1st University Placement - bfwh.nhs.uk

2016

Version 1, Mar 2016; Update due May 2016

Pete Driscoll: Programme Lead

Jane Rutt-Howard: Senior Lecturer

1st University Placement

Physician Associates Programme

School of Medicine & Dentistry

Course Specifications

2

Table of Contents

TABLE OF CONTENTS ........................................................................................................................................ 2

WEEKLY TIME TABLE ........................................................................................................................................ 4

WEEK 1, FEBRUARY 1ST

2016.................................................................................................................................... 4

WEEK 2, FEBRUARY 8TH

2016 ................................................................................................................................... 4

WEEK 3, 15TH

FEBRUARY 2016 ................................................................................................................................. 5

WEEK 4, 22ND

FEBRUARY 2016 ................................................................................................................................. 5

WEEK 5, 29TH

FEBRUARY 2016 ................................................................................................................................. 6

WEEK 6, 7TH

MARCH 2016....................................................................................................................................... 6

WEEK 7, 14TH

MARCH 2016..................................................................................................................................... 7

EASTER HOLIDAYS ................................................................................................................................................... 7

WEEK 8, 4TH

APRIL 2016 ......................................................................................................................................... 7

WEEK 9, 11TH

APRIL 2016 ....................................................................................................................................... 8

WEEK 10, 18TH

APRIL 2016 ..................................................................................................................................... 9

WEEK 11, 25TH

APRIL 2016 ................................................................................................................................... 10

WEEK 12, 2ND

MAY 2016 ...................................................................................................................................... 11

WEEK 13, 9TH

MAY 2016 ...................................................................................................................................... 12

WEEK 14, 16TH

MAY 2016: EXAM WEEK .................................................................................................................. 12

WEEK 15, 23RD

MAY 2016 .................................................................................................................................... 13

WEEK 16, 30TH

MAY 2016 .................................................................................................................................... 13

COMMUNICATION ......................................................................................................................................... 14

THERAPEUTICS & PRESCRIBING ..................................................................................................................... 15

SYSTEM EXAMINATION.................................................................................................................................. 16

SINGLE SYSTEM EXAMINATIONS: ............................................................................................................................... 16

COMBINED SYSTEM EXAMINATIONS: ......................................................................................................................... 16

INVESTIGATION INTERPRETATION ................................................................................................................. 17

IMAGING ............................................................................................................................................................. 17

Types ............................................................................................................................................................ 17

Topics ........................................................................................................................................................... 17

ECG ................................................................................................................................................................... 17

Types ............................................................................................................................................................ 17

Topics ........................................................................................................................................................... 17

FULL BLOOD COUNT (FBC) & COAGULATION RESULTS .................................................................................................. 17

UREA AND ELECTROLYTE AND GLUCOSE RESULTS .......................................................................................................... 17

ARTERIAL BLOOD GAS (ABG) RESULTS ...................................................................................................................... 18

LIVER FUNCTION TESTS ........................................................................................................................................... 18

PROCEDURAL SKILLS ...................................................................................................................................... 19

REGULAR USE: ...................................................................................................................................................... 19

ANTT............................................................................................................................................................. 19

Injections: ..................................................................................................................................................... 19

Vital sign recording: ..................................................................................................................................... 19

Ophthalmoscopy .......................................................................................................................................... 19

Auroscopy .................................................................................................................................................... 19

Lifting & handling ......................................................................................................................................... 19

INTERMEDIATE LIFE SUPPORT SKILLS .......................................................................................................................... 19

3

OBSERVED & PRACTICED ON MODEL ......................................................................................................................... 19

WEEKLY CLINICAL CONDITIONS ...................................................................................................................... 20

RATIONALE FOR A CASE BASED COURSE ...................................................................................................................... 20

CASE BASED FOCUS ................................................................................................................................................ 20

SELECTION OF CASES .............................................................................................................................................. 20

