Syllabus 2017

MCCC GPT1-2/PRRT1-2

MCCC SYLLABUS 2017

GPT1-2/PRRT1-2

Table of Contents

  • MCCC Education Program Overview
  • GPT1-2/PRRT1-2 Learning Programs
  • Learning Program 1: Initial Assessment and Orientation
  • Learning Program 2: Core Skills 1
  • Learning Program 3: Emergency Skills
  • Learning Program 4: Child and Adolescent Health
  • Learning Program 5: Sexual and Reproductive Health
  • Learning Program 6: Women’s Health
  • Learning Program 7: Men’s Health
  • Learning Program 8: Core Skills 2
  • Learning Program 9: Aboriginal and Torres Strait Islander Health
  • Learning Program 10: Mental Health
  • Learning Program 11: Chronic Disease
  • Learning Program 12: Musculoskeletal and Procedural Skills
  • Learning Program 13: Aged Care
  • Mapping of Learning Programs to RACGP and ACRRM Curricula

MCCC Education Program Overview

MCCC’s Education Program is based on the traditional ‘teacher-student’ or ‘apprenticeship’ model of training developed over many years by the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM). This on-the-job training involves the GP registrar working as an independent member of an accredited training practice’s medical team under the supervision of an accredited supervisor. MCCC GP Training registrars are supervised and assessed by experienced medical practitioners.

The level of supervision is matched to the GP registrar’s experience and learning needs. On-the-job (or in-practice) teaching and learning is augmented by the out-of-practice learning program. MCCC does not consider ‘in-practice’ and ‘out-of-practice’ learning domains as separate, rather that they are inexorably entwined, with registrars learning at work, from work, and for work.

The ‘Out of Practice Education Program’ consists of a syllabus based on RACGP and ACRRM curricula, divided into Learning Programs to facilitate delivery in each region.

Educational Learning Programs

The out of practice educational syllabus is far broader than a workshop program and will be delivered using a blended approach, employing a range of learning and teaching strategies including:

  • Lectures
  • Presentations
  • Panel Discussions
  • Inquiry Based Learning
  • Cooperative Group Learning
  • Flipped Classroom
  • Case based learning
  • Online Learning Programs and activities (including MCCC e Learning activities and existing Learning Programs developed specifically by other organisations such as ACRRM, RACGP and ThinkGP) that are completed in the registrars’ own time
  • Self-directed learning activities

For GPT1/2 & PRRT1/2 registrars, MCCC will provide

  • 17 days (119 hours) of face to face out of practice education plus
  • additional emergency skills training (1 day for metropolitan based registrars and a 2 day REST program for ACRRM and rural based registrars)

GPT3 (PRRT3) registrars will have 1 day of face to face education.

Registrars will also have 2 days (14 hours) of exam preparation, usually in GPT2/3.

The MCCC eLearning (MeL) platform has an extensive selection of e-learning programs that can be used for pre-workshop activities, post workshop revision, consolidation and extension, self-directed learning, or as part of exam preparation. These activities will be regularly reviewed by MCCC Medical Educators to ensure currency and relevance.

GPT1 (PRRT1) and GPT2 (PRRT2) Learning Programs

The Learning Programs for GPT1 (PRRT1) and GPT2 (PRRT2) registrars are divided into Core Learning Programs and Topic Based Learning Programs.

Core Learning Programs

  1. Initial assessment and orientation… face to face component delivered at the beginning of GPT1/PRRT1
  2. Core skills part 1… the two day face to face component delivered at the beginning of GPT1/PRRT1
  3. Emergency skills (combined GPT1 &2/PRRT1 &2)… face to face component delivered at the beginning of GPT1/PRRT1
  4. Aboriginal and Torres Strait Islander Health (combined GPT1 &2/PRRT1 &2)... face to face component to be delivered in the semester commencing in August
  5. Core skills part 2…a two day face to face component delivered at the beginning for GPT2/PRRT2

Topic Based Learning Programs

Semester 1

  1. Child and Adolescent Health
  2. Reproductive and sexual health
  3. Women’s Health
  4. Men’s health

Semester 2

  1. Mental Health
  2. Chronic disease
  3. Aged Care
  4. Musculoskeletal and procedural skills

GPT3/PRRT3

There are 2 Learning Programs for GPT3/PRRT3 registrars. These are

  1. Exam preparation and
  2. The future

The following themes are explicitly embedded in every Learning Program

  • GP as educator and life-long learner
  • Critical thinking and Evidence Based Medicine (EBM)
  • Consultation skills and Clinical reasoning
  • Aboriginal and Torres Strait Islander Health
  • Health of vulnerable populations
  • Medicolegal issues and Professionalism

Dermatology topics are spread through each of the Learning Programs.

