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 14: DIAGNOSE AND MANAGE CLINICAL PRESENTATIONS: Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)

Index

• General Outcomes for Diagnosis and Reasoning
• Acute and Emergency Care Diagnosis
• Cardiovascular Diagnosis
• Respiratory Diagnosis
• Haematological Diagnosis
• Diagnosis of Musculoskeletal Disorders
• Gastrointestinal Diagnosis
• Renal and Urological Diagnosis
• Endocrine Diagnosis
• Breast Disease Diagnosis
• Child Health Diagnosis
• Sexual Health Diagnosis
• Obstetrics and Gynaecology Diagnosis
• Diseases of the Elderly Diagnosis
• Psychiatric Diagnosis
• Neurological Disease Diagnosis
• Ophthalmology Diagnosis
• Dermatology Diagnosis

• General Outcomes for Diagnosis and Reasoning
  • Diagnosis and Reasoning
    1. Propose a differential diagnosis for a surgical patient
    2. Propose a differential diagnosis and formulate an initial management plan for a patient with common medical and mental health acute presentations
    3. Identify the benefits and problems of early or pre-symptomatic diagnosis (GP5)
    4. Can describe the features and management of distal radius fracture, scaphoid fracture, mtacarpal/phanageal fracture and tendon injuries (MusSkel4)
    5. Describe how to identify those at risk of malnutrition (GEP/DGM)
    6. Be able to list a differential diagnosis for a patient presenting with dysphagia.
• Acute and Emergency Care Diagnosis
  • General Outcomes fof Acute and Emergency Care Diagnosis
• Cardiovascular Diagnosis
  • General Outcomes for Cardiovascular Diagnosis
    1. Using history (symptoms), signs and ECG findings be able to diagnose and distinguish between a) cardiac arrest b) atrial flutter and fibrillation (AF), c) respiratory arrest d) ventricular tachycardia +/- pulse
    2. Explain how an ECG can be used to determine the site of myocardial infarction and indicate which vessel is occluded (CR3)
    3. Learn about differential diagnosis for retrosternal chest pain (CR3)
    4. carry out ankle brachial pressure index measurement (MET3A)
    5. Describe the criteria for the diagnosis of myocardial infarction (CR3)
  • Hypertension
  • Angina
    1. Plan how to improve one’s own skills in diagnosing and managing a person with angina.
  • Acute Coronary Syndrome and Myocardial Infarction
  • Arrhythmia and Conduction Defects
    1. Describe the relevant investigations that should be performed in patients with suspected arrhythmias including 24 hour cardiac monitoring and investigation of underlying causes (CR3)
    2. Describe the mechanism and speed of onset of action, place in therapy and major side effects of adenosine, digoxin, amiodarone, verapamil, beta blockers, lignocaine, flecainide, magnesium and atropine. (CR3)
    3. Know how to manage a patient with a cardiac arrest in line with the current UK Resuscitation Council Guidelines
  • Cardiac Failure and Pulmonary Oedema
    1. Know the differential diagnosis for breathlessness