CASES: ................................................................................................................................................................ 20

Community acquired pneumonia ................................................................................................................. 20

Asthma ......................................................................................................................................................... 21

COPD ............................................................................................................................................................ 21

Acute coronary syndrome ............................................................................................................................ 21

Left ventricular failure .................................................................................................................................. 21

Bleeding peptic ulcer .................................................................................................................................... 21

Variceal bleed .............................................................................................................................................. 21

Diverticular disease ...................................................................................................................................... 21

Ulcerative colitis ........................................................................................................................................... 21

Diabetes ....................................................................................................................................................... 21

Jaundice ....................................................................................................................................................... 21

Palpitations .................................................................................................................................................. 21

Fractured neck of femur ............................................................................................................................... 21

Hot joint (Infective) ...................................................................................................................................... 21

DVT (Leading to PE)...................................................................................................................................... 21

Hot joint (Arthritis) ....................................................................................................................................... 22

Cellulitis ........................................................................................................................................................ 22

Ischaemic Stroke .......................................................................................................................................... 22

Epilepsy ........................................................................................................................................................ 22

Syncope ........................................................................................................................................................ 22

4

Weekly Time table1

Week 1, February 1st 2016 AM PM

Monday Induction Induction

Tuesday ICS Anatomy - Intro

ICS Physiology – Intro & skin

Wednesday MS&PC Handwashing ANTT Vital Signs

All Student feedback Opportunity for academic supervision Directed / self-directed study

Thursday MS&PC Introduction to therapeutic communication ICS Microbiology - Introduction Immunology - Introduction

MS&PC Clinical Case 1 – present (breathless & cough)

Friday MT&P (10-12) ‘One dose does not fit all’ Using the BNF / information sources Antibiotics

All Consolidate week with self-directed study Opportunity for academic supervision

Week 2, February 8th 2016 AM PM

Monday ICS Pathophysiology - Respiratory

ICS Physiology - Respiratory

Tuesday ICS Respiratory Anatomy

ICS Introduction to CXR interpretation Medical CXR conditions

Wednesday MS&PC Respiratory physical examination Peak flow MDI


Thursday MS&PC Calgary Cambridge & History taking ICS Microbiology – General principles of infection & how these pertain to Community Acquired Pneumonia Immunology

MS&PC Clinical case 1 – feedback Clinical case 3 – present (wheeze & cough)

Friday MT&P Resp: drugs for the lungs / asthma drugs and peripheral nervous system

All Consolidate week with self-directed study

1 ICS = integrated clinical sciences, MS&PC = medical skills & patient care, MT&P = medical

therapeutics & prescribing

5

Week 3, 15th February 2016 AM PM

Monday ICS Pathophysiology - Cardiovascular

ICS Physiology - Cardiovascular

Tuesday ICS Anatomy – Mediastinum

ICS System for interpreting Medical CXR Trauma CXR and interpretation Applied anatomy of chest drain

Wednesday MS&PC Cardiac physical examination Taking an ECG


Thursday ICS Microbiology – General principles of infection & how these pertain to COPD Haematology – Blood cells – types, formation and function

MS&PC Clinical case 3 – feedback Clinical case 5 – present (COPD)

Friday MS&PC Complete generic hx & resp hx MT&P COPD meds Analgesia 1: opiates


Week 4, 22nd February 2016 AM PM

Monday ICS Pathophysiology - vascular

ICS Physiology - vascular

Tuesday ICS Vascular Anatomy – coronary; aortic arch and carotids Applied anatomy of thoracic emergency procedures

ICS ECG Introduction Rhythm strip interpretation ECG recording - Introduction

Wednesday MS&PC Chest exam (CVS & Respir) CXR interpretation


Thursday MS&PC Cardiac history taking ICS Microbiology - General principles of infection & how these pertain to endocarditis Immunology

MS&PC Clinical case 5 – feedback Clinical case 7 – present (chest pain)

