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: NUTRITION (TD 8.11)

Index

• Nutrition - General (See also Gastroenterology)
• Respiratory Disorders
• Renal Disorders
• Endocrine Disorders
• Haematological Disorders

• Nutrition - General (See also Gastroenterology)
  • General Outcomes for Nutrition
    1. Describe how a patient's energy requirements can be calculated (MET3A)
    2. Outline the nutritional requirements of the elderly
    3. List the current recommendations for daily exercise (MedSoc1)
    4. Outline the special nutritional requirements of children
    5. Recognise the major nutrient and vitamin requirements during infancy and childhood
    6. Be able to design appropriate diets for infants of different ages
    7. Demonstrate how to make up infant feeds
  • Under nutrition and Malnutrition
    1. Outline the impact of common micronutrient deficiencies on health
    2. Outline the long-term effects of fasting and malnutrition on body composition and metabolism
    3. Define adult groups who are at particular risk of under nutrition in the UK eg, Vitamin D deficiency in Asians; iron and vitamin deficiencies in Vegans and the elderly (MET3A)
    4. Understand possible adverse consequences of rapid refeeding after malnutrition
    5. Describe how to identify those at risk of malnutrition (GEP/DGM)
    6. Describe the clinical syndromes associated with deficiencies of the water-soluble vitamins B1 (thiamin), B6, B12 and folate (MET2)
  • Eating Disorders
    1. Recall the salient features of anorexia and bulimia
    2. Outline the management of a patient with anorexia nervosa (MET3A)
  • Carbohydrate
  • Protein Energy Malnutrition (PEM)
    1. Outline the prevalence and significance of protein-energy malnutrition
    2. Describe the effects of protein-calorie malnutrition on muscle function; delayed hypersensitivity; wound healing and gonadal function (MET3A)
  • Vitamins and Minerals
    1. Outline the nutritional and metabolic aspects of vitamin B12 and folate metabolism (including dietary aspects, absorption, body distribution and transport) (CR3)
    2. Describe the clinical syndromes associated with deficiencies of the water-soluble vitamins B1 (thiamin), B6, B12 and folate (MET2)
    3. Discuss the role of vitamins (and trace elements) as antioxidants (MET2)
    4. Give examples of water-soluble vitamins and list the principal function common to B vitamins (MET2)
    5. Understand the concept of megaloblastic anaemia and the effect of vitamin B12 and folate deficiency or inhibition on DNA synthesis (CR3)
    6. Recognise the structure of vitamin D3 and describe the sources of this vitamin in the body
    7. Understand how salt and alcohol influence cardiovascular function
    8. Give examples of important trace elements present in the diet within the context of clinical features of their deficiencies (MET2)
  • Nutrition and Ageing
    1. Outline the nutritional requirements of the elderly
  • Obesity
    1. Describe the physical, psychological social and emotional problems which may confront obese patients
    2. Discuss the important problems in obtaining a reliable nutritional history from obese patients
    3. Discuss the possible approaches to the treatment of obesity
    4. Review the main dietary factors that influence the development of coronary heart disease and hypertension
    5. List the treatment options for obesity
    6. Discuss the pathological and psychosocial consequences of obesity (MET2)
    7. Describe the prevalence of obesity in the UK and its relationship with the populations' intake of fat and carbohydrate and trends in physical exercise
    8. Enumerate the clinical signs which are relevant to the aetiology or complications of obesity
  • Nutrition in the Hospital Patient
    1. Describe how to identify those at risk of malnutrition (GEP/DGM)
    2. Outline the nutritional needs of hospitalised patients
  • Artificial Feeding (inc. Enteral Nutrition & Total Parenteral Nutrition)
    1. Understand possible adverse consequences of rapid refeeding after malnutrition
    2. Describe how feeds can be administered: sip feeds; nasogastric and gastrostomy (MET3A)
    3. Explain how artificial feeding techniques minimise the principal complications of aspiration, dehydration, hyperglycaemia, sodium overload and diarrhoea (MET3A)
    4. Describe the techniques of peripheral and central venous parenteral nutrition and how the technique employed may reduce the risk of thrombophlebitis, sepsis, hyperglycaemia and sodium overload (MET3A)
  • Food Allergy and Intolerance
  • Alcohol
    1. Understand how salt and alcohol influence cardiovascular function
  • Diet - Cholesterol Reducing
    1. List the major risk factors for cardiovascular disease
    2. Review the main dietary factors that influence the development of coronary heart disease and hypertension
    3. Differentiate between types of lipids in relation to protection from and contribution to cardiovascular disease
    4. Describe the management of hyperlipidaemia including diet, exercise and drugs (CR3)
• Respiratory Disorders
  • Cystic Fibrosis - Diet
    1. Describe nutritional problems and their management in cystic fibrosis (CR3)
• Renal Disorders
  • Diet for Renal Disorders - General
    1. Understand the role of diet in treating patients with renal calculi
    2. Understand the dietary management of chronic renal failure including the current controversy relating to the possible benefits of protein restriction on rate of decline of renal function
• Endocrine Disorders
  • Diabetic Diet
    1. Describe the principles of management of the newly diagnosed diabetic patient including the role of diet
• Haematological Disorders
  • Anaemia - Macrocytic & Microcytic
    1. Outline the nutritional and metabolic aspects of iron (including dietary iron, iron absorption, body iron distribution and transport) (CR3)
    2. Outline the nutritional and metabolic aspects of iron (including dietary iron, iron absorption, body iron distribution and transport) and the concept of iron overload.

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