    2. Be able to distinguish between the following terms and conditions: a) left ventricular failure b) right ventricular failure c) congestive cardiac failure / bi-ventricular failure d) diastolic and systolic failure e) cardiogenic shock f) low output failure
  • Acute Circulatory Failure and Shock
    1. Learn to distinguish between bronchial and “cardiac asthma”
  • Cardiorespiratory Arrest
    1. Learn how to recognise cardiorespiratory arrest (CR3)
    2. Recognise cardiac rhythm problems, particularly ventricular fibrillation (VF) and ventricular tachycardia (VT) on an ECG trace (CR3)
    3. Describe the prognosis of a patient in hospital who has a cardio-respiratory arrest and explain how underlying illnesses (acute and chronic), such as cancer influences this prognosis (CR3)
  • Vascular Disease (Inc. CVA)
    1. Learn the patho-physiology of atherosclerosis (CR3, CR3)
    2. Identify a patient with cerebro-vascular accident
    3. Learn the common symptoms and signs of mesenteric ischaemia
    4. Learn the management of mesenteric ischaemia (CR3)
    5. Give an outline of a simple classification of vasculitis (CR3)
    6. Give an account of polyarteritis nodosa (CR3)
  • Endocarditis
    1. Give a differential diagnosis for an unexplained fever (CR3)
    2. Explain how the diagnosis of infective endocarditis is made and describe the role of investigations including blood cultures and echocardiography in this process (CR3)
  • Limb Ischaemia / Peripheral Vascular Disease (See also the Metabolic System)
  • Arterial Aneurysms (See also the Metabolic System)
    1. Give a differential diagnosis for an epigastric mass (CR3)
    2. Learn the risk factors for arterial aneurysm and describe how these should be assessed and controlled (CR3)
  • Pericardial Disease
    1. Describe the ECG changes expected in a patient with acute pericarditis and explain how these differ from the changes seen with an MI (CR3)
    2. Understand the ECG and echocardiography findings in patients with pericardial effusion and constrictive pericarditis/cardiac tamponade (CR3)
  • Myocardial Disease and Cardiomyopathy
    1. Describe symptoms and signs of dilated, hypertrophic and restrictive cardiomyopathy and explain why these differ between types (CR3)
    2. Describe symptoms and signs of dilated, hypertrophic and restrictive cardiomyopathy and explain why these differ between types (CR3)
    3. Give causes of dilated, hypertrophic and restrictive cardiomyopathy (CR3)
  • Congenital Cardiovascular Diseases
    1. Give a differential diagnosis for central cyanosis (CR3)
  • Rheumatic Fever and Rheumatic Heart Disease
    1. Describe how the Duckett-Jones criteria are used to make the diagnosis of rheumatic fever (CR3)
• Respiratory Diagnosis
  • General Outcomes for Respiratory Diagnosis
    1. Give a differential diagnosis for a cough productive of sputum
    2. Give a differential diagnosis for finger clubbing
    3. Identify the anatomical features of COPD, pneumonia, carcinoma and tuberculosis on pathological specimens and on radiographs (CR2)
  • Asthma
    1. Give a differential diagnosis for a wheeze (CR3)
  • Chronic Obstructive Pulmonary Disease (COPD)