Friday MT&P CVS 1: categories of meds (ACS, MI) Anti-arrhythmics


6

Week 5, 29th February 2016 AM PM

Monday ICS Pathophysiology - Renal

ICS Physiology - Renal

Tuesday ICS Anatomy: Thoraco-Lumbar spine: bones – structure & function

ICS ECG recording – Rhythm strip interpretation

Wednesday MS&PC Back examination Chest examination (Respir & CVS) ECG interpretation (rhythm strips)


Thursday MS&PC Calgary Cambridge, resp & cardiac Hx ICS Microbiology - Immunology

MS&PC Clinical case 7 – feedback Clinical case 9 – present (dyspnoea)

Friday MT&P CVS 2: hypertension heart failure


Week 6, 7th March 2016 AM PM

Monday ICS Pathophysiology – GI Tract

ICS Physiology – GI Tract

Tuesday ICS Anatomy: Organisation of the peritoneal cavity & Gastro-intestinal tract

ICS ECG – Introduction to 12 ECG interpretation Applied anatomical aspects of the gastro-intestinal tract

Wednesday All Student feedback (12-1pm) Opportunity for academic supervision Directed / self-directed study

MS&PC Abdominal physical examination ECG interpretation (12 lead & axis)

Thursday MS&PC Abdominal Hx and review SH & FH ICS Microbiology Immunology

MS&PC Clinical case 9 – feedback Clinical case 11 – present (Haematemesis & melaena)

Friday MT&P GI: motility, diarrhoea, anti-emetics, antacids


7

Week 7, 14th March 2016 AM PM

Monday ICS Pathophysiology – Renal; Pelvic &urinary

ICS Physiology – Renal; pelvic & urinary

Tuesday ICS Anatomy: Pelvis & urinary

ICS Applying Anatomy and physiology to common respiratory conditions

Wednesday MS&PC Torso exam + CXR & ECG (Respir; CVS & Abdo)


Thursday MS&PC Review Pain assessment ICS Microbiology Immunology

MS&PC Clinical case 11 – feedback Clinical case 13 – present (lower abdominal pain)

Friday MT&P Diuretics, incontinence drugs


Easter Holidays

Week 8, 4th April 2016 AM PM

Monday 4th Opportunity for academic supervision Directed / self-directed study

Tuesday 5th ICS

Anatomy: Autonomic nervous system (AG)

ICS Physiology – Renal - U&E results (SJ)

Wednesday 6th MS&PC

Inguinal area & PR examination

Urine analysis

ABG interpretation

Student feedback MS&PC Pathophysiology: Respiratory 2 (PAD)

Thursday 7th MS&PC

9-11 Comms: Learning to listen

Endocrine History Taking

ICS

11-12 Microbiology –Fungal infection

12- 1 Immunology – Anaemia & introduce

transfusion

MS&PC

Clinical case 11 – feedback

Clinical case 13 – present

(lower abdominal pain)

Friday 8th MT&P

9-10 Mechanisms of prescribing, supplying

and administering medicines

10-12 Diabetes

ICS CVS pathophysiology 1 (JRH)

8



Tuesday 12th ICS

Anatomy: GI review

Anatomy: Cervical spine

ICS

Physiology (SJ): Metabolism &

Nutrition 1; Exercise & BMI

Wednesday 13th

MS&PC

Cervical spine examination

Data interpretation: ABG/ CXR &

ECG

Abdo exam (complete)

Student feedback MS&PC

Applied anatomy of the cervical

spine & imaging

Thursday 14th MS&PC

9-11 Comms: Giving information.