Further details of the Educational Philosophy underlying the MCCC program can be found in the document

ED0001 Education and Training Philosophyon the Policy section of MCCC website

GPT1-2/PRRT1-2 Learning Programs

Learning Program 1: Initial Assessment and Orientation

This Learning Program will be delivered at the beginning of the GPT1/PRRT1 term i.e. twice per year. This will be in February for those registrars commencing GPT1/PRRT1 term in Semester 1 and in August for those commencing in Semester 2. As the cohort commencing in Semester 2 is smaller workshop groups may include registrars from 2 or more regions.

The face to face component will be a two day workshop.

Mapping to College Curricula

As with all of MCCC learning Programs, the content is based on the RACGP and ACRRM curricula.

  • The ACRRM Primary Curriculum Edition 4 2013 is available at:
  • The RACGP Curriculum 2016 is available at:

Relevant sections of each to this Learning Program are listed below.

ACRRM

Domains

Domain 1: Provide medical care in the ambulatory and community setting

Domain 4: Apply a population health approach

Domain 5: Address the health care needs of culturally diverse and disadvantaged groups

Domain 6: Practice medicine within an ethical, intellectual and professional framework

Domain 7: Practice medicine in the rural and remote context

Curriculum Statements

  • 6.1 Aboriginal and Torres Strait Islander Health
  • 6.5 Business and Professional Management
  • 6.7 Dermatology
  • 6.17 Research and Teaching

RACGP

The Core skills unit is the cornerstone of the curriculum and is relevant to all learning programs

  • CS16 - Core Skills Unit : This unit covers core skills across all 5 RACGP Domains.

Relevant contextual units include:

  • DH16 - Doctor's health
  • AH16 - Aboriginal and Torres Strait Islander Health Unit
  • GR16 - General practice research

Topics and Learning Outcomes: Initial Assessment and Orientation
Initial assessment
OSCE case
DVD
Feedback / The purpose of the initial assessment process is to collect information about the registrars’ areas of strength, learning needs and capacity to perform at an expected GPT1/PRRT1 level through a range of relevant activities.
The information will be used by the education teams to guide the registrar’s early learning journey, including the level of supervision and support, and to assist in the registrar’s development of a relevant plan for learning.
Feedback is provided to registrars to assist them in understanding their strengths and learning areas needing more attention.
Orientation
On completion of this Learning Program a GP registrar will be able to:
Orientation to MCC
  • Overview
  • What the acronyms mean (REAP etc.)
  • who’s who in MCCC and in your subregional hub
  • Pivotal training
  • MeL
RACGP/ACRRM requirements / Describe MCCC’s role in supporting and augmenting registrar learning.
Access and utilise the MCCC electronic learning platform (MeL)
Access and utilise the online administrative platform (Pivotal)for recording their training progress
Develop a knowledge of other available online platforms available for directed and self-directed learning
Have a working knowledge of AGPT pathways – RACGP, ACRRM, FARGP
Understand assessment within training and summative requirements
Understand the mandatory activities required to be completed during training
,
Orientation to General practice:
  • Structure of general practice
  • Philosophy of general practice (medical home)
  • models of consultation/domains, an intro to active listening and the golden minute
  • Differences from hospital environment
  • Medicare and Pharmaceutical Benefits Service (PBS)basics
/ Describe the concept of the Medical Home
Characterise where general practice sits in the Australian health system
Compare and contrast general practice and hospital practice
Recognise health pathways in your region
Discuss the challenges and benefits of a general practice career.
Describe the domains of general practice (RACGP/ACRRM)
Interpret the Medical Benefits Schedule and the pharmaceutical benefits system and how they apply to general practice consultations and practice management
Describe the concept of patient centred care
Demonstrate the concept of active listening and the importance of the first minute of the consultation in communication and information gathering and commence developing these skills in practice
Being a practitioner:
  • Professionalism
  • Critical appraisal
(critical appraisal is an larger component of core skills 1 and core skills 2 and is included as a theme in all learning programs) / Demonstrate familiarity with “Good medical practice: a code of conduct for Australian doctors”
Understand the role of the team in general practice and how to access and work within the team
Reflect on ethical dilemmas in general practice
Understand the role of evidence based medicine in general practice
Discuss the evaluation, use and application of sources of medical information
Self-care:
  • VDHP,
  • MCCC psychologist access, RACGP psychological access,
  • importance of having own GP
  • Regulations about treating self/family members
  • VDHP,
  • MCCC psychologist access, RACGP psychological access,
  • importance of having own GP
  • Regulations about treating self/family members
/ Develop an understanding of boundary issues and navigate them in general practice
Identify potential stressors for GP registrars and GPs and develop strategies to alleviate stress
Describe the importance of self-care and personal access to medical services
Plan a balance between work/study/life
Learning environment:
  • In practice teaching
  • Making the most of your supervisor
  • expectations of out of practice learning including self-directed learning, peer learning/teaching, MEL and other pre and post workshop
  • Obligations as a registrar
/ Discussthe knowledge, skills and attitudes that are required to be capable of unsupervised GP in Australia
Connect as an active participant in learning in MCCC
Describe the role of self-directed learning in achieving coverage of curriculum and planning learning
Aboriginal and Torres Strait Islander Health
  • Close the gap measures
  • Local cultural mentors and educators and MCCC Aboriginal Liaison and Cultural Mentor (Jade Johnson)
  • Resources for Aboriginal and Torres Strait Islander Health
/ Outline the ‘closing the gap’ measures that are available to Aboriginal and Torres Strait Islander patients and to general practices caring for them
Demonstrate awareness of the role of cultural mentors and educators in improving Aboriginal and Torres Strait Islander health and identify the cultural mentors and educators in their region
Access available resources to assist in improving cultural awareness and knowledge in Aboriginal and Torres Strait Islander Health
Resources:
(job for RME/RLO) / Access electronic learning platform and administrative component
Generate a list of commonly used resources
Access and use exam resources
RLO session: / Describe the role of the Registrar Liaison Officer
List personnel who can assist Registrars with problems or concerns during their training and resources available for Registrar support

