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 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
    1. Be able to a focussed and diagnostic history of a patient presenting with falls
    2. Is able to take an appropriate, focussed history, and examine an older patient presenting with cardiovascular or respiratory disease
    3. To appreciate the basic science behind clinical skills
    4. Be able to take an appropriate, focussed history, and examine a patient presenting with common surgical disorders
    5. Initiate consultation and establish rapport (MET3A)
    6. Be able to take an appropriate, focussed history, and examine a patient presenting with a common malignancy of the elderly.
    7. Perform a mental-state examination. (YR5intro)
    8. Be able to obtain an appropriate dermatological history from a patient presenting with a skin complaint. (DERM4)
    9. Be able to obtain a full psychiatric history.
    10. Discuss the important problems in obtaining a reliable nutritional history from obese patients
    11. Can take a detailed and throrough medical history from an acutely unwell patient or from a relative or others
    12. Take, record and present a neurological history, including a drug history (NEURO4, NEURO4, NEURO4)
    13. Take and record a patient's medical history, including family and social history, talking to relatives or other carers where appropriate. (YR5intro)
    14. Can take a detailed and comprehensive history from a patient in a community setting (click here for list ) (GP5)
    15. Can take a detailed history from a surgical patient, relatives and others
    16. Be able to competently take an ophthalmic history.
    17. Achieve a balance between listening and interrupting. To orientate, guide and structure the interview within a time frame. (PSYCH4, PSYCH4)
    18. Identify common errors in interpreted consultations ()
    19. Take history and define the presenting complaint (MET3A, MET3A)
    20. Be able to take and record a patient's medical history, and recognize the role of taking a focussed history (GPCC3)
    21. Be able to elicit psychiatric signs and symptoms (PSYCH4)
    22. To be able to take a history from a person with poor memory/communication skills (CC4)
    23. Identify good practice in interpreted consultations ()
    24. Ascertain relevant past medical history, including drug history, allergies, family history and social history (MET3A)
    25. Know how to elicit psychiatric symptoms and signs of a patient with a personality disorder. (PSYCH4)
    26. Be able to present a coherent summary of a patient's medical history (GPCC3)
    27. 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)
    28. Communicate with patients who have psychiatric disorders: obtain information, provide reassurance and establish rapport (PSYCH4, PSYCH4)
    29. Practice gaining a history and establishing rapport with a patient through a trained interpreter ()
    30. Demonstrate how to obtain consent from a patient for history taking
    31. To be able to screen for depressive symptoms (PSYCH4, PSYCH4)
    32. Discuss difficulties in taking a history and strategies that help ()
    33. Undertake systems review (MET3A)
    34. Deal with dilemmas of confidentiality and detaining patients. (PSYCH4, PSYCH4)
    35. To be able to screen for manic and hypomanic symptoms (PSYCH4, PSYCH4)
    36. Explain the ethical and practical guidelines for interviewing patients
    37. Take a history to gain accurate and relevant information without making assumptions about sexual relations and behaviours. ()
    38. 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)
