Family Medicine I (RGA_023)
About Study Course
Objective
To ensure acquisition of theoretical knowledge and practical skills in family medicine in accordance with the requirements of the specialty regulation in order to prepare the doctor for certification in the family doctor specialty.
Learning outcomes
1.Knowledge of the six key competences of family medicine
1. Organisation/management of primary health care:
- to manage and present facts about epidemiological knowledge, about problems in primary health care,
- to demonstrate knowledge in regular, continuous care of chronic patients,
- to demonstrate in-depth knowledge and understanding of preventive work, organisation thereof in the family doctor practice,
- to demonstrate knowledge of the work organisation of a primary health care (PHC) institution,
- to demonstrate understanding of the importance of communication skills in working with patients and staff of the doctor’s practice,
- to demonstrate knowledge of the work organisation of the health care system and its functioning in relation to primary health care,
- to improve knowledge of communication skills, particularly emphasising doctor-patient cooperation.
2. Person-centred care:
- to demonstrate knowledge on patient-centred care, understand its importance in relation to the patient, their problems and living conditions,
- to demonstrate knowledge in understanding the processes related to the growth and development of an individual, the years of maturity and ageing,
- to demonstrate understanding and knowledge about the functioning of family, its role in society, the influence of social and cultural specifics in the family and family values,
- to understand the patient-oriented family doctor consultation model, to perceive contact with the patient as an equal partner,
- to demonstrate knowledge in building relationships with the patient, evaluating priorities in the decision-making process,
- to demonstrate knowledge of creating a continuous, long-term and sequential care process.
3. Specific problem solving skills:
- knowledge on solving specific problems, the decision-making process, the ability to evaluate the spread of the disease, the incidence in the given population,
- the ability to evaluate the specifics and habits of the given population (age, gender distribution, incidence of chronic diseases),
- knowledge of obtaining and interpreting information based on anamnesis data, physical and laboratory examination of the patient,
- the ability to ask specific, disease-related questions during the examination of the patient, to use the known anamnesis about the patient’s family, social conditions,
- knowledge of the available options for investigation and treatment of the given problem,
- knowledge in evaluating emergency situations, making decisions in emergency situations,
- the ability to accurately analyse and evaluate the situation – in which case emergency assistance is required, the organisation of emergency therapeutic measures, in which case it is possible to carry out diagnostic and therapeutic measures in a planned manner,
- the ability to evaluate symptoms and signs of the disease, clinical findings, rapid and additional diagnostic tests in the process of diagnosis and treatment,
- the ability to orient in the costs of medical and diagnostic manipulations, to evaluate the necessity of these manipulations in the specific situation, understanding of the effect of specific treatment on the body.
4. A comprehensive approach to problem solving:
- understanding and knowledge of the concept of multimorbidity,
- knowledge of treatment options for several simultaneous diseases,
- knowledge of the possibilities of applying guidelines, evidence-based research data,
- knowledge of health promotion measures, disease prevention strategy, concept of health,
- understanding the role of family doctor and their team in promoting public health,
- recognition and identification of ethnic specifics in society,
- knowledge and ability to involve members of the family doctor’s team in the process of individual treatment, care, palliative care, organising the rehabilitation process, understanding the role of each member of the family doctor’s team in this process, being able to implement an individual approach to each patient, skilfully coordinating team work.
5. Community-oriented health care:
- knowing the existing resources in the given environment, being able to match the needs of individuals with the needs of the society in which they live,
- to understand public health in general, based on the epidemiological situation in the given population,
- to understand the relationship between health care and social care,
- to understand the impact of poverty, ethnicity, epidemiological situation on health,
- to understand the structure of the health care system and its economic possibilities,
- to evaluate the work of other specialists and know how to find opportunities for cooperation,
- to understand the possibilities of using the health care system in the interests of the patient and the doctor (procedure of referrals, patient payments, sick leaves, legislative acts).
6. A holistic approach:
- knowledge and understanding of the holistic care principle and application thereof in family medicine,
- ability to perceive and work with the patient as a bio-psycho-social being,
- knowledge and ability to interpret and use the information obtained in the diagnostic and treatment process about the cultural and ethnic specifics of the patients,
- knowledge of how to use the patient’s experience, wishes, trust in the doctor in the health care process.
1.Skills in the six key competences of family medicine.
Ability to independently apply theory, methods and problem-solving skills to perform highly qualified professional functions or research activity. Acquired skills:
1. Organisation/management of primary health care:
- ability to apply knowledge in the organisation and performance of preventive work,
- ability to examine and care for a patient with several health problems that are not differentiated yet,
- ability to provide emergency medical assistance, to organise the care of patients with acute and chronic diseases,
- ability to organise and perform palliative care,
- skills in the process of diagnosing a disease: obtaining an anamnesis of the disease, physical examination of the patient, performing ancillary diagnostic tests,
- therapeutic skills, which include both drug and non-drug therapy,
- ability to prioritise problems,
- good communication skills in working with the patient, PHC (primary health care) institution staff, as well as other PHC doctors and specialists,
- ability to organise the work of the PHC team,
- communication skills, ability to train patients and their family members in the examination and treatment process,
- ability to organise correct entry of patient data into outpatient charts, to process information,
- placement management skills, ability to audit placement work quality,
- ability to act as a defender of the patient’s interests,
- skill in negotiating with the patient, finding a compromise,
- ability to evaluate primary health care from the position of a family doctor, ability to understand the patient’s uncertainty, peculiarities, curiosity, ability to be careful, diligent.