    1. Give a differential diagnosis for exertional breathlessness and cough (CR3)
    2. Give a differential diagnosis for increased breathlessness in a patient with COPD (CR3)
    3. Give five most common causes of cough
  • Lung Cancer
    1. Explain why it is important to differentiate between small cell and non-small cell forms of lung cancer (CR3)
  • Deep Vein Thrombosis
    1. Give the differential diagnosis for calf swelling / tenderness (CR3)
  • Pulmonary Tuberculosis
    1. Be able to understand the difference between primary and post-primary tuberculosis
    2. Describe how tuberculosis affecting organs other than the lung may present
    3. Describe the presentation of tuberculosis, especially potential difficulties in diagnosis.
  • Pleural Effusion and Pleural Disease
    1. Differentiate clinical signs of a pleural effusion from those of pulmonary consolidation, collapse, pneumothorax and lung fibrosis (CR3)
    2. Describe how investigations including chest X-Ray, pleural tap, pleural biopsy and CT chest can help to differentiate between causes of effusion
  • Chest Trauma and Haemothorax
    1. Describe the diagnosis and management of haemothorax
  • Sarcoidosis
  • Sleep Apnoea
    1. Discuss the difference between obstructive and central sleep apnoea (CR3)
  • Occupational Lung Disease - General
    1. Learn about how mesothelioma is diagnosed (CR3)
  • Pulmonary Embolism
    1. Give a differential diagnosis for pleuritic chest pain (CR3)
    2. Describe the role of D-Dimer, CXR, ECG, V/Q scanning, Spiral CT scanning and pulmonary angiogram in the diagnosis of pulmonary embolus (CR3)
    3. Describe the differential diagnosis of those conditions which present with similar symptoms (other than pleuritic chest pain) to PE
• Haematological Diagnosis
  • General Outcomes for Haematological Diagnosis
    1. Understand how the patient’s presentation, examination findings and other investigations including blood counts, complement microscopic analyses of blood films. Begin to interpret such information to form likely diagnoses in common conditions (CR2)
    2. Outline the laboratory diagnosis of a haemolytic process and understand the concept of extravascular and intravascular haemolysis
  • Anaemia
    1. Give a differential diagnosis for normocytic anaemia (anaemia of chronic disease) (CR3)
    2. Outline the investigation and management of a patient with iron deficiency anaemia (CR3)
    3. Differentiate, by laboratory tests, anaemia due to iron deficiency from other causes of microcytic anaemia (CR3)
    4. Describe the symptoms, signs and laboratory diagnosis of megaloblastic anaemia (CR3)
    5. Describe an approach to the investigation and management of a patient with anaemia (CR3)
  • Haemoglobinopathies (Sickle Cell / Thalassaemia)
    1. Outline the laboratory diagnosis of sickle cell disease and thalassaemia (CR3)
  • Platelet Disorders
    1. Outline the investigation and management of a patient with autoimmune thrombocytopenic purpura
    2. Give a differential diagnosis for thrombocytosis (raised platelet count)
  • Disorders of Haemostasis
  • Leukaemias
    1. Be able to classify leukaemia into acute (AML and ALL) and chronic (CML and CLL) based on the clinical and laboratory findings
    2. Compare and contrast the main differences between acute and chronic leukaemia
    3. Describe the diagnostic pathway required to confirm the diagnosis of leukaemia
  • Myeloma
    1. Distinguish myeloma from benign paraproteinaemia
  • Lymphoma
  • Polycythaemia
    1. Give a differential diagnosis for polycythaemia (CR3)
• Diagnosis of Musculoskeletal Disorders
  • Diagnosis of Musculoskeletal Disorders
    1. Can describe the features and management of meniscal tears, anterior cruciate ligament tear, medial collateral ligament sprain, patella fracture (MusSkel4)
    2. Can list a differential diagnosis for a patient presenting with a hot swollen joint. (MusSkel4)
    3. Can list a differential diagnosis for a patient presenting with acute polyarthritis (MusSkel4)
    4. List a differential diagnosis for a patient presenting with persistent pain in a single joint.
    5. Can list a differential diagnosis for a patient presenting with persistant polyarthritis. (MusSkel4)
    6. Describe the diagnostic laboratory and radiological investigation of osteomalacia
    7. Understand how the anatomy can help physicians and surgeons to treat these conditions. (LOC2)
    8. Knows the clinical and radiological features of spondylosis, spondylolisthesis and spondylolysis (MusSkel4)
