 4)
- Understand approach to diagnosing vaginal discharge (history and examination) (I&I 4)
- List a differential diagnosis for a male patient presenting with urethral and or rectal discharge
- List the diagnostic tests used (microscopy, culture, urinalysis) (I&I 4)
- List diagnostic tests used (eg microscopy, culture, NAATs) (I&I 4)
- List a differential diagnosis for a female patient presenting with vaginal and/or rectal discharge (I&I 4)
- List a differential diagnosis patient presenting with urethral or rectal discharge and/or dysuria (including NGU and LGV) (I&I 4)
- Offer STI and HIV testing if appropriate (I&I 4)
- General Outcomes for Genital Discharge
- Genital Ulcers and Lumps
- Pelvic Pain
- General Outcomes for Pelvic Pain
- List a differential diagnosis for a female patient presenting with acute and or chronic pelvic pain
- Understand approach to diagnosing female pelvic pain (history, examination, pregnancy test) (I&I 4)
- List the diagnostic tests used (microscopy, culture, urinalysis, pregnancy test) (I&I 4)
- List differential diagnoses (eg ectopic pregnancy, PID, UTI) (I&I 4)
- Understand referral pathway for urgent management of ectopic pregnancy (I&I 4)
- Offer STI & HIV testing as part of management (I&I 4)
- Explain other aspects of management – eg Patient Information, Partner Notification issues, condom use (I&I 4)
- Pelvic Inflammatory Disease (PID)
- General Outcomes for Pelvic Pain
- Testicular Pain