    39. Screen for psychiatric symptoms in a sensitive way (PSYCH4, PSYCH4)
    40. Take an accurate family history and present the results as an informative pedigree (GEP/HD, HD2)
    41. To know how to make a cultural formulation as part of a psychiatric assessment.
    42. Taking a History (OPHTH4)
    43. 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)
    44. Demonstrate skills necessary for dealing with aggressive and uncooperative patients (PSYCH4, PSYCH4)
  • History from Older People
    1. To be able to take a history and examine a patient over the age of 75yrs (CC4)
• Cardiorespiratory System
  • Examination of the Cardiovascular System
    1. 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)
    2. Be able to describe the rate and rhythm of the radial and carotid pulses (CR2)
    3. Demonstrate examination of varicose veins including distribution, communication with deep veins and complications (CR3)
    4. 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)
    5. Describe how clinical examination can be used to distinguish between the causes of shock listed (CR3)
    6. You should be able to recognise the pulsation of the normal JVP and assess its vertical height above the manubrio-sternal angle. (CR2)
    7. Recognise the first and second heart sounds on cardiac auscultation and identify systolic and diastolic murmurs (CR3)
    8. You should be able to accurately locate the normal apex beat, and report on its location by standard anatomical landmarks. (CR2)
    9. 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)
    10. 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)
    11. You should be aware of the four main areas to auscultate, and the use of the bell and diaphragm of the stethoscope. (CR2)
    12. Demonstrate examination of the relevant neurological system following stroke (CR3)
    13. 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)
    14. Distinguish between the causes of diastolic murmurs using characteristics of the murmur (site, radiation, character, pitch) and associated clinical features (CR3)
    15. Demonstrate competency in use of an ophthalmoscope to recognise retinal vascular abnormalities (CR3)
  • Examination of the Respiratory System
    1. You should be able to auscultate the lungs and recognise normal breath sounds. (CR2)
    2. You should be putting together examination of the hands, pulse, JVP and lungs to conduct a systematic examination of the normal respiratory system. (CR2)
    3. List causes of haemoptysis
    4. Explain how clinical history and examination can be used to distinguish between causes of pleuritic chest pain (CR3)
    5. Demonstrate a basic examination of the respiratory system (MedSoc1)
  • Patient History for Haematological Disorders
    1. Identify questions which, on history taking, help elucidate likely causes of iron deficiency anaemia (CR3)
    2. Identify questions which, on history taking, help elucidate likely causes of macrocytic anaemia (CR3)
• Gastrointestinal
  • Patient History for GI Disorders
    1. Be able to take a history of a patient with diarrhoea (MET3A)
    2. Be able to obtain an accurate history from a patient with an small bowel obstruction (MET3A)
    3. Understand the assessment of a patient with diarrhoea (MET3A)
    4. Be able to take a history of a patient with an acute abdomen (MET3A)
    5. Describe the different methods of nutritional assessment (GEP/DGM)
    6. Competently be able to take an accurate and comprehensive history for an acute patient with bowel obstruction
    7. Be able to take a history for a patient with colorectal disease (MET3A)
    8. Competently be able to obtain an accurate history from a patient with large bowel obstruction (MET3A)
    9. To be able to take a focussed history form a patient with obstructive jaundice (MET3A)
    10. Be able to present clinical findings with a patient with obstructive jaundice (MET3A)
    11. Be able to take an appropriate history of a patient presenting with a lump in the groin
    12. List the diagnostic features in a history which are suggestive of peptic ulceration (MET3A)
    13. Be able to take an accurate and comprehensive history from an acute patient with cholecystitis (MET3A)
    14. Be able to take a history from, and examine a patient with inflammatory bowel disease (MET3A)
    15. Understand the significance of complaints of diarrhoea, constipation and altered bowel habit (MET3A)
  • Abdominal Examination
    1. Competently be able to examine a patient with small bowel obstruction (MET3A)
    2. The anatomical basis of the abdominal examination
    3. Appreciate the examination techniques required to perform superficial and deep palpation of the abdomen (MET1)
    4. How to gain consent to examine a person/patient's abdomen
    5. Appreciate the examination techniques required to assess a patient for hepatomegaly and splenomegaly (MET1)
    6. Be able to perform an examination of a patient with an acute abdomen (MET3A)
    7. How to position a patient/person correctly prior to examining their abdomen
    8. Appreciate the examination technique of balloting (for renal enlargement). (MET1)
    9. Be able to elicit guarding (voluntary and involuntary), and rebound tenderness (MET3A)
    10. How to identify the common clinical signs that signal a patient with abdominal disease is unwell
    11. Competently be able to perform an examination of an acute patient with bowel obstruction
    12. Appreciate how to auscultate for bowel sounds. (MET1)
    13. 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
    14. Able to offer a suitable differential diagnosis (MET3A)
    15. Be able to classify the causes of an acute abdomen (MET3A)
    16. Be able to elicit Murphys sign (MET3A)
    17. How to perform a systematic examination of a patient with abdominal disease including some peripheral and central clinical signs
    18. Demonstrate the appropriate techniques required to perform a holistic clinical examination of a patient with abdominal disease
    19. The associated clinical examination and investigations required to complete a clinical assessment of a patient with abdominal disease
    20. Be able to perform an appropriate examination eliciting signs that would support the diagnosis of a direct inguinal, an indirect inguinal or femoral hernia
    21. Competently be able to perform an abdominal examination for an acute patient with cholecystitis (MET3A)
    22. Know what a patient with peritonitis board like rigidity is like to examine (MET3A)
  • Colorectal Examination
    1. Be able to present clinical findings in a clear and logical manner (MET3A)
  • Vascular Examination (See also Cardiovascular)
• Renal and Urinary Tract
  • Fluid Assessment
    1. Be able to carry out a fluid assessment of a patient ie, know if they are volume deplete or volume expanded
    2. Understand the role of daily weight, lying and standing blood pressure and other clinical signs in the assessment of fluid balance
    3. Understand that fluid balance must be assessed clinically rather than by laboratory tests
• Endocrine and Breast
  • Examination of the Thyroid
    1. Distinguish thyroid enlargement from other lesions in the neck by examination
  • Examination of the Breasts
    1. Recognise normal and physiological findings
    2. Take a history of breast symptoms
    3. Take a history to assess the risk factor for breast disease
    4. Be able to carry out an examination of the breasts including examination of the axillary lymph nodes and lymph node drainage sites
    5. Assess potential sites of distant disease
    6. Be able to identify features of breast cancer, eg, skin attachment, peau d'orange, deep muscle attachment
    7. 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
    1. Knows the specific items required for a paediatric history in a community setting (CC4)
  • Examination of the Newborn
    1. 5. An understanding of differences in baby sizes at birth
    2. 4. An understanding of the assessment of maturity.
