General Practice (GP)

• Establish effective rapport with patients and their families in a manner that will enhance the history taking process
• Utilise a problem-oriented approach to gather historical information
• Obtain and record a complete and accurate medical history: presenting complaint, history of presenting complaint, past medical history, past surgical history, family history, personal and social history, and review of systems
• Obtain and record an interval history pertaining to ongoing disease states, or a follow-up history of improved or deteriorating patient condition
• Obtain pertinent information from patients’ medical records

The student will be able to perform a complete or directed physical examination on any patient, demonstrating ability to:

• Gain patient confidence and provide reassurance about the examination in a manner that will enhance the collection of data.
• Utilise data from the medical history to determine which organ systems should be emphasised in the physical examination.
• Distinguish normal from abnormal physical examination findings in male and female patients of any age group.
• Appropriately utilise the various instruments and tools of physical examination, with a technique that provides protection to the patient and examiner from blood-borne pathogens or injury.
• Perform and record the findings from a comprehensive, logical, systematic physical examination.
• Alter the sequence and content of the physical examination to correspond with the individual needs of the patient.
• Perform and record directed and limited physical examinations when indicated.
• Incorporate special physical examination procedures that are indicated from the medical history or other physical examination findings.
• Seek out physical examination data to support or modify tentative diagnostic impressions developed from the patient’s history.

Order indicated tests in a cost-effective and rational manner, based upon the differential diagnosis made from a patient’s history and physical exam.
· Obtain technically valid specimens.
· Demonstrate knowledge of the indications for laboratory tests and diagnostic procedures common in family practice.
· Discuss the benefits, risks, specificity and sensitivity of common laboratory tests and diagnostic procedures.
· Demonstrate skills in collecting routine specimens including but not limited to:
· Wound cultures
· Blood samples
· Sputum samples
· Urine samples
· Tissue samples
· Throat cultures
· For the following basic laboratory tests, the student will be able to obtain an appropriate sample in the correct clinical setting and be able to interpret the results. The student will be able to perform those tests marked in bold type by the end of their first year, and the others during their second year:
· Pregnancy testing
· High vaginal swab
· Blood glucose testing with in-office glucometer
· Urinalysis (dipstick and microscopic)
· Full blood count with differential
· Erythrocyte sedimentation rate and C-reactive proteins
· Stool analysis for presence of blood, inflammatory markers, enteric infection, and ovum and parasites
· Culture and sensitivity of various samples, including urine
· Electrolytes, glucose, liver functions, and other common serum tests
· Thyroid function testing (sensitive TSH, free T4 and T3)
· Lipid panel / cholesterol screening and long-term monitoring
· Haemoglobin A1C
· Troponins, CK and other markers of myocardial damage
· Be familiar with how to perform and interpret 12 lead ECGs and rhythm strips
· Understand the indication for and perform basic interpretations of X-ray studies of the chest and extremities
· Be able to order and interpret pulmonary function tests
· Understand indications for, and uses of the following imaging modalities:
· CT scans
· MRI
· Cardiac treadmill testing
· Angiography
· Nuclear medicine studies
· Ultrasound studies, including echocardiography

Discuss and observe prescription of pharmacologic therapy, demonstrating understanding of the indications, contraindications, major side-effects, and correct dosing schedules for medications commonly used in general practice.

• The student will analyse information obtained from the history, physical examination, laboratory tests and diagnostic procedures to:
  • Recognise and diagnose medical emergencies
  • Formulate a problem list
  • Develop a comprehensive, prioritised differential diagnosis list
  • Utilise all available clinical data to accurately determine the diagnosis
• The student will be able to identify, order, discuss and perform therapeutic treatment modalities for the management of commonly occurring primary care entities. The student will be able to perform those tests marked in bold type by the end of their first year, and the others during their second year:
  • Administration of injections subcutaneously and intramuscularly
  • Suturing lacerations
  • Incision and drainage of abscesses
  • Administration of nebuliser treatments to patients of all ages
  • Provide education and counselling for a wide variety of primary care issues, including:
  • Age-appropriate health maintenance guidelines and preventative medicine issues
  • General nutritional requirements, including discussion of lifestyle changes to support management of obesity, diabetes, hypercholesterolaemia, kidney disease, hypertension, and nutritional/vitamin deficiencies
  • Appropriate indications for antibiotic treatments, and discussion of antibiotic stewardship
  • Contraception and pregnancy counselling
  • Immunisation guidelines
  • The student will be able to arrange appropriate referrals on to secondary care/specialist services
  • The student should be knowledgeable of community resources and refer the patient to the appropriate agency when indicated.
  • The student should be able to provide appropriate follow-up care.