GMC Domains

• THE DOCTOR AS A SCHOLAR
  • TD 8: APPLICATION OF BIOMEDICAL SCIENTIFIC PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: ANATOMY (TD 8.1)
    • Medical knowledge: PHYSIOLOGY (TD 8.2)
    • Medical knowledge: BIOCHEMISTRY (inc. Metabolism) (TD 8.3)
    • Medical knowledge: CELL BIOLOGY (TD 8.4)
    • Medical knowledge: MOLECULAR BIOLOGY and GENETICS (TD 8.5, 8.6)
    • Medical knowledge: PATHOLOGY (TD 8.7)
    • Medical knowledge: CANCER
    • Medical knowledge: IMMUNOLOGY and INFLAMMATION (TD 8.8)
    • Medical knowledge: MICROBIOLOGY and INFECTION (TD 8.9)
    • Medical knowledge: PHARMACOLOGY (TD 8.10)
    • Medical knowledge: NUTRITION (TD 8.11)
    • Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
  • TD 9: APPLICATION OF PSYCHOLOGICAL PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: PSYCHOLOGY (TD 9 a-g)
  • TD 10: APPLICATION OF SOCIAL SCIENCE PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: SOCIOLOGY (TD 10 a-e)
  • TD 11. PRINCIPLES, METHODS AND KNOWLEDGE OF POPULATION HEALTH
    • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH (TD 11 a-j)
  • TD 12; APPLICATION OF SCIENTIFIC METHOD AND APPROACHES TO MEDICAL RESEARCH
    • Medical knowledge: EPIDEMIOLOGY
    • Medical Knowledge: SCIENTIFIC METHOD & RESEARCH
• THE DOCTOR AS A PRACTITIONER
  • TD 13: CARRY OUT A CONSULTATION WITH A PATIENT
    • Clinical skills: HISTORY (TD 13 a-b)
    • Clinical skills: PHYSICAL EXAMINATION (TD 13 c)
    • Clinical skills: MENTAL STATE EXAMINATION (TD 13 d)
  • TD 14: DIAGNOSE AND MANAGE CLINICAL PRESENTATIONS
    • Clinical skills: INTERPRETING FINDINGS AND INITIAL ASSESSMENT (TD 14 a-b)
    • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Clinical skills: SURGERY and ANAESTHETICS (TD 14 g)
    • Clinical skills: SUPPORTING PATIENTS and IDENTIFYING ABUSE and NEGLECT (TD 14 h-i)
    • Clinical Skills: CARE OF PATIENTS AND RELATIVES AT END OF LIFE (TD 14 j)
  • TD 15: COMMUNICATE EFFECTIVELY WITH PATIENTS AND COLLEAGUES
    • Clinical skills: INTERACTION WITH PATIENTS (TD 15 a-b)
    • Clinical skills: MANAGING INFORMATION (TD 15 c)
  • TD 16: PROVIDE IMMEDIATE CARE IN MEDICAL EMERGENCIES
    • Emergency Management of Patients (TD 16 b-e)
  • TD 17: PRESCRIBE DRUGS SAFELY, EFFECTIVELY AND ECONOMICALLY
    • Clinical skills: PRESCRIBING DRUGS SAFELY AND EFFECTIVELY (TD 17 a-h)
  • TD 18: CARRY OUT PRACTICAL PROCEDURES SAFELY AND EFFECTIVELY
    • Clinical skills: DIAGNOSTIC PROCEDURES (TD 18 a)
    • Clinical skills: THERAPEUTIC PROCEDURES (TD 18 b)
  • TD 19: USE INFORMATION EFFECTIVELY IN A MEDICAL CONTEXT
    • Clinical skills: EVIDENCE BASED MEDICINE
• THE DOCTOR AS A PROFESSIONAL
  • TD 20: BEHAVE ACCORDING TO ETHICAL AND LEGAL PRINCIPLES
    • Professional issues: ETHICS and LAW (TD 20 a-g)
  • TD 21: REFLECT, LEARN AND TEACH OTHERS
    • Professional Issues: PERSONAL LIMITS OF CARE (TD 21e)
    • Professional issues: LEARNING (TD 21 a-d)
    • Professional issues: TEACHING AND MENTORING (TD 21 f)
  • TD 22: LEARN AND WORK EFFECTIVELY WITHIN A MULT-PROFESSIONAL TEAM
    • Professional issues: WORKING IN TEAMS (TD 22 a-c)
  • TD 23: PROTECT PATIENTS AND IMPROVE CARE
    • Professional issues: DUTIES OF A DOCTOR (TD 23 a-b)