    3. 2. Knowledge of the normal values for weight, length and occipital frontal circumference (OFC).
    4. 3. An understanding of the method of physical examination.
    5. 1. An understanding of the aims of routine examination of the newborn.
    6. Have an understanding of the aims of routine examination of the newborn
    7. Know the normal values of weight, length and head circumference of an infant and plot these measurements on a centile chart
    8. Be able to measure the length, weight and head circumference of an infant and plot these measurements on a centile chart
    9. Have knowledge of the normal values for weight, length and occipital frontal circumference (OFC)
    10. Have an understanding of the method of physical examination of the newborn
    11. Have an understanding of the assessment of maturity of the newborn
    12. Have an understanding of differences in baby sizes at birth
  • Examination of Children
    1. 4. Understand the methods by which development may be objectively assessed in young children.
    2. Describe how children with a disability are assessed (GEP/HD, HD2)
    3. Discuss the importance and the skills used when exploring psychological and physical symptoms
    4. Be able to perform a full examination of a child in a community setting (CC4)
    5. Take a history to determine the relevant features which may contribute to a diagnosis of short stature
    6. Understand the use of centile charts in assessing child growth
    7. Be able to perform a basic developmental check
    8. Be able to describe child health surveillance (6-8 week check) and developmental examinations, in particular up to 12 months (CC4)
• Sexual Health
  • General
    1. 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)
    2. List the required competencies in The Fraser Ruling (I&I 4)
    3. Understand approach to diagnosing female pelvic pain (history, examination, pregnancy test) (I&I 4)
    4. List a differential diagnosis for a female patient presenting with acute and or chronic pelvic pain
    5. Understand approach to diagnosing dysuria & discharge (history and examination) (I&I 4)
    6. Identify clinical situations where it is appropriate to take a sexual history ()
    7. 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)
    8. List the reasons for high teenage pregnancy rates or rises in STI prevalence (I&I 4)
    9. Identify the reasons for taking a sexual history ()
    10. Understand some of the difficulties patients might have in discussing issues regarding sex, sexuality and sexual practices and problems (I&I 4)
    11. Understand causes of genital warts and difference between low-risk and high-risk HPV types (I&I 4)
    12. Demonstrate correct condom technique (I&I 4)
    13. Understand and be able to explain the principles of Fraser Competency for under 16s and vulnerable young people and adults (I&I 4)
    14. To understand how to take a sexual history (I&I 4)
    15. Take a brief alcohol and recreational drug history and understand the relevance to high risk sexual behaviours (I&I 4)
    16. To gain an appreciation of some of the different types of sexual practices (I&I 4)
    17. Describe the presenting features and referral pathway for testicular torsion (I&I 4)
    18. 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)
    19. Understand the relationship between HHV8, EBV and HPV in the etiology of malignancy (I&I 4)
    20. Understand the pathogenesis, diagnosis and management of Pelvic Inflammatory Disease
    21. 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)
    22. 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)
• Obstetrics and Gynaecology
  • O&G history
    1. Understanding the relevant terminology commonly used in O&G (O&G4)
    2. To be able to define presenting complaints by detailed history placing in context of background problems (O&G4)
    3. Identify the ethical issues of the patient when dealing with issues involving the woman, her partner (s), and children (O&G4)
  • Sexual history
    1. Be able to take an appropriate to take a sexual history
    2. Take a history to gain accurate and relevant information without making assumptions about sexual relations and behaviours
  • O&G Examination
    1. Describe the anatomy of the vagina and cervix and their clinical examination
    2. List a differential diagnosis for a female patient presenting with acute and or chronic pelvic pain
    3. Describe what investigations can be performed to establish the causes of infertility (GEP/HD)
    4. Understand the basics of presentation, diagnosis and management of early pregnancy problems (click to see list) (CC4)
    5. Be able to perform competently an obstetric examination in a community setting (CC4)
• Neurological and Ophthalmological
  • Examination of the Nervous System - General
    1. Perform and present an examination of the conscious level, the cranial nerves and the neurology of the upper and lower limbs
    2. Appreciate the anatomical basis of the central neurological examination (BB2)
    3. Appreciate the anatomical / physiological basis of the peripheral neurological examination (BB2)
    4. How to gain consent to examine a person / patient’s peripheral neurological system (BB2)