Therapeutic communication during

physical exam

ICS

11-12 Microbiology – viral infection

12-1 Immunology - Clotting

MS&PC



(Diabetes)

Friday 15th MT&P

9-10 Pharmacovigilance, safe

prescribing & prescribing errors

10-12 Analgesia 2 - Anti-

inflammatory, local anaesthetics

ICS

Pathophysiology (SJ): Diabetes

and metabolic disorders

9



Tuesday 19th ICS

Anatomy: Upper limb

ICS

Physiology (SJ): Metabolism 2;

GI tract; biliary & pancreas

Wednesday 20th

MS&PC

Hypertension – simulated cases

CSpine interpretation

ECG interpretation


CVS pathophysiology 2 (JRH)

Thursday 21st MS&PC

9-1 Comms: Clinical decisions,

Red flags Hx taking DM & thyroid

MS&PC



(Jaundice)

Friday 22nd MT&P

9-10 Prescription writing (FP10,

drug chart acute care)

10-12 Thyroid, adrenal and steroids

ICS

Pathophysiology (SJ): Jaundice

10


Monday 25th

Opportunity for academic supervision Directed / self-directed study

Visit & presentation by PA (Ms Williams)

Tuesday 26th ICS

Anatomy: Revision (Min ARC)

(Christina)

ICS

Physiology (SJ): Metabolism 3,

Thyroid, adrenals & pituitary

Wednesday 27th MS&PC

Nutrition

Phlebotomy

Abdo x-ray interpretation


Applying anatomy and

physiology knowledge to

interpret liver function tests

(PAD)

Thursday 28th MS&PC

9-1 Comms: Negotiation, +/-

vignettes

MSK History Taking

MS&PC



(Thyroid)

Friday 29th MT&P

9-10 Prescription writing for fluid

regimes

10-12 IV fluids

ICS

Pathophysiology (SJ): Endocrine

disorders

11

Week 12, 2nd May 2016 AM PM

Monday 2nd Bank Holiday

Opportunity for academic supervision Directed / self-directed study

Tuesday 3rd ICS

Anatomy: Lower limb

ICS

Physiology (SJ): Musculo-

skeletal

Wednesday 4th MS&PC

Shoulder examination

Neck examination


Upper limb applied anatomy

Thursday 5th MS&PC

9-12 Comms: Breaking difficult

news/LTC.

ICS

12-1 Microbiology – infected

arthritis

MS&PC



(Fractured NOF)

Friday 6th MT&P

9-10 Legal framework. ADRs &

Yellow Card Reporting

10-12 Clotting: Warfarin & heparin;

anti-platelets, cholesterol

ICS

Pathophysiology (SJ): Muscle

and bone (including fractures)

Splints

12

Week 13, 9th May 2016 AM PM


Tuesday 10th ICS

Anatomy: Neck triangles (AG)

ICS

Physiology (SJ): PNS

Wednesday 11th MS&PC

Knee examination

Lower limb PNS examination


Applied anatomy of the lower

limb (PAD)

Thursday 12th MS&PC

9-11 Comms: Closing the

consultation. Safety netting. SBAR.

ICS

11-12 Microbiology – Catch up

12-1 Immunology – Catch up

MS&PC


Friday 13th MT&P

9-10 Patient adherence, compliance

and concordance

10-12 Catch up

ICS

Pathophysiology (SJ): Impaired

mobility

Week 14, 16th May 2016: Exam week AM PM


Tuesday 17th ICS

Anatomy: Revision

ICS

Physiology (SJ): Revision

Wednesday 18th UM4100 – 4300 Exam

2 hour MCQ exam

MS&PC

Ultrasound demonstration (Ms.

Birchill)

Thursday 19th UM4200

OSCE

UM4200

OSCE

Friday 20th MT&P

09:30-10: GB – PA in GP

10:00 – 11:00: Pharmacovigliance,

safe prescribing & prescribing errors

(JRH)

11:00 – 13:00: Antibiotics (JH)

ICS

Pathophysiology (SJ): Types of

shock and injury response

13

Week 15, 23rd May 2016 AM PM

Monday 23rd Opportunity for academic supervision Directed / self-directed study

Tuesday 24th ICS

Anatomy: CNS (AG)

