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
- TD 10: APPLICATION OF SOCIAL SCIENCE PRINCIPLES, METHOD AND KNOWLEDGE
- TD 11. PRINCIPLES, METHODS AND KNOWLEDGE OF POPULATION HEALTH
- TD 12; APPLICATION OF SCIENTIFIC METHOD AND APPROACHES TO MEDICAL RESEARCH
- TD 8: APPLICATION OF BIOMEDICAL SCIENTIFIC PRINCIPLES, METHOD AND KNOWLEDGE
- THE DOCTOR AS A PRACTITIONER
- TD 13: CARRY OUT A CONSULTATION WITH A PATIENT
- 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
- TD 16: PROVIDE IMMEDIATE CARE IN MEDICAL EMERGENCIES
- TD 17: PRESCRIBE DRUGS SAFELY, EFFECTIVELY AND ECONOMICALLY
- TD 18: CARRY OUT PRACTICAL PROCEDURES SAFELY AND EFFECTIVELY
- TD 19: USE INFORMATION EFFECTIVELY IN A MEDICAL CONTEXT
- THE DOCTOR AS A PROFESSIONAL
- TD 20: BEHAVE ACCORDING TO ETHICAL AND LEGAL PRINCIPLES
- TD 21: REFLECT, LEARN AND TEACH OTHERS
- TD 22: LEARN AND WORK EFFECTIVELY WITHIN A MULT-PROFESSIONAL TEAM
- 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)
TD 13: CARRY OUT A CONSULTATION WITH A PATIENT: Clinical skills: HISTORY (TD 13 a-b)
Index
- General Outcomes for Patient Examination
- General Outcomes for History Taking
- Cardiorespiratory System
- Gastrointestinal
- Renal and Urinary Tract
- Endocrine and Breast
- Child Health
- Sexual Health
- Obstetrics and Gynaecology
- Neurological and Ophthalmological
- Musculoskeletal
- Dermatology
- General Outcomes for Patient Examination
- General Outcomes for History Taking
- Taking a History
- Take, record and present a neurological history, including a drug history (NEURO4, NEURO4, NEURO4)
- Can take a detailed and throrough medical history from an acutely unwell patient or from a relative or others
- Can take a detailed history from a surgical patient, relatives and others
- Can take a detailed and comprehensive history from a patient in a community setting (click here for list ) (GP5)
- Perform a mental-state examination. (YR5intro)
- Take and record a patient's medical history, including family and social history, talking to relatives or other carers where appropriate. (YR5intro)
- Be able to obtain a full psychiatric history.
- Discuss the important problems in obtaining a reliable nutritional history from obese patients
- Be able to a focussed and diagnostic history of a patient presenting with falls
- Be able to obtain an appropriate dermatological history from a patient presenting with a skin complaint. (DERM4)
- Is able to take an appropriate, focussed history, and examine an older patient presenting with cardiovascular or respiratory disease
- Be able to take an appropriate, focussed history, and examine a patient presenting with common surgical disorders
- Initiate consultation and establish rapport (MET3A)
- Be able to take an appropriate, focussed history, and examine a patient presenting with a common malignancy of the elderly.
- To appreciate the basic science behind clinical skills
- Be able to elicit psychiatric signs and symptoms (PSYCH4)
- Be able to take and record a patient's medical history, and recognize the role of taking a focussed history (GPCC3)
- To be able to take a history from a person with poor memory/communication skills (CC4)
- Identify common errors in interpreted consultations ()
- Take history and define the presenting complaint (MET3A, MET3A)
- Be able to competently take an ophthalmic history.