    9. Can describe six red flag features and understand their diagnostic value (MusSkel4)
    10. Knows how to diagnose and treat a patient with rheumatoid arthritis (MusSkel4)
    11. Can list a differential diagnosis for a patient presenting with myalgia (MusSkel4)
    12. Describe the clinical features, pathology, diagnosis and treatment of polymyalgia rheumatica (MusSkel4)
    13. Can describe how to diagnose and treat giant cell arteritis (MusSkel4)
    14. Can list a differential diagnosis for a patient with chronic widespread musculoskeletal pain (MusSkel4)
    15. Can diagnose and treat a patient with chronic widespread pain / fibromyalgia (MusSkel4)
• Gastrointestinal Diagnosis
  • General Outcomes for Gastrointestinal Diagnosis
    1. Be able to assess a patient with chronic liver disease
    2. Describe the different methods of nutritional assessment (GEP/DGM)
    3. Be able to offer a differential diagnosis for a patient presenting with diarrhoea (MET3A)
    4. How to identify the common clinical signs that signal a patient with abdominal disease is unwell
    5. 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
    6. Be able to present clinical findings in a clear and logical manner
    7. How to perform a systematic examination of a patient with abdominal disease including some peripheral and central clinical signs
    8. Be able to distinguish between the following terms and conditions: cirrhosis; alcoholic liver disease; encephalopathy; hepatitis; oesophageal varices; ascites
    9. Be able to differentiate between a mechanical and dynamic obstruction
    10. Know when and how to investigate a patient with diarrhoea, constipation or altered bowel habit (MET3A)
  • Acute Abdomen - General
  • Appendicitis
    1. Know the differential diagnosis of appendicitis (MET3A)
    2. Be able to discriminate appendicitis from the other differential diagnoses on the patient's history (MET3A)
  • Pancreatitis
    1. Understand the difference between mild and severe pancreatitis (MET3A)
    2. Be able to describe the early and late complications of acute pancreatitis (MET3A)
    3. Understand the difference between acute and chronic pancreatitis (MET3A)
    4. Understand the difference between acute and chronic pancreatitis
    5. Know the classical clinical presentation of acute pancreatitis (MET3A)
    6. Know the causes of acute pancreatitis (MET3A)
    7. Know the pathophysiology of acute pancreatitis (MET3A)
    8. Know the differential diagnosis of acute pancreatitis
    9. Know the differential diagnosis of acute pancreatitis (MET3A)
    10. Know the diagnostic investigations useful for the diagnosis of acute pancreatitis (MET3A)
    11. Know the role of Ultrasound, CT and ERCP in the management of acute pancreatitis (MET3A)
    12. Know Atlanta criteria for severity scoring (MET3A)
    13. Know the importance and prognostic value of the scoring systems (Ranson & Glasgow) in patient management (MET3A)
    14. Know the importance and prognostic value of the scoring systems (Ranson & Glasgow) in patient management
    15. Be aware that acute severe pancreatitis can lead to multi-organ failure (MET3A)
  • Cholecystitis
    1. Be able to differentiate between acute and chronic cholecystitis (MET3A)
    2. Be able to differentiate biliary colic from cholecystitis (MET3A)
    3. Be able to construct a differential diagnosis (MET3A)
    4. Be able to present clinical findings in a clear and logical manner (MET3A)
  • Hernia
    1. Know the differential diagnosis for a lump in the groin
  • GI Bleeding
    1. Be able to assess whether the patient requires immediate resuscitation (ABC) (MET3A)
    2. Be able to distinguish between upper and lower gastrointestinal bleeding (MET3A)
  • Diarrhoeal and Inflammatory Disorders
    1. Understand the difference between Crohns Disease and Ulcerative Colitis (MET3A)
    2. Be able to distinguish between the following terms and conditions: increased bowel frequency; diarrhoea; inflammatory / secretory / osmotic diarrhoea; irritable bowel syndrome; diverticular disease; vomiting centre; chemoreceptor trigger zone (MET3A)
    3. List the causes of diarrhoea and outline the diagnostic features in the history (MET3A)
    4. Be able to distinguish between the following terms and conditions: Crohn's Disease; Ulcerative Colitis; Irritable Bowel Syndrome; Acute Flare; Toxic Megacolon; Infective Diarrhoea (MET3A)
  • Bowel Obstruction (General)
