GMC Domains

• THE DOCTOR AS A SCHOLAR
  • TD 8: APPLICATION OF BIOMEDICAL SCIENTIFIC PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: ANATOMY (TD 8.1)
    • Medical knowledge: PHYSIOLOGY (TD 8.2)
    • Medical knowledge: BIOCHEMISTRY (inc. Metabolism) (TD 8.3)
    • Medical knowledge: CELL BIOLOGY (TD 8.4)
    • Medical knowledge: MOLECULAR BIOLOGY and GENETICS (TD 8.5, 8.6)
    • Medical knowledge: PATHOLOGY (TD 8.7)
    • Medical knowledge: CANCER
    • Medical knowledge: IMMUNOLOGY and INFLAMMATION (TD 8.8)
    • Medical knowledge: MICROBIOLOGY and INFECTION (TD 8.9)
    • Medical knowledge: PHARMACOLOGY (TD 8.10)
    • Medical knowledge: NUTRITION (TD 8.11)
    • Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
  • TD 9: APPLICATION OF PSYCHOLOGICAL PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: PSYCHOLOGY (TD 9 a-g)
  • TD 10: APPLICATION OF SOCIAL SCIENCE PRINCIPLES, METHOD AND KNOWLEDGE
    • Medical knowledge: SOCIOLOGY (TD 10 a-e)
  • TD 11. PRINCIPLES, METHODS AND KNOWLEDGE OF POPULATION HEALTH
    • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH (TD 11 a-j)
  • TD 12; APPLICATION OF SCIENTIFIC METHOD AND APPROACHES TO MEDICAL RESEARCH
    • Medical knowledge: EPIDEMIOLOGY
    • Medical Knowledge: SCIENTIFIC METHOD & RESEARCH
• THE DOCTOR AS A PRACTITIONER
  • TD 13: CARRY OUT A CONSULTATION WITH A PATIENT
    • Clinical skills: HISTORY (TD 13 a-b)
    • Clinical skills: PHYSICAL EXAMINATION (TD 13 c)
    • Clinical skills: MENTAL STATE EXAMINATION (TD 13 d)
  • TD 14: DIAGNOSE AND MANAGE CLINICAL PRESENTATIONS
    • Clinical skills: INTERPRETING FINDINGS AND INITIAL ASSESSMENT (TD 14 a-b)
    • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Clinical skills: SURGERY and ANAESTHETICS (TD 14 g)
    • Clinical skills: SUPPORTING PATIENTS and IDENTIFYING ABUSE and NEGLECT (TD 14 h-i)
    • Clinical Skills: CARE OF PATIENTS AND RELATIVES AT END OF LIFE (TD 14 j)
  • TD 15: COMMUNICATE EFFECTIVELY WITH PATIENTS AND COLLEAGUES
    • Clinical skills: INTERACTION WITH PATIENTS (TD 15 a-b)
    • Clinical skills: MANAGING INFORMATION (TD 15 c)
  • TD 16: PROVIDE IMMEDIATE CARE IN MEDICAL EMERGENCIES
    • Emergency Management of Patients (TD 16 b-e)
  • TD 17: PRESCRIBE DRUGS SAFELY, EFFECTIVELY AND ECONOMICALLY
    • Clinical skills: PRESCRIBING DRUGS SAFELY AND EFFECTIVELY (TD 17 a-h)
  • TD 18: CARRY OUT PRACTICAL PROCEDURES SAFELY AND EFFECTIVELY
    • Clinical skills: DIAGNOSTIC PROCEDURES (TD 18 a)
    • Clinical skills: THERAPEUTIC PROCEDURES (TD 18 b)
  • TD 19: USE INFORMATION EFFECTIVELY IN A MEDICAL CONTEXT
    • Clinical skills: EVIDENCE BASED MEDICINE
• THE DOCTOR AS A PROFESSIONAL
  • TD 20: BEHAVE ACCORDING TO ETHICAL AND LEGAL PRINCIPLES
    • Professional issues: ETHICS and LAW (TD 20 a-g)
  • TD 21: REFLECT, LEARN AND TEACH OTHERS
    • Professional Issues: PERSONAL LIMITS OF CARE (TD 21e)
    • Professional issues: LEARNING (TD 21 a-d)
    • Professional issues: TEACHING AND MENTORING (TD 21 f)
  • TD 22: LEARN AND WORK EFFECTIVELY WITHIN A MULT-PROFESSIONAL TEAM
    • Professional issues: WORKING IN TEAMS (TD 22 a-c)
  • TD 23: PROTECT PATIENTS AND IMPROVE CARE
    • Professional issues: DUTIES OF A DOCTOR (TD 23 a-b)
    • Professional issues: MEDICAL FRAMEWORK IN THE UK (TD 23 c)
    • Professional issues: RISK MANAGEMENT and PATIENT SAFETY (TD 23 d)
    • Professional issues: GOVERNANCE, QUALITY MATTERS and AUDIT (TD 23 e)
    • Professional issues: PERSONAL ATTITUDES and SELF CARE (TD 23 f-j)