- Achieve a balance between listening and interrupting. To orientate, guide and structure the interview within a time frame. (PSYCH4, PSYCH4)
- Identify good practice in interpreted consultations ()
- Know how to elicit psychiatric symptoms and signs of a patient with a personality disorder. (PSYCH4)
- Be able to present a coherent summary of a patient's medical history (GPCC3)
- Communicate with patients who have psychiatric disorders: obtain information, provide reassurance and establish rapport (PSYCH4, PSYCH4)
- To be able to take a collateral history where appropriate- and understand how and where to get additional information from with regards to community patients with poor communication skills (CC4)
- Ascertain relevant past medical history, including drug history, allergies, family history and social history (MET3A)
- Practice gaining a history and establishing rapport with a patient through a trained interpreter ()
- Demonstrate how to obtain consent from a patient for history taking
- To be able to screen for depressive symptoms (PSYCH4, PSYCH4)
- Discuss difficulties in taking a history and strategies that help ()
- Undertake systems review (MET3A)
- Deal with dilemmas of confidentiality and detaining patients. (PSYCH4, PSYCH4)
- To be able to screen for manic and hypomanic symptoms (PSYCH4, PSYCH4)
- Explain the ethical and practical guidelines for interviewing patients
- Take a history to gain accurate and relevant information without making assumptions about sexual relations and behaviours. ()
- Establish the relationship and in particular to judge the distance both interpersonally and physically that is appropriate when interviewing patients with mental health problems. (PSYCH4, PSYCH4)
- Screen for psychiatric symptoms in a sensitive way (PSYCH4, PSYCH4)
- Take an accurate family history and present the results as an informative pedigree (GEP/HD, HD2)
- To know how to make a cultural formulation as part of a psychiatric assessment.
- Taking a History (OPHTH4)
- Be familiar with the role of the following professionals in the care of psychiatrically ill patients and be able to communicate effectively with each member of the multidisciplinary care team:- ward nurses, occupational therapists, social workers, genera (PSYCH4)
- Demonstrate skills necessary for dealing with aggressive and uncooperative patients (PSYCH4, PSYCH4)
- History from Older People
- Taking a History
- Cardiorespiratory System
- Examination of the Cardiovascular System
- Be confident in locating (via anatomical landmarks) and commenting on the strength of the following pulses: radial, brachial, carotid, popliteal, dorsalis pedis; posterior tibial (CR2)
- Demonstrate examination of varicose veins including distribution, communication with deep veins and complications (CR3)
- Be able to describe the rate and rhythm of the radial and carotid pulses (CR2)
- Describe how clinical examination can be used to distinguish between the causes of shock listed (CR3)
- You should be able to take blood pressure competently on a normal person by first estimating the systolic pressure by palpation and then accurately measuring by auscultation. (CR2)
- You should be able to recognise the pulsation of the normal JVP and assess its vertical height above the manubrio-sternal angle. (CR2)
- Recognise the first and second heart sounds on cardiac auscultation and identify systolic and diastolic murmurs (CR3)
- You should be able to accurately locate the normal apex beat, and report on its location by standard anatomical landmarks. (CR2)
- You should be able to auscultate the normal heart, and time the heart sounds with the pulse in your assessment of the cardiac cycle. (CR2)
- You should be confident in recognising the first and second heart sounds, the systolic and diastolic spaces, by timing the cardiac cycle against a central pulse. (CR2)
- You should be aware of the four main areas to auscultate, and the use of the bell and diaphragm of the stethoscope. (CR2)
- Demonstrate examination of the relevant neurological system following stroke (CR3)
- You should be starting to put together your assessment of the pulse, peripheral pulses, blood pressure and cardiac examination to form an examination of the cardiovascular system. (CR2)
- Distinguish between the causes of diastolic murmurs using characteristics of the murmur (site, radiation, character, pitch) and associated clinical features (CR3)
- Demonstrate competency in use of an ophthalmoscope to recognise retinal vascular abnormalities (CR3)
- Examination of the Respiratory System
- You should be able to auscultate the lungs and recognise normal breath sounds. (CR2)
- You should be putting together examination of the hands, pulse, JVP and lungs to conduct a systematic examination of the normal respiratory system. (CR2)
- List causes of haemoptysis
- Explain how clinical history and examination can be used to distinguish between causes of pleuritic chest pain (CR3)
- Demonstrate a basic examination of the respiratory system (MedSoc1)
- Patient History for Haematological Disorders
- Examination of the Cardiovascular System
- Gastrointestinal
- Patient History for GI Disorders
- Be able to take a history of a patient with diarrhoea (MET3A)
- Be able to take a history of a patient with an acute abdomen (MET3A)
- Be able to obtain an accurate history from a patient with an small bowel obstruction (MET3A)
- Understand the assessment of a patient with diarrhoea (MET3A)