    5. Know how to gain consent to examine a person / patient's neurological system(s)
    6. Know how to correctly identify some simple abnormalities of the neurological system including signs of stroke disease
    7. Know how to position a patient / person correctly prior to examining their peripheral neurological nervous system, gait and cerebellar system. (BB2)
    8. Be able to identify the common clinical signs that show a patient has neurological deficit and / or the patient is unwell. (BB2)
    9. Know how to identify the common clinical signs that show a patient has neurological deficit and / or the patient is unwell. (BB2)
    10. Be able to perform a cutaneous sensory examination (low threshold touch; pinprick; point position sensation; vibration; temperature)
    11. 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)
    12. 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)
    13. Be able to perform a reflex tendon examination of the following reflexes: beceps, triceps, knee, ankle and plantar flexor
    14. 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)
    15. Be able to perform an EMG (electromyography) of the muscles of the upper limb and interpret the data generated
    16. Appreciate how to perform the associated clinical examination and investigations required to complete a neurological assessment. (BB2)
    17. Be able to perform a sensory and motor examination of the hand to assess the functions of the main nerves that innervate the hand
    18. Know how to perform the associated clinical examination and investigations required to complete a neurological assessment. (BB2)
    19. Appreciate how to complete the neurological assessment of a patient. (BB2)
  • Examination of the CNS inc. Cranial Nerves
    1. Appreciate the anatomical / physiological basis of the neurological examination including the cranial nerves and their functions and the supporting basic neuroanatomy
    2. Know how to gain consent to examine a person / patient’s cranial nerves (BB2)
    3. Know how to position a patient / person correctly prior to examining their cranial nerves. (BB2)
    4. To elicit those reflexes obtainable in the eye (pupil, cornea) and to examine their physiological mechanism
    5. 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)
    6. Know how to conduct Rinnes and Webers tests and be able to interpret the results. (ENT4)
    7. Be able to perform clinical examination of cranial nerves III - VII and XI - XII
    8. Associate specific tests with cranial nerves, sensory modalities and ascending or descending pathways
    9. 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
    1. Appreciate the anatomical and physiological basis of the peripheral neurological examination
    2. to be familiar with the neuroanatomical basis for normal tendon reflexes in a series of skeletal muscles
    3. To observe and appreciate the plantar flexion reflex and recognise the significance of its pathological forms (e.g. Babinski reflex)
    4. Know the correct techinque used to perform a limited motor and sensory examination of the upper and lower limbs
  • Examination of the Eye
    1. Be able to competently perform an examination of eye movements and extra-ocular muscle function including use of the cover test.
    2. Examination of the Eye (OPHTH4)
    3. Be able to competently perform an examination of eye movements and extra-ocular muscle function including use of the cover test (OPHTH4)
    4. 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)
    5. 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.
    6. Know the correct technique used to make an assessment of a patient's eyes - including visual acuity, visual fields, ocular movements and pupillary reflexes
    7. Be able to perform an assessment of visual acuity, pupils, colour vision and visual fields.
    8. Be able to perform an assessment of visual acuity, pupils, colour vision and visual fields (OPHTH4)
    9. 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
    10. 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)
    11. 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.
    12. 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)
    13. Be able to perform an examination of the basic visual reflexes
    14. Be able to competently take an ophthalmic history (OPHTH4)
• Musculoskeletal
  • Musculosketal History
    1. To obtain an appropriate musculoskeletal history from a patient presenting with either arthralgia, mylagia, back pain or chronic widespread disease (CC4)
    2. Can obtain a detailed musculoskeletal history from a patient presenting with either arthralgia, mylagia, back pain or chronic widespread disease (MusSkel4)
  • Musculoskeletal Examination
• Dermatology
  • Examination of the Skin
    1. Demonstrate an ability to discriminate between different patterns of hair loss eg distribution, pathology (scarring, non-scarring alopecia) (DERM4)
    2. To take a history and examine patients with common skin diseases seen in general practice(click to see list) (CC4)
    3. Be able to demonstrate an appropriate level of skill in skin examination, including nails, hair and mucosa. (DERM4)

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