    1. List a differential diagnosis for small bowel obstruction (MET3A)
    2. Know the difference between simple, complicated obstruction, acute, sub-acute and chronic obstruction
    3. Understand the difference between simple and strangulating intestinal obstruction (MET3A)
    4. Understand the term closed loop obstruction
    5. Know the differential diagnosis for bowel obstruction
  • Vascular Diagnosis (See also Cardiovascular)
• Renal and Urological Diagnosis
  • General Outcomes for Renal and Urological Diagnosis
  • Nephrotic Syndrome and Glomerulonephritis
    1. Know and understand the diagnostic criteria for nephrotic syndrome
    2. Know the differing diagnostic / treatment approaches to childhood and adult nephrotic syndrome
    3. Know the differential diagnosis for nephrotic syndrome
  • Acute Renal Failure
    1. Understand how urinalysis and microscopy can help distinguish the various categories of acute renal failure
  • Chronic Renal Failure
    1. Understand the role of proteinuria in the monitoring of patients with chronic renal failure and its role in progression
  • Bladder Dysfunction and Urinary Tract Infection
    1. Distinguish between urge incontinence, stress incontinence, overflow incontinence and leak incontinence (GEP/DGM)
    2. Know predisposing factors for urinary tract infections (UTI's) and how to diagnose them
  • Malignancies of the Renal Tract
    1. Understand the significance of microscopic and macroscopic haematuria
• Endocrine Diagnosis
  • General Outcomes for Endocrine Diagnosis
  • Diabetes and Insulin Resistance Diagnosis
    1. Describe the diagnostic criteria for Diabetes Mellitus (DM), impaired fasting glycaemia (IFG), and impaired glucose tolerance (IGT)
  • Disorders of the Thyroid
    1. List the possible causes of thyroid enlargement in a euthyroid patient
  • Adrenal Disorders
    1. Describe the clinical syndromes underlying causes and pathology associated with adrenocortical hypofunction
• Breast Disease Diagnosis
  • General Outcomes for Breast Diagnosis
    1. Be able to propose a diagnosis from clinical findings and plan mangement
• Child Health Diagnosis
  • Diagnosis in Children
    1. Understand Paediatric ocular problems including the neonatal eye, squint and amblyopia. (OPHTH4)
    2. Be able to recognise the child with Autistic Spectrum Disorder
    3. Know the presentation, clinical signs and multidiciplinary management of ADHD
    4. Understand that many childhood presenting complaints have no organic basis and to be able to confidently and confidentially explore these areas with the family
    5. List disorders seen in child mental health clinics and identify which of them are common
    6. Know the common surgical problems throughout childhood: both acute and chronic; recognition, management, and prognosis; preparing a child and family for the operating theatre
    7. Understand Paediatric ocular problems including the neonatal eye, squint and amblyopia
    8. Be able to identify common infectious diseases in children (chicken pox, measles, viral rashes, acne) (CC4)
    9. Diagnosis in Children (OPHTH4)
• Sexual Health Diagnosis
  • General Outcomes for Sexual Health Diagnosis
    1. Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis (I&I 4)
    2. Understand the pathogenesis, diagnosis and management of the following in the context of HIV: Kaposi’s sarcoma, Non-Hodgkin’s B cell Lymphoma, Primary cerebral lymphoma, Burkitt’s lymphoma and squamous cell carcinoma
    3. Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum, (I&I 4)
    4. Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei (I&I 4)
    5. Recognise the significance and list possible causes for the following symptoms in an HIV infected person: Generalised seizures; Loss of consciousness; Focal neurological deficit; Change in affect; Shortness of breath; Rash; Fever (I&I 4)
    6. Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
    7. Understand approach to diagnosing vaginal discharge (history and examination) (I&I 4)
    8. 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
    9. Understand approach to diagnosis of genital lumps (history and examination) (I&I 4)
    10. List a differential diagnosis for a male patient presenting with urethral and or rectal discharge
    11. List a differential diagnosis for a female patient presenting with vaginal and or rectal discharge
    12. Understand approach to diagnosing genital sores (history and examination) (I&I 4)
    13. List the diagnostic tests used for genital sores (Dark ground, PCR) (I&I 4)