- Competently be able to take an accurate and comprehensive history for an acute patient with bowel obstruction
- Be able to take a history for a patient with colorectal disease (MET3A)
- Describe the different methods of nutritional assessment (GEP/DGM)
- Competently be able to obtain an accurate history from a patient with large bowel obstruction (MET3A)
- To be able to take a focussed history form a patient with obstructive jaundice (MET3A)
- Be able to present clinical findings with a patient with obstructive jaundice (MET3A)
- Be able to take an appropriate history of a patient presenting with a lump in the groin
- List the diagnostic features in a history which are suggestive of peptic ulceration (MET3A)
- Be able to take an accurate and comprehensive history from an acute patient with cholecystitis (MET3A)
- Be able to take a history from, and examine a patient with inflammatory bowel disease (MET3A)
- Understand the significance of complaints of diarrhoea, constipation and altered bowel habit (MET3A)
- Abdominal Examination
- Competently be able to examine a patient with small bowel obstruction (MET3A)
- The anatomical basis of the abdominal examination
- Appreciate the examination techniques required to perform superficial and deep palpation of the abdomen (MET1)
- How to gain consent to examine a person/patient's abdomen
- Appreciate the examination techniques required to assess a patient for hepatomegaly and splenomegaly (MET1)
- Be able to perform an examination of a patient with an acute abdomen (MET3A)
- How to position a patient/person correctly prior to examining their abdomen
- Appreciate the examination technique of balloting (for renal enlargement). (MET1)
- Be able to elicit guarding (voluntary and involuntary), and rebound tenderness (MET3A)
- How to identify the common clinical signs that signal a patient with abdominal disease is unwell
- Competently be able to perform an examination of an acute patient with bowel obstruction
- Appreciate how to auscultate for bowel sounds. (MET1)
- How to systematically observe a patient from the end of the bed using the 'feet to face' principle, identifying some common abnormalities of abdominal disease
- Able to offer a suitable differential diagnosis (MET3A)
- Be able to classify the causes of an acute abdomen (MET3A)
- Be able to elicit Murphys sign (MET3A)
- How to perform a systematic examination of a patient with abdominal disease including some peripheral and central clinical signs
- Demonstrate the appropriate techniques required to perform a holistic clinical examination of a patient with abdominal disease
- The associated clinical examination and investigations required to complete a clinical assessment of a patient with abdominal disease
- Be able to perform an appropriate examination eliciting signs that would support the diagnosis of a direct inguinal, an indirect inguinal or femoral hernia
- Competently be able to perform an abdominal examination for an acute patient with cholecystitis (MET3A)
- Know what a patient with peritonitis board like rigidity is like to examine (MET3A)
- Colorectal Examination
- Vascular Examination (See also Cardiovascular)
- Patient History for GI Disorders
- Renal and Urinary Tract
- Fluid Assessment
- Be able to carry out a fluid assessment of a patient ie, know if they are volume deplete or volume expanded
- Understand the role of daily weight, lying and standing blood pressure and other clinical signs in the assessment of fluid balance
- Understand that fluid balance must be assessed clinically rather than by laboratory tests
- Fluid Assessment
- Endocrine and Breast
- Examination of the Thyroid
- Examination of the Breasts
- Recognise normal and physiological findings
- Take a history of breast symptoms
- Take a history to assess the risk factor for breast disease
- Be able to carry out an examination of the breasts including examination of the axillary lymph nodes and lymph node drainage sites
- Assess potential sites of distant disease
- Be able to identify features of breast cancer, eg, skin attachment, peau d'orange, deep muscle attachment
- Be able to carry out an examination of the breasts using a systematic approach and including preparing and positioning the patient appropriately
- Child Health
- History from children
- Examination of the Newborn
- 5. An understanding of differences in baby sizes at birth
- 4. An understanding of the assessment of maturity.
- 2. Knowledge of the normal values for weight, length and occipital frontal circumference (OFC).
- 3. An understanding of the method of physical examination.
- 1. An understanding of the aims of routine examination of the newborn.
- Have an understanding of the aims of routine examination of the newborn
- Know the normal values of weight, length and head circumference of an infant and plot these measurements on a centile chart
- Be able to measure the length, weight and head circumference of an infant and plot these measurements on a centile chart
- Have knowledge of the normal values for weight, length and occipital frontal circumference (OFC)
- Have an understanding of the method of physical examination of the newborn
- Have an understanding of the assessment of maturity of the newborn
- Have an understanding of differences in baby sizes at birth
- Examination of Children
- 4. Understand the methods by which development may be objectively assessed in young children.
