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 11. PRINCIPLES, METHODS AND KNOWLEDGE OF POPULATION HEALTH: Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH (TD 11 a-j)

Index

• Public Health
• Public Screening Programmes
• Global Health

• Public Health
  • General Outcomes for Public Health
    1. List the overall aims and objectives of the year 1 Medicine in society course and describe the process by which they will be assessed
    2. Be able to describe to a colleague or patient the human science and public health aspects of surgical care
    3. Apply to medical practice the principles, method and knowledge of population health and the improvement of health and healthcare (click to see list) (YR5intro)
    4. Revisit the basic science, human science and public health aspects of surgical care, the use of evidence-based practice, guidelines and audit in surgical care.
    5. Recognise that health promotion and public health measures have an impact on the health of the population.
    6. List the public health influences that affect the development of ill-health and the restoration of health (MedSoc1)
  • Lifestyle and Disease
    1. Provide the major arguments supporting denial of NHS treatment from those condition was caused by their lifestyle. ()
    2. Be able to distinguish between the following terms and conditions: Rhythm method; Spermacide; Barrier method; Intra-uterine device (IUD)
    3. Describe the importance of lifestyle factors such as eating and exercise on obesity (CSP3)
    4. Appreciate the incidence and costs of patient non-adherence to medical advice.
    5. To understand factors which lead to unwanted pregnancy
    6. Outline some of the difficulties in trying to help people change their lifestyles. (CSP3)
    7. Provide the major arguments against denial of NHS treatment from such patients. ()
    8. Identify the most prevalent types of chronic illness in the UK.
    9. Describe the value of prevention versus treatment and begin to apply it to all medicine for the rest of your career
    10. To understand the role of stress and social deprivation etc on mental health (PSYCH4)
    11. Understand the social context of the question. ()
    12. Outline the rationale and efficacy of dietary, behavioural, pharmacological, and surgical treatments for obesity. (CSP3)
    13. Identify many of the human behaviours that lead to ill-health. (GEP/HSPH)
    14. Demonstrate skills in providing elementary guidance to obese patients. (CSP3)
    15. Explain the key driving factors behind current health policy as regards management of chronic illness.
  • 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)
    2. Recognise the importance of exponential growth (PH3)
    3. Distinguish organisms with and without environmental reservoirs. (PH3)
    4. Know the determinants of the risk of an infectious disease outbreak in a community. (PH3)
    5. Know the determinants of case severity. (PH3)
    6. Recognise that infectious diseases may cause chronic diseases including cancer. (PH3)
    7. Understand the nature of epidemics. (PH3)
    8. Understand the public health implications and management of infectious diarrhoea (MET3A)
  • Vaccination and Immunisation
    1. For the neurone in your brain that stores the word "vaccination" to synapse with the neurone that stores the term "herd immunity". (PH3)
    2. Know the normal immunisation programme
    3. Be familiar with the present vaccination schedule. (PH3)
    4. Recognise the normal immunisation programme. (GEP/HD, HD1)
    5. Understand the dangers to the individual and the herd of not immunizing. (GEP/HD, HD1)
    6. Recognise that realistic levels of vaccine uptake can eliminate infectious diseases nationwide. (PH3)
    7. Understand the dangers to the individual and the herd of not immunising
    8. Recognise the ultimate objective of eliminating infectious diseases worldwide. (PH3)
    9. Recognise the importance of striving for high uptake of a vaccine. (PH3)
    10. Relate experience in the UK to worldwide programmes of protection. (GEP/HD, HD1)
    11. Appreciate that vaccines are extremely safe (despite the scare stories). (PH3)
    12. Know the indications for vaccination against the following: a) influenza b) pneumococcus (CR3)
    13. List the indications for immunisation against TB and describe the vaccine used and its effectiveness
  • Antenatal Care