    14. List a differential diagnosis for a male and female patient presenting with genital lumps (including normal anatomical variance) (I&I 4)
    15. Understand the effect of co-infection with HIV and Hepatitis B and C on the natural history of HIV and Hepatitis B and C (I&I 4)
    16. List differential diagnoses (eg ectopic pregnancy, PID, UTI) (I&I 4)
    17. List a differential diagnosis patient presenting with urethral or rectal discharge and/or dysuria (including NGU and LGV) (I&I 4)
    18. List a differential diagnosis for a patient presenting with acute or chronic testicular pain (I&I 4)
    19. List a differential diagnosis for a male and female patient presenting with genital ulceration, focussing on Herpes Simplex and Syphilis infection (I&I 4)
    20. Describe the methods of diagnosis and monitoring of Hepatitis B and C infection (I&I 4)
    21. With reference to HIV, Hepatitis B and C and STDs the student should be able to: a) Identify the skills, roles and responsibilities of the health care team; b) To understand that a patient needs to give consent for an HIV test and that pre-test/post-test counselling are no longer performed routinely in order to reduce the stigma associated with HIV. (I&I 4)
    22. Understand the pathogenesis, diagnosis and management of epididymitis (I&I 4)
    23. Recognise the clinical presentations of non-infective genital ulceration (eg Bechet’s disease) (I&I 4)
    24. Describe the presenting features and referral pathway for testicular torsion (I&I 4)
    25. Be able to explain asymptomatic shedding of HSV (I&I 4)
    26. Be able to explain incubation periods and transmission (I&I 4)
    27. Explain why HIV infection predisposes to certain malignancies (I&I 4)
    28. Explain other aspects of management – e.g. Patient Information, Partner Notification issues, condom use (I&I 4)
    29. Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
    30. To have an introduction to Sexually Transmitted Infection (STI) and their treatments (I&I 4)
    31. Consider appropriate differential diagnoses for each condition (I&I 4)
• Obstetrics and Gynaecology Diagnosis
  • Diagnosis of Obstetric and Gynaecological Disorders
    1. Describe what investigations can be performed to establish the causes of infertility (GEP/HD)
    2. List differential diagnoses (eg ectopic pregnancy, PID, UTI) (I&I 4)
    3. Understands the basics of : presentation, diagnosis and management of common and important gynaecological problems seen in the community (click to see list) (CC4)
    4. List of differential diagnosis of pelvic pain in women - gynaecological, non-gynaecological, psychological and psychosexual
• Diseases of the Elderly Diagnosis
  • Diagnosis in Older People
    1. To understand how capacity is assessed (CC4)
• Psychiatric Diagnosis
  • General Outcomes for Psychiatric Diagnosis
    1. Alcohol Abuse: Describe the use of simple behavioural screening tests to recognise problematic alcohol use (PSYCH4)
    2. Give a differential diagnosis of common psychiatric disorders with supporting reasons. (PSYCH4, PSYCH4)
    3. To list the features that distinguish schizophrenia from a mood disorder with psychotic features (PSYCH4)
    4. To know of risk factors and assessment of risk for psychiatric conditions (PSYCH4)
    5. To summarise the signs and symptoms, differential diagnosis, course of illness, co-morbidity, prognosis and complications of mood disorders (PSYCH4, PSYCH4)
    6. Anxiety Disorders: To discuss the diagnosis and management of panic disorder, agoraphobia, social phobia and specific phobias. (PSYCH4)
    7. To formulate a differential diagnosis for an individual presenting with psychosis (PSYCH4, PSYCH4)
    8. Obsessive-Compulsive Disorder: To discuss the diagnosis and management of obsessive-compulsive disorder. (PSYCH4)
• Neurological Disease Diagnosis
  • General Outcomes for Neurological Diagnosis
    1. Interpret the history and examination in order to begin to formulate a differential diagnosis for a patient complaining of dizziness, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate. (NEURO4)
    2. Be able to assess and list a differential diagnosis in a patient presenting with facial palsy.
    3. Describe the presentation, examination and management of patients with headaches in primary care (NEURO4)
    4. Interpret historical and examination findings in order to begin to formulate a differential diagnosis, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate (NEURO4)