- Describe how children with a disability are assessed (GEP/HD, HD2)
- Discuss the importance and the skills used when exploring psychological and physical symptoms
- Be able to perform a full examination of a child in a community setting (CC4)
- Take a history to determine the relevant features which may contribute to a diagnosis of short stature
- Understand the use of centile charts in assessing child growth
- Be able to perform a basic developmental check
- Be able to describe child health surveillance (6-8 week check) and developmental examinations, in particular up to 12 months (CC4)
- Sexual Health
- General
- Understand approach to diagnosing dysuria & discharge (history and examination) (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)
- Identify clinical situations where it is appropriate to take a sexual history ()
- Understand approach to diagnosing female pelvic pain (history, examination, pregnancy test) (I&I 4)
- List the required competencies in The Fraser Ruling (I&I 4)
- List a differential diagnosis for a female patient presenting with acute and or chronic pelvic pain
- Be able to obtain a contraceptive and reproductive health history to assess contraceptive need and to discuss contraceptive choices to enable patients to make informed decisions on those choices (I&I 4)
- List the reasons for high teenage pregnancy rates or rises in STI prevalence (I&I 4)
- Identify the reasons for taking a sexual history ()
- 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)
- Demonstrate correct condom technique (I&I 4)
- Understand and be able to explain the principles of Fraser Competency for under 16s and vulnerable young people and adults (I&I 4)
- Take a brief alcohol and recreational drug history and understand the relevance to high risk sexual behaviours (I&I 4)
- To understand how to take a sexual history (I&I 4)
- Describe the presenting features and referral pathway for testicular torsion (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)
- Understand the pathogenesis, diagnosis and management of Pelvic Inflammatory Disease
- 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)
- 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
- Obstetrics and Gynaecology
- O&G history
- Understanding the relevant terminology commonly used in O&G (O&G4)
- To be able to define presenting complaints by detailed history placing in context of background problems (O&G4)
- Identify the ethical issues of the patient when dealing with issues involving the woman, her partner (s), and children (O&G4)
- Sexual history
- O&G Examination
- Describe the anatomy of the vagina and cervix and their clinical examination
- List a differential diagnosis for a female patient presenting with acute and or chronic pelvic pain
- Describe what investigations can be performed to establish the causes of infertility (GEP/HD)
- Understand the basics of presentation, diagnosis and management of early pregnancy problems (click to see list) (CC4)
- Be able to perform competently an obstetric examination in a community setting (CC4)
- O&G history
- Neurological and Ophthalmological
- Examination of the Nervous System - General
- Appreciate the anatomical basis of the central neurological examination (BB2)
- Appreciate the anatomical / physiological basis of the peripheral neurological examination (BB2)
- Perform and present an examination of the conscious level, the cranial nerves and the neurology of the upper and lower limbs
- How to gain consent to examine a person / patient’s peripheral neurological system (BB2)
- Know how to gain consent to examine a person / patient's neurological system(s)
- Know how to correctly identify some simple abnormalities of the neurological system including signs of stroke disease
- Know how to position a patient / person correctly prior to examining their peripheral neurological nervous system, gait and cerebellar system. (BB2)
- Be able to perform a cutaneous sensory examination (low threshold touch; pinprick; point position sensation; vibration; temperature)
- Be able to identify the common clinical signs that show a patient has neurological deficit and / or the patient is unwell. (BB2)
- Know how to identify the common clinical signs that show a patient has neurological deficit and / or the patient is unwell. (BB2)
- Appreciate how to systematically observe a patient from the end of the bed using the 'feet to face' principle, identifying some common abnormalities of peripheral neurological disease. (BB2)
- Be able to perform a reflex tendon examination of the following reflexes: beceps, triceps, knee, ankle and plantar flexor
- Know how to systematically observe a patient from the end of the bed using the 'feet to face' principle, identifying some common abnormalities of central neurological disease. (BB2)
- Be able to demonstrate the appropriate techniques required to perform a systematic examination of a patient’s peripheral neurological system including gait and cerebellar disorders. (BB2)