    1. Describe the factors affecting the risk of having a baby with Down's syndrome. (PH3)
    2. State the major health complications associated with Down's syndrome. (PH3)
    3. Know the antenatal screening programmes available in the UK and elsewhere. (PH3)
    4. Describe a Multiple of the Median (MoM), how it is calculated and why it is useful in screening for Down's syndrome. (PH3)
    5. Be able to explain a screening test to a woman considering the test. (PH3)
    6. Explain why certain family origin groups are at greater risk of developing blood disorders such as sickle cell anaemia. (PH3)
  • Influenza
  • Asthma
    1. Discuss the environmental factors that increase the vulnerability of young children to develop wheeze (GEP/HD, HD2)
  • Smoking
    1. Describe the smoking trends among men and women. (PH3)
    2. Describe the pharmacological and psychological aspects of smoking. (CSP3)
    3. Know the diseases caused by smoking. (PH3)
    4. Show awareness of existing treatments for smokers, and of their efficacy. (CSP3)
    5. Understand the relative merits of different methods of helping people stop smoking. (PH3)
    6. Show basic skills in advising smokers in routine medical consultations. (CSP3)
    7. Describe how a patient's 'pack years' are calculated (CR3)
    8. To recognise that the smoking epidemic is only just beginning in developing countries. (PH3)
  • HIV/AIDS and Sexually Transmitted Infections
    1. To understand the ways in which Sexual Health services are different from general medical services, including access issues and public health role
    2. Explain the principles of safe sex and risk reduction, and identify at risk groups (I&I 4)
    3. To understand the process when a patient attends a GUM clinic (I&I 4)
    4. List the reasons for high teenage pregnancy rates or rises in STI prevalence (I&I 4)
    5. Be able to explain the events within the immune system which result from HIV infection (I&I 4)
    6. Describe the specific immune responses to HIV (I&I 4)
    7. To identify opportunities for sexual health promotion including opportunities for early diagnosis of HIV in related and unrelated medical contexts (I&I 4)
    8. Explain the factors that may confer resistance to HIV (I&I 4)
    9. Define the term long-term non progressor (I&I 4)
  • Alcohol and Substance Abuse
  • Pulmonary Tuberculosis
    1. Discuss the purpose of TB notification and describe the processes whereby this is done
    2. List the people in contact with a person with TB who should be traced
    3. Describe the importance of tracing and investigating contacts in the control of TB and explain how this is done
  • Occupation and Disease
    1. Describe measures that can be taken to prevent occupational lung disease (CR3)
    2. Learn about those occupations that have a high chance of asbestos exposure (CR3)
    3. Learn about the patient categories with asbestos-related lung disease who are entitled to compensation (CR3)
    4. Explain the impact of cardiomyopathy for a patient's occupation
  • Oral Health
    1. Know that the major dental diseases of caries (tooth decay); periodontal disease (gum and supporting bone); oral cancer are, in the main, preventable chronic conditions. (PH3)
    2. Know that (oral) health depends on controlling consumption of free sugars, tobacco & alcohol by having a healthy diet, brushing twice daily with fluoridated toothpaste, not smoking. (PH3)
    3. Understand that material and social deprivation are significantly associated with poor oral health, access and uptake of dental services; children and the elderly are at the forefront of disadvantage. (PH3)
  • Diabetes
    1. Discuss some factors that may be contributing to the rise in prevalence of Type 2 diabetes (MedSoc1)
• Public Screening Programmes
  • Public Screening Programmes
    1. To outline national screening programs relevant to sexual and reproductive health and HIV (currently cervical screening, Chlamydia screening and antenatal HIV testing)
    2. Know how to calculate and interpret the three parameters of a screening test (detection rate, false-positive rate and odds of being affected given a positive test result).
    3. Recognise the trade-off between higher detection rate but higher false-positive rate.
    4. Be able to calculate and interpret the risk of being affected with a disorder for an individual based on a quantitative screening marker.