ICS

Physiology (SJ): CNS & ICP

Wednesday 25th

MS&PC

Neuro examination – PNS & CNS


Differentiating between PNS

and CNS lesions

Neuro imaging

Thursday 26th MS&PC

9-12 Comms: Neurological history

taking

ICS

12-1 Microbiology – Meningitis

MS&PC


(Stroke)

Friday 27th MT&P

9-10 Prescribing for specific patient

groups (JRH)

10-12 Epilepsy medications (JH)

ICS

Pathophysiology (SJ): Stroke,

reduced consciousness;

syncope; seizure and raised ICP

Week 16, 30th May 2016 AM PM


Tuesday 31th ICS

Anatomy: Special senses

ICS

Physiology (SJ): Special senses

Wednesday 1st MS&PC

Neuro examination (Cranial nerves)

Ophthalmology

Student feedback: MS&PC

Neuro catch up

Auroscopic examination

Thursday 2nd MS&PC

9-1 Comms: Prep clinical placement,

hx taking & SBAR

MS&PC


Friday 3rd MT&P

9-10 Medication reviews &

Prescription writing (JRH)

10-12 Neuro-degenerative –

Parkinson’s (JH)

ICS

Pathophysiology (SJ): Sight,

hearing & balance

14

Communication This is taught as a whole group with occasions for smaller group sessions depending on the nature of

the session material.

During the first half of the block there is a strong focus on consultation skills, introducing the Calgary

Cambridge consultation model, core principles of communication and exploring history taking. They

are taught using the POMR approach and run in tandem with the clinical cases to consider focused

systems approach e.g. illustrating history taking from a respiratory perspective when the clinical case

is COPD and the anatomy, physiology and pathophysiology are all addressing the same system.

There is also the opportunity to recapitulate some key systems making effective use of clinical

scenarios and role play.

During the second half of the block (i.e. Post Easter break), there is a resumption of some of the

nuances of effective therapeutic communication where issues such a negotiation, communicating

with peers and breaking bad news are dealt with. We will be able to utilize service users from our

team at Commensus so that the students will have some real life experiences of talking with

patients. This enables the students to employ their skills in a safe and supportive environment whilst

being able to gain confidence. The service users are trained to role play (as needed) and to also

facilitate feedback from a patient perspective.

Competence will be assessed during the clinical OSCEs.

Session number

Date Time Broad session outline

1 04/02/16 9-11am Introduction to communication skills.

2 11/02/16 9-11am Calgary Cambridge Consultation Model & History taking (CC 1 – pneumonia)

3 19/02/16 9-10am 12-1pm

Consolidate generic history taking Respiratory History Taking (CC 3 – asthma)

4 25/02/16 9-11am Cardiovascular History Taking (CC 5 – COPD)

5 03/03/16 9-11am Consolidate Respiratory & Cardiac History Taking (CC 7 - AMI)

6 10/03/16 9-11am Abdominal Hx and review FH & SH (CC 9 – Heart Failure)

7 17/03/16 9-11am Review Pain assessment (CC 11 – Gastric Ulcer)

EASTER BREAK

8 07/04/16 9-11am Communication without speaking, learning to listen gathering information techniques. Endocrine History Taking

9 14/04/16 9-11am Giving information & Informing patients Therapeutic Communication during physical examination

10 21/04/16 9-11am Explanation & Planning – clinical decision making Red flag concept

11 28/04/16 9-11am The art of Negotiating a plan MSK History Taking.

12 05/05/16 9-11am Breaking bad news & dealing with bereavement

13 12/05/16 9-11am Closing the consultation Safety netting

14 19/05/16 Exam week

9-11am OSCE practice (communication part only) Self-directed study & catch-up sessions

15 26/05/16 9-11am Neurological History Taking Communicating with colleagues - SBAR

16 02/06/16 9-11am Preparation for clinical practice & SBAR continued

15

Therapeutics & Prescribing

Delivered by both an experienced pharmacist and a non-medical prescriber, medical therapeutics

and prescribing makes use of a two themed approach.