- Be able to perform an EMG (electromyography) of the muscles of the upper limb and interpret the data generated
- Appreciate how to perform the associated clinical examination and investigations required to complete a neurological assessment. (BB2)
- Be able to perform a sensory and motor examination of the hand to assess the functions of the main nerves that innervate the hand
- Know how to perform the associated clinical examination and investigations required to complete a neurological assessment. (BB2)
- Appreciate how to complete the neurological assessment of a patient. (BB2)
- Examination of the CNS inc. Cranial Nerves
- Appreciate the anatomical / physiological basis of the neurological examination including the cranial nerves and their functions and the supporting basic neuroanatomy
- Know how to gain consent to examine a person / patient’s cranial nerves (BB2)
- Know how to position a patient / person correctly prior to examining their cranial nerves. (BB2)
- To elicit those reflexes obtainable in the eye (pupil, cornea) and to examine their physiological mechanism
- Be able to demonstrate the appropriate techniques required to perform a systematic examination of cranial nerves II, III, IV, V, VI, VII and XII. (BB2)
- Know how to conduct Rinnes and Webers tests and be able to interpret the results. (ENT4)
- Be able to perform clinical examination of cranial nerves III - VII and XI - XII
- Associate specific tests with cranial nerves, sensory modalities and ascending or descending pathways
- The student should know the principles of the examination with reference to the basic neuroanatomy and neurophysiology of the cranial nerves and pathways
- Examination of the PNS
- Appreciate the anatomical and physiological basis of the peripheral neurological examination
- to be familiar with the neuroanatomical basis for normal tendon reflexes in a series of skeletal muscles
- To observe and appreciate the plantar flexion reflex and recognise the significance of its pathological forms (e.g. Babinski reflex)
- Know the correct techinque used to perform a limited motor and sensory examination of the upper and lower limbs
- Examination of the Eye
- Be able to competently perform an examination of eye movements and extra-ocular muscle function including use of the cover test.
- Examination of the Eye (OPHTH4)
- Be able to competently perform an examination of eye movements and extra-ocular muscle function including use of the cover test (OPHTH4)
- Be able to perform a visual assessment including that for driving, refractive errors and their correction, management of the visually-handicapped patient in the community (OPHTH4)
- Be able to perform a visual assessment including that for driving, refractive errors and their correction, management of the visually-handicapped patient in the community.
- Be able to perform an assessment of visual acuity, pupils, colour vision and visual fields.
- Be able to perform an assessment of visual acuity, pupils, colour vision and visual fields (OPHTH4)
- Know the correct technique used to make an assessment of a patient's eyes - including visual acuity, visual fields, ocular movements and pupillary reflexes
- Be competent in the use of direct ophthalmoscope to examine the fundus including: how to recognise signs of diabetic retinopathy, normal and abnormal optic nerves, the macula, abnormalities of the retinal vasculature; examination for red reflex
- Be competent in the use of direct ophthalmoscope to examine the fundus including: how to recognise signs of diabetic retinopathy, normal and abnormal optic nerves, the macula, abnormalities of the retinal vasculature; examination for red reflex (OPHTH4)
- Competently be able to carry out an examination of the eye using a torch, magnifying aid and where possible, a slit lamp; methods and use of pupil dilation (OPHTH4)
- Competently be able to carry out an examination of the eye using a torch, magnifying aid and where possible, a slit lamp; methods and use of pupil dilation.
- Be able to competently take an ophthalmic history (OPHTH4)
- Be able to perform an examination of the basic visual reflexes
- Examination of the Nervous System - General
- Musculoskeletal
- Musculosketal History
- To obtain an appropriate musculoskeletal history from a patient presenting with either arthralgia, mylagia, back pain or chronic widespread disease (CC4)
- Can obtain a detailed musculoskeletal history from a patient presenting with either arthralgia, mylagia, back pain or chronic widespread disease (MusSkel4)
- Musculoskeletal Examination
- Musculosketal History
- Dermatology
- Examination of the Skin
- Demonstrate an ability to discriminate between different patterns of hair loss eg distribution, pathology (scarring, non-scarring alopecia) (DERM4)
- To take a history and examine patients with common skin diseases seen in general practice(click to see list) (CC4)
- Be able to demonstrate an appropriate level of skill in skin examination, including nails, hair and mucosa. (DERM4)
- Examination of the Skin