    • Professional issues: MEDICAL FRAMEWORK IN THE UK (TD 23 c)
    • Professional issues: RISK MANAGEMENT and PATIENT SAFETY (TD 23 d)
    • Professional issues: GOVERNANCE, QUALITY MATTERS and AUDIT (TD 23 e)
    • Professional issues: PERSONAL ATTITUDES and SELF CARE (TD 23 f-j)

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TD 8: APPLICATION OF BIOMEDICAL SCIENTIFIC PRINCIPLES, METHOD AND KNOWLEDGE: Medical knowledge: MICROBIOLOGY and INFECTION (TD 8.9)

Index

• General Outcomes for Microbiology and Infection
• Microbiology of Cardiovascular Infections
• Microbiology of Respiratory Infections
• Microbiology of Haematological Infections
• Microbiology of Gastrointestinal Infections
• Microbiology of the Renal System and Urinary Tract
• Microbiology of Childhood Infections
• Microbiology of Sexually Transmitted Infections (Inc. HIV/AIDS)
• Microbiology of Obstetric and Gynaecological Infections
• Microbiology of Neurological Infections
• Microbiology of Musculoskeletal Infections

• General Outcomes for Microbiology and Infection
  • General Outcomes for Microbiology
    1. List the basic characteristics of viruses and the criteria by which they are classfied (FM1)
    2. Be able to distinguish between the different groups of pathogens (FM1)
    3. Outline the structure of bacteria, emphasising differences from eukaryotic cells (FM1)
    4. Causative organisms leading to bone and joint sepsis (LOC2)
    5. Describe the structure of viruses, defining the terms: capsid; capsomeres; genome; nucleocapsid, envelope (FM1)
    6. Describe how bacteria can be classified on the basis of staining properties and morphology (FM1)
    7. Describe how viruses replicate (FM1)
    8. List those parts of the body which should be sterile and those which have a normal flora (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)
  • Pathogenesis
    1. Discuss major infectious disease problems; case studies of bacteria; lessons from history (public health, pathology, pathogenesis)
    2. Describe portals of entry of pathogens and their adherence mechanisms (FM1)
    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. Have basic knowledge of the epidemiology and pathogenesis of malaria and of the parasite life cycle
    5. 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)
    6. Describe how pathogens are disseminated through host organs and how they exit from the host (FM1)
  • Antimicrobials and Bacterial Infections
    1. Antimicrobial therapy (LOC2)
    2. List innate and acquired defences against infection in man. (CSP3)
    3. Describe the principle of selective toxicity (FM1)
    4. Define humoral and cellular immunity. (CSP3)
    5. Describe the structure and function of targets in microbes that differ from their counterparts in the host (FM1)
    6. List iatrogenic and non-iatrogenic causes of immunosuppression. (CSP3)
    7. List organisms causing disease in the immunocompromised host relating these to the immunological defect particularly associated with infection by a particular organism. (CSP3)
    8. Outline the clinical evaluation and diagnostic procedures used when investigating the febrile immunosuppressed patient. (CSP3)