During the first half of the block, there is a strong presence of medical therapeutics, drugs and their

mechanisms of action. The BNF is used as a key source of information and as a clinical tool for

treatment decision making; students are acquainted with its effective use, both as a book and as an

electronic resource.

Post-Easte, the prescribing element of the module is introduced to complement the ongoing

therapeutics. Topics such as prescription writing and mechanisms of prescribing, supplying and

administering are covered.

Assessment will be in the form of MCQs.

Week Date Time Topic

1 05.02 10 - 12 ‘One dose does not fit all’, Using the BNF, information sources. Antibiotics

2 12.02 10 - 12 Resp: drugs for the lungs / asthma drugs and peripheral nervous system

3 19.02 10 - 12 COPD meds Analgesia 1: opiates

4 26.02 10 - 12 CVS 1: categories of meds (ACS, MI) Anti-arrhythmics

5 04.03 10 - 12 CVS: Hypertension and heart failure meds

6 11.03 10 - 12 GI: motility, diarrhoea, anti-emetics, antacids

7 18.03 10 - 12 Urodynamic meds e.g.diuretics, incontinence meds

EASTER BREAK

8 08.04 9 -12 Diabetes Mechanisms of prescribing, supplying and administering medicines

9 15.04 9 -12 Renal, IV fluids and T&P Pharmacovigilance, safe prescribing & prescribing errors

10 22.04 9 -12 Thyroid & Adrenaline & Steroids Prescription writing (FP10, drug chart acute care)

11 29.04 9 -12 Analgesia 2: anti-inflammatory; NSAID, local anaesthetic Recording medications appropriately

12 06.05 9 -12 Blood: clotting & anti-platelets, warfarin, cholesterol Prescribing for specific patient groups

13 13.05 9 -12 Catch up Patient adherence, compliance and concordance. Communication

14 20.05 9 -12 Exam week

15 27.05 9 -12 Epilepsy & neuro-degenerative meds Ethical and legal framework that applies to safe & effective use of medicines and prescribing decisions (CDs, mixing, off-label, unlicensed). ADRs and Yellow Card system

16 02.06 9 -12 Prescription writing & review

16

System Examination These are taught in an interactive, hands-on approach – augmenting lectures, videos and workbooks

and direct & repeated practice. Competence is assessed using OSCEs and set at the level of a medical

student commencing their first clinical placement.

Single system examinations: Respiratory system

Cardio-vascular system

Gastro-intestinal (excluding PR)

Renal system

Reticulo-endothelial system

Peripheral nervous system

Central nervous system

Thoraco-lumbar spine

Cervical spine

Shoulder joint

Knee joint

Combined system examinations: Chest examination

Torso examination

Torso & nervous system examination

17

Investigation interpretation In all cases there is an integration of these investigations with the applied basic sciences covered so

during the 16 weeks. Competence is assessed using OSCEs, clinical scenarios and MCQs.

Imaging

Types

Plain chest radiology

Plain abdominal radiology

Plain spinal (cervical; thoracic & lumbar) radiology

Plain musculo-skeletal (focus on long bones and main joints) radiology

CT abdomen

CT head

MR head

Topics

Transferring gross 3-D anatomical knowledge into a 2-D black & white image

Learning a systematic approach for radiological interpretations

Determine the technical quality of the film

Identifying iatrogenic interventions and their effect

ECG

Types

Rhythm strip

12 lead

Topics

Standardization of ECG recordings

Identification of normal QRS T complexes

Identification of normal PR; ST and QT intervals

A systematic approach to rhythm strip interpretation

A systematic approach to 12 lead ECG interpretation

Full Blood Count (FBC) & coagulation results Systematic approach to FBC interpretation

Identification of common types of anaemia

Identification of common types of coagulopathy

Urea and electrolyte and glucose results Systematic approach to U&E interpretation