Learning Program 2: Core Skills 1

This Learning Program will be delivered at the beginning of the GPT1/PRRT1 term i.e. twice per year. This is likely to be in March for those registrars commencing GPT1/PRRT1 term in Semester 1 and in September for those commencing in Semester 2.

The face to face component will be a two day workshop.

Mapping to College Curricula

As with all of MCCC learning Programs, the content is based on the RACGP and ACRRM curricula.

  • The ACRRM Primary Curriculum Edition 4 2013 is available at :
  • The RACGP Curriculum 2016 is available at:

Relevant sections of each to this Learning Program are listed below.

ACRRM

Domains

Domain 1: Provide medical care in the ambulatory and community setting

Domain 4: Apply a population health approach

Domain 5: Address the health care needs of culturally diverse and disadvantaged groups

Domain 6: Practice medicine within an ethical, intellectual and professional framework

Curriculum Statements

  • 6.2 Adult Internal Medicine
  • 6.5 Business and Professional Management
  • 6.7 Dermatology
  • 6.8 Information Management and Information Technology
  • 6.9 Mental Health
  • 6.16 Rehabilitation
  • 6.17 Research and Teaching

RACGP

The Core skills unit is the cornerstone of the curriculum and is relevant to all learning programs

  • CS16 - Core Skills Unit:This unit covers core skills across all 5 RACGP Domains.

Relevant contextual units include:

AD16 - Adult MedicinePM16 - Pain Management

GR16 - General practice research OM16 - Occupational Medicine

AM16 - Addiction medicine DE16 - Dermatology

Topics and Learning Outcomes: Core Skills 1
Consulting skills
On completion of this Learning Program a GP registrar will be able to:
Consultation structure including
  • engaging patients,
  • golden minute,
  • managing time,
  • negotiating agendas
/ Demonstrate the critical role of communication in patient centred consultation models and effective practice
Discuss a range of patient centred approaches to consultation
Demonstrate active listening and communication micro skills in relation to the consultation
Demonstrate awareness of factors inhibiting effective communication.
Practice giving feedback
Angry Patient / Recognise factors which contribute to a patient becoming angry
Outline options for dealing with an angry patient highlighting successful and less successful outcomes
Breaking bad news / Describe and demonstrate a framework for breaking bad news
The drug seeking patient / (see prescribing section below)
Recognise the drug seeking patient
Outline options for dealing with a drug seeking patient
List useful resources when managing these consultations
Lifestyle modifications – smoking, alcohol, nutrition, physical activity, sleep. / Discuss the importance of preventative medicine in general practice
Develop explanation, planning and shared decision-making skills to augment a partnership approach
Identify a range of preventative health guidelines and available resources, including SNAP model
Highlight the principles of motivational interviewing and apply these in clinical settings
Common problems in General Practice
On completion of this Learning Program a GP registrar will be able to:
Hypertension / Describe the guidelines for identification, investigation and management of Hypertension
Demonstrate the use of tools in advocating lifestyle modification
List appropriate anti-hypertensive drugs and when and how to use them
Define the goals of treatment for hypertension
Managing Upper Respiratory Tract Infections (URTIs) / Describe National Prescribing Service (NPS)guidelines for managing URTIs
Implement evidence based medicine that supports non-prescription of antibiotics
Develop a repertoire of non-antibiotic interventions for patients with URTIs
NB all registrars must complete a GPMHSC approvedMental Health Skills course prior to the face to face workshop for the Mental Health Learning Program
Depression
(Depression is revisited in the Mental Health Learning Program) / Discuss some of the common mental health conditions in general practice, including depression
Characterise the difference between “distress” and “disorder”
Describe how to manage a patients with depression, including appropriate risk assessment and interventions – pharmacological and non-pharmacological
Outline Medicare Mental Health Care item numbers
Describe the legal considerations and rights of the patient with a mental health problem
Diabetes
(Diabetes is revisited in the Chronic Disease Learning Program) / Describe screening and assessment of the general population in regards to diabetes
Describe the investigations related to the diagnosis and assessment of patients with diabetes, impaired fasting glucose and impaired glucose tolerance
Demonstrate lifestyle management counselling for patients with diabetes
Sleep Disturbance / Appropriately use therapeutic interventions in patients with insomnia
Diagnose and manage obstructive sleep apnoea and restless legs syndrome
Clinical reasoning and critical thinking
On completion of this Learning Program a GP registrar will be able to:
Undifferentiated illness e.g. fatigue and using that topic to explore time management ,safety netting, follow up / Describe an approach to assessment and diagnosis of undifferentiated illness and management of persistence of uncertainty
Develop a framework for assessment and management of a patient with fatigue
Understand the limitations of conventional laboratory testing for patients with fatigue
Rational use of investigations / Describe the common drivers for over-testing, including tolerance to uncertainty
Describe the risks associated with over-testing
Apply rational use of investigations to clinical practice
Describe the importance of pre-test probabilities in interpreting test results and utilise this information in the clinical setting
Apply the principles of screening for important diseases in general practice
Incorporate current screening and prevention guidelines into their clinical practice, in particular for Vitamin D, PSA and FOBT testing
Critical appraisal
(further explored Core Skills 2 and incorporated in all Learning Programs) / Describe the role of evidence based medicine in general practice
Evaluate types of evidence
Discuss the evaluation, use and application of sources of medical information
Develop a structured approach to asking clinical questions
Appraise a scientific article
Describe the principles of clinical audit
General practice tools
On completion of this Learning Program a GP registrar will be able to:
GPMP/TCA…basics / Develop a General Practice Management Plan / Team Care Arrangement and describe how to claim these under Medicare
Workcover basics / Describe approaches to return to work and rehabilitation for workers including the use of objective assessment tools.
Manage WorkSafe procedures and WorkSafe paperwork for injured workers
Prescribing do’s and don’ts / Describe prescribing do’s and don’ts
Understand S8 permit application and special schedule 4 poisons
Prescribe opiates appropriately
Dermatology
On completion of this Learning Program a GP registrar will be able to:
Terminology and descriptions / Describe an approach to dermatology presentations
List important questions to ask in a dermatology history
Describe a system for examining the skin
Describe findings on examination using dermatological terminology
Red scaly rashes/common GP presentations / Recognise some common skin conditions and use a simple structure for distinguishing rashes based on their itchiness as well as other morphological and distribution characteristics
Describe where to get help when required, including for management once a diagnosis is made
Describe the implications of skin disease outbreaks in the general community (ie. schools and nursing homes)
Describe diagnosis and management of common rashes that are red and scaly, including dermatitis/eczema, psoriasis and fungal infections
Demonstrate management of eczema
List the relative potencies of steroid preparations
Medicolegal
On completion of this Learning Program a GP registrar will be able to:
sick certs and legalities/referrals, / Describe the legal requirements for writing a sick certificate
Describe the legal requirements and options when writing a referral
recalls and reminders, following up abnormal resultsand legalities ( case based) / Describe the principles of risk management including follow up
Differentiate between recall and reminders
Describe a system for following up on clinically significant 6 Rs- recalls, reports, referrals, results, reviews and requests
When should I get a second opinion?
What happens if I disagree with the specialist? / Discuss patient rights and ethical considerations in relation to specialist opinion
Release of medical information/external correspondence / Describe issues of confidentiality with regard to release of medical information
Describe how to manage patient access to records
Identify situations in which legal or ethical issues take precedence over the maintenance of confidentiality
Accepting gifts / Discuss possible approaches to patient gifts in medical practice and debate the associated ethical issues

Learning Program 3: Emergency Skills

This Learning Program will be delivered as early as possible in the GPT1/PRRT1 term in both Semester 1(for those registrars commencing in February) and Semester 2 (for those registrars commencing in August.)