    9. Understand the mechanisms and implications of inherent and acquired antimicrobial resistance in bacteria (FM1)
    10. List principles of therapy in the immunocompromised host. (CSP3)
    11. List preventive measures employed against infection in known immunosuppressed hosts. (CSP3)
  • Antivirals and Viral Infections
    1. List the stages in the viral replication cycle from virus entry into the cell to virus release
    2. Innate and acquired defences against infections (CSP3)
    3. Know the concept of inhibition of virus specific enzymatic activities (FM1)
    4. Describe the nature of viruses and the main therapeutic interventions against viral disease.
    5. How to inhibit cellular factors important for virus replication (FM1)
    6. Define humoral and cellular immunity (CSP3)
    7. What are the treatment strategies and treatment side effects for selected viral infections (FM1)
    8. Iatrogenic and non-iatrogenic causes of immunosuppression (CSP3)
    9. List the drugs that can inhibit each stage of the viral life cycle
    10. Explain why emerging viruses are such a threat.
    11. Lists organism causing disease in the immunocompromised host (CSP3)
    12. List the stages of the influenza life cycle that can be inhibited by drugs and the drugs concerned
    13. Outline clinical evaluation and diagnostic procedures (CSP3)
    14. Principles of therapy in the immunocompromised host (CSP3)
  • 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)
  • Antifungals and Fungal Infections
  • Protozoal Infections
    1. Draw the life cycle of malarial species in man and the mosquito (CR3)
    2. Learn about the different species of Plasmodium that cause malaria in humans (CR3)
  • Sources of Infection and Routes of Transmission
    1. Define the terms: incidence; prevalence; endemic; epidemic; pandemic (FM1)
    2. To realise the concept of normal skin microflora and of chronic carriage of micro-organisms, such as Staphylococcal aureus. (LOC2)
    3. Discuss how pathogens are transmitted (FM1)
    4. Discuss methods of controlling infectious diseases (prevention, immunisation, treatment) and the significance of herd immunity. (FM1)
    5. List the major routes of transmission of HIV (I&I 4)
  • Management of Infection
  • Metabolic and Immunological Consequences of Infection
  • Prevention and Control of Infection
• Microbiology of Cardiovascular Infections
  • Endocarditis
    1. Learn about the organisms that cause infective endocarditis and explain how cardiac infection with each may be acquired (CR3)
    2. Be able to define minimum inhibitory concentration (MIC), minimal bactericidal concentration (MBC) and antimicrobial synergy (CR3)
    3. Be able to list the common bacterial causes of endocarditis in people with normal valves, abnormal native valves and prosthetic valves (CR3)
    4. Infective endocarditis: organisms, valves, guidelines for choosing antimicrobial (CSP3)
  • Rheumatic Fever and Rheumatic Heart Disease
    1. Explain how Group A streptococcal pharyngeal infection can lead to heart, skin, joint and CNS involvement and describe the pathological changes in these tissues. (CR3)
• Microbiology of Respiratory Infections
  • General Outcomes for Respiratory Tract Infections
  • Lower Respiratory Tract Infections - General
    1. Describe the main causes of lower respiratory tract infections.
    2. Explain how organisms causing lower respiratory tract infections are differentiated and identified by microbiological investigations (CR3)
    3. Discuss the importance of lower respiratory tract infections as a cause of morbidity and mortality, both in the hospital and community setting.
    4. Describe the clinical features (signs and symptoms) that suggest an atypical organism is responsible for lower respiratory tract infections
  • Upper Respiratory Tract Infections - General
    1. Discuss the effect of viruses on pre-existing respiratory conditions.
  • Chronic Obstructive Pulmonary Disease (COPD)
    1. List organisms that may cause pulmonary infection in patients with COPD (CR3)
    2. State features of diagnosis and treatment of infections with mycobacteria other than mycobacterium tuberculosis.
  • Pneumonia
    1. Learn pulmonary, immunological or other conditions which predispose patients to pulmonary infection (CR3)
    2. Name the principal organisms that cause pneumonia in a) immuno-competent people b) immuno-compromised people, and c) people in hospitals and institutions
  • Cystic Fibrosis
    1. Learn about the organisms that exacerbate bronchiectasis and cystic fibrosis and explain how you would choose an antibiotic for patients with exacerbations (CR3)
    2. Cystic Fibrosis, Pseudomonas Aeruginosa, Staphylococcus Aureus, Physiotherapy, Ciproflaxacin, Flucloxacilin, DNAase, CFTR