  • Screening for Gynaecological Cancers
    1. Discuss the principles of screening for and prevention of malignancies of the cervix, breast and ovary
  • Screening for Breast Cancer
    1. Evaluate the role of breast screening programmes.
  • Screening for Prostate Cancer
    1. Discuss the principles of screening for and prevention of malignancies of the prostate
  • Screening for Cardiovascular Diseases
    1. Discuss the advantages and disadvantages of screening in families with cardiomyopathy (CR3)
    2. Describe the role of screening for hyperlipidaemia (CR3)
  • Cancer prevention
    1. Know the major risk factors for breast cancer. (PH3)
    2. Know the agents that have potential to prevent breast cancer. (PH3)
    3. Understand the effectiveness of tamoxifen. (PH3)
    4. Recognise the key role of HPV in cervix cancer. (PH3)
    5. Know the major types of HPV involved in disease. (PH3)
    6. Understand the merits of HPV testing vs cytology in screening. (PH3)
    7. Know the two HPV vaccines currently available, and the UK vaccination programme. (PH3)
    8. Understand the issues about who to vaccinate. (PH3)
  • Cancer screening
    1. Define lead time and length time bias. (PH3)
    2. Understand the difference between mortality and survival. (PH3)
    3. Understand the reason for randomisation in cancer treatment trials and when to use an intention-to-treat and an on-treatment analysis. (PH3)
    4. Know the three NHS cancer screening programmes in Britain. (PH3)
• Global Health
  • General Global Health Topics
    1. To demonstrate an understanding of global health issues with regards to neglected tropical diseases (CSP4b)
    2. To understand the terminology, history and debate between schools of selective and comprehensive public health care (CSP4b)
    3. The aim of the lecture is to contextualize the role of diagnostics in the control and elimination of malaria in the 21st Century in terms of WHO recommendations, case definitions and treatment regimens. (CSP4b)
    4. To understand key principles of community development approaches to health improvement (CSP4b)
    5. To understand the terminology and history of tension between vertical programmes and public health care. (CSP4b)
    6. To understand approaches to evaluating health improvement interventions (CSP4b)
    7. To understand some of the opportunities the proposals for a new public health in local authorities offer (CSP4b)
    8. To understand the evidence deficit in health improvement. (CSP4b)
  • Health Systems including the HNS
    1. Compare health care spending in the UK with that of other government departments and of other countries. (PH3)
    2. Explain the significance of health care systems for population health (CSP4b)
    3. Explain the basis of funding and organization of the health service in the UK (CSP4b)
    4. Understand the relative merits of cutting NHS costs by reducing numbers of beds in a hospital, reducing length of admission, closing hospitals and merging hospitals. (PH3)
    5. Understand the ways in which health care systems differ from the perspective of funding, financing and planning (CSP4b)
    6. Describe the key market oriented changes introduced in the NHS over the last three decades and the basis of the evidence in support of them (CSP4b)
    7. Know the reasons for the increasing number of admissions. (PH3)
    8. Describe how the systems of funding and organization of health care impacts on access to health care and use of services by the population. (CSP4b)
    9. Explain the key proposals set out in the Health and Social Bill 2011 and explore implications for public health (CSP4b)
    10. Know the reasons for the increasing cost of the NHS over time. (PH3)
  • Migration, Conflict and Mental Health
    1. Define different types of migration (CSP4b)
    2. To give an overview of states of world refugeesTo give an overview of the mental health of refugees (CSP4b)
    3. To be familiar with causes and consequences of global migration (CSP4b)
    4. To be familiar with specific health and social care needs of forced migrant populations (CSP4b)
    5. To be able to understand the complex mental health states of refugees and migrant groups (CSP4b)
  • Health Inequalities
    1. Describe the extent of health and income inequalities worldwide (CSP4b)
    2. Describe the extent of health and income inequalities worldwide (CSP4b)
    3. Understand some of the key factors that might explain why some countries with similar incomes achieve variant child health outcomes (CSP4b)
    4. Understand some of the key factors that might explain why some countries with similar incomes achieve variant child health outcomes (CSP4b)
  • Social Policy
    1. To convey the importance of food policy for public health (CSP4b)
    2. Some of the key aspects of intellectual property and public health, particularly access to essential medicines. (CSP4b)
    3. To improve understanding of the health and social policy evidence base surrounding ‘welfare to work’, in the context of dominant public values and their reinforcement (CSP4b)
    4. To summarise some main food debates (CSP4b)
    5. Made aware of the interaction of intellectual property with other areas of law in the field of public health, including human rights and competition law. (CSP4b)
    6. To improve understanding of the relevance of this to working with patients who are unfit to work or who are concerned about their capacity to work (CSP4b)
    7. Understand the social context of the question. ()
    8. To introduce the notion of sustainable diets. (CSP4b)
    9. To improve understanding of the changing role of medical practitioners in relation to fitness for work (CSP4b)
    10. To improve understanding of what an informed approach to capacity to work might look like both locally and nationally, and how doctors can make a positive contribution in a new commissioning context (CSP4b)

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