2. Person-centred care:
- ability to assess, insight into the patient’s illness,
- ability to organise a patient-oriented consultation that starts by listening to the patient’s complaints (ideas, concerns, hopes) and integrating the doctor’s suggestions into them, future decisions, finding a common solution to the problem, drawing up an examination and care plan for the future,
- ability to analyse and present the results of examination in a way that the patient understands, including explaining further solutions to the patient, drawing up future treatment plan in collaboration with the patient,
- ability to make future decisions respecting the interests and autonomy of the patient,
- ability to avoid subjectivity in medical decision-making,
- skills and abilities in developing the doctor-patient relationship,
- skills and abilities to establish a balanced (close and distant at the same time) relationship with the patient,
- ability to understand and put into practice the three key principles of continuity: 1) continuity of the doctor-patient relationship throughout the treatment process, 2) provision of regular treatment episodes, providing and explaining medical information to the patient, 3) regular availability of family medical services,
3. Specific problem solving skills:
- specific decision-making skills (using tools such as clinical approach, decision-making algorithms),
- ability to take an anamnesis, perform a physical examination and interpret its data,
- willingness and ability to involve the patient in the decision-making process,
- such general practice skills as understanding, empathy and caring,
- ability to use such diagnostic and therapeutic tools as “time”, the patient-doctor relationship in the decision-making process,
- ability to evaluate and understand the presence of inevitability and doubt in the process of solving primary health care problems, as well as ability to tolerate it,
- ability to make a decision, to provide help in an emergency situation,
- ability to advise severe patients with serious health problems,
- ability to orient in the costs of medical and diagnostic manipulations, to evaluate the necessity of these manipulations in the specific situation.
4. A comprehensive approach to problem solving:
- ability to orient in several concurrent health problems, set priorities, learn the mutual interaction of these diseases, choose appropriate treatment tactics,
- ability to work with medical documentation, to use the possibilities of electronic information,
- ability to apply the latest scientific achievement and research data in practice,
- health promotion through prevention and health promotion programmes in primary care,
- ability to coordinate and organise the work of family doctor team members, performing both treatment and preventive measures, as well as palliative care of patients and organising rehabilitation measures.
5. Community-oriented health care:
- ability to evaluate health problems in a given society, taking into account the specific epidemiological situation,
- ability to cooperate with other professionals working in the society, to understand their role,
- ability to understand and use the health care system for the benefit of the patient and the doctor, skilfully organising one’s work,
- ability to avoid gaps in the health care system.
6. A holistic approach:
- ability to work with the patient as a bio-psycho-social being,
- ability to use the holistic care principle in practical work with patients,
- ability to use the patient’s experience, wishes, trust in the doctor in the health care process.
1.Family doctor competences.
Able to independently formulate and critically analyse complicated scientific and professional problems. The knowledge and skills of a family doctor are manifested in six key competences:
1. Organisation/management of primary health care,
2. Person-centred care,
3. Specific problem solving skills,
4. A comprehensive approach to problem solving,
5. Community-oriented health care,
6. A holistic approach.
The acquired competences allow to justify decisions, to perform additional analysis if necessary:
- Able to explain the impact of environmental changes on the incidence of diseases in the population, to understand the application of preventive, diagnostic and therapeutic methods in this aspect.
- Able to assess patient complaints, their connection to the patient’s state of health. Has a broad understanding of diseases and risk factors thereof, the most common diseases in the population, care in case of chronic diseases, diseases that cause disability, and conditions that require emergency care.
- Has an understanding of the use of preventive and diagnostic manipulations in primary health care, which covers practically all specialties (i.e. paediatrics, gynaecology, surgery, otolaryngology, dermatovenerology, ophthalmology, neurology, psychiatry, cardiology).
- Ability to provide treatment to the patient at the level of primary care, organise rehabilitation if necessary.
- Understanding of diagnostic possibilities at the primary and secondary level of health care, the possibilities of referring the patient to a specialist doctor if necessary.
- Ability to organise and conduct consultations on issues related to the organisation of health care, especially in matters related to maternal and child health care, family planning.
- Understanding of public health issues.
- Ability to understand the importance of a positive doctor-patient relationship, to teach the patient to understand their complaints, to learn to live with them.
- Ability to work in a team with other members of the primary health care team and other specialists.
Able to integrate knowledge from different fields:
- Understanding of health care organisation issues in general and primary health care organisation in particular.
- Knowledge of legislative acts and directives in health care, ability to participate in the development thereof.
- Knowledge and understanding in special disciplines: clinical chemistry, physiology, microbiology, pharmacology, care of acute conditions, basic principles of family medicine, ethical issues, psychology, epidemiology, statistics, research methods in family medicine, preventive work methods and application thereof, and other disciplines.