Identification of common types of hypo and hypernatraemia

Identification of common types of hypo and hyperkalaemia

Identification of hypoglycaemia and types hyperglycaemia

18

Arterial Blood Gas (ABG) results Systematic approach to ABG interpretation

Identification of compensated and uncompensated respiratory acidosis

Identification of compensated and uncompensated metabolic acidosis

Identification of mixed respiratory and metabolic acidosis

Interpretation of the PaO2 in light of the inspired oxygen concentration

Liver function tests Systematic approach to LFT interpretation

Identification of the three types of jaundice

Identification of the common types of acute hepatitis

Identification of the common types of chronic hepatitis

19

Procedural skills In all cases there is an integration of these procedural skills with the applied basic sciences covered

during the 16 weeks. Competence for those listed as, “Regular use” is assessed using OSCEs and set

at the level of a medical student commencing their first clinical placement.

Regular use:

ANTT

Injections:

Subcutaneous

Intramuscular

Vital sign recording:

Respiratory rate

Heart rate

Blood pressure measure

Tympanic temperature

Pulse oximetry

AVPU

Glasgow coma score

NEWS

Ophthalmoscopy

Auroscopy

Lifting & handling

Intermediate Life support skills Basic life support

Airway management

Defibrillation

Observed & practiced on model Phlebotomy

Cannulation

Catheterization

MDI use

ABG

ECG recording

PR examination

20

Weekly Clinical Conditions

Rationale for a case based course Produce horizontal integration to the first block of the PA programme by linking the key

learning objectives in the previous week’s theme into a single clinical context.

Produce vertical integration to the first block of the PA programme by having cases which

increase in complexity so that they require the use of competences acquired previously in the

course.

Focus on the Emergency & top 20 cases as listed in the National Practitioner Programme.

Encourage team working.

Demonstrate real life aspects in arriving at a diagnosis & management plan:

Time delays in waiting for results

Need for further consultation

Literature searching2

Provide a focus for the end of week round up.

Case based focus The PA faculty have listed a series of competences which the student needs to achieve during the

two year course. A number of these will be introduced during this 16 week block. Consequently

there are many areas of commonality between PA and MBBS curricula. However a straight

duplication of a typical MBBS programme is not appropriate. It would take too long and would lead

to a loss of focus on what the PA students require at this stage in their training.

The approach used at UCLAN will be to base this part of the programme on 15 clinical presentations.

Their selection is based on:

The National Practitioner Programme – mainly 1A cases (i.e. conditions they need to be able to

diagnose and manage without medical assistance)

Relevance to this part of the training scheme

Common adult presentations in Emergency Medicine; Acute Medicine and Primary care

In structuring it this way the aim is to enhance relevance and focus to all teaching episodes.

Selection of cases Appropriate to the week’s theme.

Incorporate as many of the previous week’s key learning objectives as possible.

Build up in complexity as the week progress.

The final case will use the information/ skills of the whole 16 week module placement

Cases:

Community acquired pneumonia

Case 01: Primary care presentation

Case 02: Emergency Department presentation

2 There is potential for increasing the use literature searching later in the programme. For this initial block

focus would be on material they have covered or have already been directed to.

21

Asthma



COPD



Acute coronary syndrome

Case 7: Heart Care unit (STEMI)

Case 08: Emergency Department presentation (NSTEMI)

Left ventricular failure



Bleeding peptic ulcer


Variceal bleed


Diverticular disease


Ulcerative colitis


Diabetes



Jaundice



Palpitations

Case 19: Primary care presentation (Thyrotoxicosis)

Case 20: Emergency Department presentation (Atrial fibrillation)

Fractured neck of femur


Hot joint (Infective)


DVT (Leading to PE)


22

Hot joint (Arthritis)


Cellulitis



Ischaemic Stroke



Epilepsy


Syncope


1st University Placement - bfwh.nhs.uk

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