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TD 8: APPLICATION OF BIOMEDICAL SCIENTIFIC PRINCIPLES, METHOD AND KNOWLEDGE: Medical knowledge: CANCER

Index

• General Outcomes for Cancer
• Pathology of Cancer - Respiratory System
• Pathology of Cancer - Haematological
• Pathology of Cancer - Gastrointestinal
• Pathology of Cancer - Renal and Urological System
• Pathology of Cancer - Endocrine System
• Pathology of Cancer - Gynaecological
• Pathology of Cancer - Neurological and Ophthalmological
• Pathology of Cancer - Head and Neck
• Pathology of Cancer - Musculoskeletal
• Pathology of Cancer - Dermatological

• General Outcomes for Cancer
  • General
    1. Revise the principles of cancer biology ()
    2. Describe what lymph nodes are
    3. Have insight into cancer research and treatment at Barts and the London
    4. Describe the division into Hodgkin's lymphoma and non-Hodgkin's lymphoma.
    5. Draw a diagram of the structure of a lymph node, labelling its parts.
    6. 3. To know the hallmarks of cancer and describe the alterations in physiology that collectively result in malignant growth (FM1)
    7. Explain cancer incidence and mortality
    8. Understand the steps in the cancer patient pathway ()
    9. Describe the features of Hodgkin's lymphoma: macroscopic and microscopic, with the features of Reed-Sternberg cells, LandH popcorn cells, and listing other cells present.
    10. Describe the cancer screening programmes in the UK
    11. Identify and describe the key features of metastasis (FM1)
    12. Describe the subdivisions of Hodgkin's disease classical (Nodular sclerosis, Mixed cellularity, Lymphocyte depleted, Lymphocyte rich) and lymphocyte predominant (nodular or diffuse).
    13. List the cell types present in a lymph node (lymphoid, accessory, stromal).
    14. Understand the concept of red flags in cancer diagnosis and the cancer referral process ()
    15. Have a basic knowledge of grading and staging tumours (FM1)
    16. Describe the staging of Hodgkin's lymphoma.
    17. List the five main patterns of lym node hyperplasia: Follicular hyperplasia, Paracortical hyperplasia, Sinus hyperplasia, Granulomatous hyperplasia, Acute lymphadenitis.
    18. Describe the purpose of the MDT and the role of the individuals within it ()
    19. Describe Non-Hodgkin's lymphoma, with the four basic histological types (slow growing B-cell, rapidly growing B-cell, Slow-growing T-cell, rapidly growing T-cell).
    20. Understand the general principles of cancer treatment: surgery, radiotherapy, chemotherapy, targeted and biological therapy. ()
    21. Describe the five main patterns, and give examples of when they occur.
    22. Explain cancer treatment options.
    23. Describe follicular lymphomas, small lymphocytic lymphoma (SLL)/Chronic lymphatic leukaemia (CLL), Diffuse Large B Cell Lymphoma (DLBCL), Burkitts lymphoma (BL), MALT lymphoma.
    24. Describe the features of lymph node enlargement in HIV and metastatic neoplasia.
    25. Appreciate the role of the immune system in cancer ()
    26. Describe Adult T cell lymphoma/leukaemia and Angioimmunoblastic T cell lymphoma.
    27. Understand the part research plays in the cancer patient pathway ()
    28. Appreciate the implications of living with and beyond cancer ()
    29. Develop insight into the patient experience of cancer ()
  • Neoplasia
    1. Define the terms: tumour, neoplasm, benign, malignant, histogenesis, differentiation, metastasis (FM1)
    2. Revise the principles behind the classification of malignant neoplasms
    3. Describe the principles of cancer diagnosis and the classification of malignant neoplasms
    4. Identify and compare the major pathological features of benign and malignant neoplasms (FM1)
    5. Give a brief classification of benign and malignant neoplasms according to their cell of origin (FM1, FM1)
    6. Identify and compare the behaviour between benign and malignant neoplasms (FM1)
    7. Classify common malignant neoplasms according to their cell of origin
    8. Define the term paraneoplastic syndrome and give some examples (FM1)
    9. To be able to describe the pathological features of carcinomas (FM1)
    10. List the aetiological agents that have been linked to the development of some malignant neoplasms (FM1)
    11. Give a brief classification of benign and malignant neoplasms according to their cell of origin (histogenesis) (FM1)
    12. Describe the effects of a neoplasm on the host (FM1, FM1)