  • Tuberculosis
    1. Describe the nature of Mycobacterium tuberculosis and of other types of atypical mycobacterium.
    2. State features of diagnosis and treatment of infections with other mycobacteria.
• Microbiology of Haematological Infections
  • Immunosuppression
• Microbiology of Gastrointestinal Infections
  • Gastroenteritis and other Diarrhoeal Infections
    1. Significance of GI infections as a cause of morbidity /mortality
    2. Routes of transmission
    3. Major bacterial/protozoal /viral causes in the UK/worldwide
    4. Laboratory methods for diagnosis
    5. Public health measures to prevent them
    6. Abdominal infections and diarrhoea: prophylaxis and treatment of abdominal sepsis; management of infective diarrhoea (rehydration, isolation, notification, antimicrobials), clostridium difficile (CSP3)
  • Hepatitis
  • Helminthic Infections
• Microbiology of the Renal System and Urinary Tract
  • Urinary Tract Infections
    1. Classification, predisposing factors, symptoms, & diagnostic criteria for urinary tract infections.
    2. Types of samples, sources of error, & testing strategies.
    3. Causative organisms in urinary tract infections in general practice, in hospital, with calculi, & in the post-treatment patient.
    4. Treatment in UTIs: available antimicrobials, resistance to antimicrobials, treatment strategies & regimes, to treat or not to treat.
    5. UTIs in special groups; infants/children, pregnant women, nonpregnant women, young men, diabetic patients, people with underlying renal abnormalities, the elderly.
    6. Prevention & treatment of UTIs by non-antibiotic methods: fluid intake, cotton underwear, avoid bubble baths, & cranberry juice.
• Microbiology of Childhood Infections
  • Childhood Infections - General
    1. Categorise the main causes of childhood infections
• Microbiology of Sexually Transmitted Infections (Inc. HIV/AIDS)
  • General Outcomes for HIV and AIDS
    1. List the opportunistic infections that commonly cause clinical disease in HIV infection
    2. Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
    3. 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)
    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)
    5. Describe the structure of HIV and name the important constituent structures (I&I 4)
    6. 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
    7. To recognise the presentations of HIV infected patients with Pneumocystis pneumonia, Candidiasis, Toxoplasmosis, Cryptococcosis, Tuberculosis, Cytomegalovirus, Kaposiís Sarcoma, Lymphoma, Hepatitis B and C
    8. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
    9. To describe available Post Exposure Prophylaxis regimens for HIV and how best to access these regimens
    10. Describe factors affecting rates of transmission following exposure to HIV-infected materials (I&I 4)
    11. 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
    12. To be able to explain pathogenesis of HIV
    13. Explain the functions of the various parts of the HIV virus particle (I&I 4)
    14. Demonstrate knowledge of the CDC classification system for HIV infection (I&I 4)
    15. List the phases of the HIV replication cycle that can be inhibited by drug treatment
    16. Describe the genome of HIV with reference to the regulatory proteins produced and their functions. (I&I 4)
    17. Demonstrate the life cycle of HIV, with particular reference to the areas that have implications for therapeutic interventions (I&I 4)
    18. Describe how widespread HIV is; know what is meant by clades (CSP3)
    19. Demonstrate the events that occur at a cellular level during acute HIV infection (I&I 4)
  • Sexually Transmitted Infections - General
    1. Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei (I&I 4)
    2. Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum, (I&I 4)
    3. Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis (I&I 4)
    4. List the major routes of transmission of HIV (I&I 4)
• Microbiology of Obstetric and Gynaecological Infections
  • Obstetric and Gynaecological Infection - General
    1. List the viruses and other organisms that can harm a pregnancy (GEP/HD)
  • Infections in Pregnancy
    1. Discuss the ethical issues raised by infections during pregancy eg fetal abnormality as a result of infection
• Microbiology of Neurological Infections
  • Brain Abscess
  • Meningitis
• Microbiology of Musculoskeletal Infections
  • General Outcomes for Musculoskeletal Infections
    1. Risk factors and pathogenesis of bone and joint infections (LOC2)
    2. Can describe the clinical features and management of bone and joint infections (MusSkel4)

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