• Ophthalmology Diagnosis
  • General Outcomes for Ophthalmology Diagnosis
    1. Know the symptoms of cataract and be able to diagnose cataract (OPHTH4)
    2. Know the common neuro-ophthalmic disorders to include the interpretation of visual field abnormalities.
    3. Know about the common ophthalmic emergencies and how they are diagnosed eg Central Retinal Artery Occlusion; Temporal Arteritis (OPHTH4)
    4. Understand the involvement of the eye in diabetes and other systemic disorders e.g. hypertension. (OPHTH4)
    5. Understand Paediatric ocular problems including the neonatal eye, squint and amblyopia. (OPHTH4)
    6. Know about the common ophthalmic emergencies and how they are diagnosed eg Central Retinal Artery Occlusion; Temporal Arteritis
    7. Know about ocular trauma
    8. Know the causes of visual loss due to cataract (OPHTH4)
    9. Know the causes of acute and gradual visual loss with and without pain (OPHTH4)
    10. Know the causes of acute and gradual visual loss with and without pain.
    11. Understand Paediatric ocular problems including the neonatal eye, squint and amblyopia
    12. Know the causes of visual loss in the ageing eye (OPHTH4)
    13. Know the causes of visual loss in the ageing eye to include cataract, glaucoma and macular degeneration.
    14. Know the complications that can arise from cataract operations (OPHTH4)
    15. Know the diagnosis of red eyes (OPHTH4)
    16. Know the diagnosis of red eyes (OPHTH4)
    17. Know the common neuro-ophthalmic disorders to include the interpretation of visual field abnormalities (OPHTH4)
• Dermatology Diagnosis
  • Diagnosis of Skin Disorders
    1. Demonstrate an ability to recognise a dermatologic emergency including the following conditions: Erythroderma; Toxic Epidermal Necrosis; Necrotising Fascitiis and Stevens Johnson Syndrome (DERM4)
    2. Demonstrate an ability to recognise the signs and symptoms of a patient with a blistering dermatosis. (DERM4)
    3. Demonstrate an ability to recognise common inflammatory skin disorders including: Psoriasis; Eczema and Lichen Planus (DERM4)
    4. Demonstrate an ability to recognise skin signs of common or important systemic diseases including: Granuloma Annulare; Dermatitis herpetiformis, Necrobiosis lipoidica; Acanthosis nigricans; Splinter haemorrhage; Dermatomyositis; Systemic lupus erythematos (DERM4)
    5. Demonstrate an ability to recognise and distinguish malignant lesions including; Actinic Keratoses; Basal Cell Carcinoma; Squamous Cell Carcinoma and Melanoma (DERM4)
    6. Be able to demonstrate an ability to recognise presentation of common skin infections including: Cellulitis; Impetigo; Fungal infection; Herpes simplex; Herpes zoster; Human papillomavirus and Yeast infections (DERM4)
    7. Demonstrate an ability to recognise and distinguish common benign skin lumps including: Moles; Freckles; Dermato-fibroma; Pyogenic Granuloma; Seborrheic Keratosis and Haemangioma (DERM4)
    8. Demonstrate an ability to recognise and distinguish malignant lesions including; Actinic Keratoses; Basal Cell Carcinoma; Squamous Cell Carcinoma and Melanoma (DERM4)
    9. Demonstrate competence in the recognition of moles, dysplastic moles and melanoma (DERM4)
    10. Demonstrate an ability to recognise the signs of skin cancer and premalignant lesions.
    11. The above, but also for Erythema nodosum; Erythema multiforme and Pruritus (DERM4)
    12. Be able to recognise common skin diseases seen in general practice (eczema, dermatoses, psoriasis) (CC4)
    13. Be able to construct an appropriate differential diagnosis and plan of investigation for a patient presenting with the index dermatological conditions (DERM4)
    14. Be able to identify suspicious cutaneous lesions that require further investigations (Pre-malignant and malignant skin tumours and other skin lesions that are not obviously benign. Skin signs of systemic disease e.g. excoriation in liver disease) (CC4)

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