    13. Define the term paraneoplastic syndrome and give some examples (FM1)
    14. List aetiological agents that have been linked to the development of some malignant neoplasms
  • Pathology of Cancer
    1. Appreciate the concepts of benign, dysplastic and malignant.
    2. Give a brief classification of benign and malignant tumours based on origin of cell and morphological features (FM1)
    3. Appreciate the pre-cancerous (dysplastic) nature of solar/actinic keratoses and Bowen’s disease.
  • Cancer and Genetic Disease
    1. Describe the genetic changes that occur in oncogenes (FM1)
    2. Describe the processes of spontaneous and carcinogenic DNA damage (FM1)
    3. Describe the role of gain of function mutations in oncogenes and loss of function mutations in tumour suppressor genes in cancer initiation and progression (FM1)
  • Chemical Agents Causing Disease
    1. Account for the aetiological agents (chemical, physical, biological) causing ancer.
  • Radiotherapy and Chemotherapy
  • Clinical Trials
• Pathology of Cancer - Respiratory System
  • General Outcomes for Lung Cancer
    1. Provide a histological classification of lung cancer
    2. Describe the different histological types of lung cancer, spread of lung cancer and prognostic features.
    3. Describe the histological types of bronchial carcinoma in relation to mode of presentation including secretion of ACTH and ADH by small cell carcinoma and PTHrp by squamous carcinoma
  • Bronchial Carcinoma
  • Malignant Mesothelioma
• Pathology of Cancer - Haematological
  • Hodgkin Lymphoma
  • Non-Hodgkin Lymphoma
    1. The conditions: Non-Hodgkin's lymphoma, Hodgkin's lymphoma, Myeloma. (CSP3)
    2. Biology, Clinical features, classification, investigations, diagnosis, further tests, management & prognosis of the above conditions. (CSP3)
  • Leukaemia
    1. The conditions: chronic myeloid leukaemia, polycythaemia rubra vera, essential thromocythaemia, myelofibrosis. (CSP3)
    2. Biology, clinical features, investigations, diagnosis, further tests, management & prognosis of the above conditions. (CSP3)
  • Multiple myeloma
• Pathology of Cancer - Gastrointestinal
  • Liver Cancer
  • Colorectal Carcinoma
  • Gastric Carcinoma
  • Oesophageal Carcinoma
  • Upper Gastro-intestinal Cancer
    1. To understand the aetiology of gastric cancer (MET3A)
  • Lower Gastro-intestinal Cancer
    1. Understand the role of the primary care team in the palliative care of terminal haematological disease
• Pathology of Cancer - Renal and Urological System
  • Testicular Cancer
  • Prostate Cancer
    1. Understand the use and limitations of prostate specific antigen (PSA) in the diagnosis and monitoring of prostate cancer
  • Renal Carcinoma
  • Bladder Carcinoma
• Pathology of Cancer - Endocrine System
  • Pancreatic Cancer
  • Thyroid Cancer
  • Anterior Pituitary Tumour
    1. To relate anatomy to specific tumoral secretory syndromes
• Pathology of Cancer - Gynaecological
  • Gynaecological Malignancies - General
    1. Describe various malignancies of the breast and female reproductive tract, and their incidence
    2. Explain the aetiology, pathogenesis, risk factors, presenting symptoms, main investigative procedures employed and prognosis of, the various cancers
  • Ovarian Carcinoma
  • Endometrial Carcinoma
  • Carcinoma of the Cervix
  • Vulval Carcinoma
    1. Neoplastic conditions (benign and malignant) affecting the vulva
• Pathology of Cancer - Neurological and Ophthalmological
  • Brain tumors
• Pathology of Cancer - Head and Neck
  • Cancer of the Head and Neck
    1. Be familiar with the concept of TNM classification.
    2. Know the aetiology and pathology of head and neck cancer. (ENT4)
  • Oesophageal Carcinoma
    1. Know the aetiology of oesophageal cancer (MET3A)
• Pathology of Cancer - Musculoskeletal
  • Cancer of the Musculoskeletal System
    1. Can describe the diagnosis and management of the more common benign and malignant bone tumours (MusSkel4)
    2. Understand the diagnosis and management of other malignant conditions, such as myeloma and other haematological conditions, that can affect the musculoskeletal system (MusSkel4)
• Pathology of Cancer - Dermatological
  • Melanocytic Lesions
  • Malignant Melanoma
    1. Understand the significance of the prognostic factors associated with melanoma. (DERM4)
    2. Understand the difference between melanoma and non-melanoma skin cancers: their epidemiology, clinical manifestations and treatment

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