Veidlapa Nr. M-3 (8)
Study Course Description
Basics of Family Medicine
Course Code
GMK_009
Branch of Science
Clinical medicine
ECTS
4.00
Target Audience
Medicine
LQF
Level 7
Study Type And Form
Full-Time
Study Course Implementer
Course Supervisor
Vija Siliņa
Structure Unit Manager
Vija Siliņa
Structural Unit
Department of Family Medicine
Contacts
Riga, 26a Anninmuizas boulevard, 2nd floor, Rooms No. 236 and 237, gmk@rsu.lv, +371 29413956
About Study Course
Objective
To gain understanding about competences o a family physician and pecularities of patient management in primary health care. Using clinical cases, to learn: a) communication specifics with individuals under lifelong and wholistic care, as well as their relatives; b) syndromologic and nozologic diagnostics, differentialdiagnostics in primary health care; c) intergration of public and individual health promotion and preventive measures; d) team work specifics in primary health care; e) patient management options in primary health care. To introduce with documentation and legislation in primary health care, as well as use of diagnostic equipment in primary health care clinics.
Preliminary Knowledge
Preclinical theoretical knowledge about the structure and function of the human body (1st, 2nd, 3rd year study subjects), General theoretical knowledge and skills in clinical medicine: propaedetics course, internal diseases, pediatrics, infectious diseases, surgery, neurology, obstetrics-gynecology, psychosomatic medicine and psychiatry-narcology and law basics course.
Learning Outcomes
Knowledge
1.Successful completion of the course will allow to: • understand the role of family physician in health care; • define syndromologic and nozologic diagnosis in primary health care; • draw up investigation/ treatment plan for a patient in primary health care; • organize individual health promotion and preventive measures, including immunization, cancer screening and lifestyle changes; • understand team work in primary health care; • know and apply the equippment most often used for diagnostics in primary health care.
Skills
1.Successful completion of the course will allow student to communicate with primary health care team, patients and their relatives, as well as to use diagnostic equipment, draw-up treatment and examination plan of a patient of all ages in primary health care.
Competences
1.Successful completion of the course will allow student to work in primary health care under a supervision of a family physician.
Assessment
Individual work
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Title
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% from total grade
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Grade
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1.
Individual work |
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-
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Students are refreshing knowledge of previous courses, especially guidelines of most common acute and chronic conditions in primary health care. Students can use available simulators to improve practical skills.
In order to evaluate the quality of the study course as a whole, the student must fill out the study course evaluation questionnaire on the Student Portal.
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Examination
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Title
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% from total grade
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Grade
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1.
Examination |
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10 points
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Active participation in all classes. The final assessment of the study course "Fundamentals of Family Medicine" will be provided as a cumulative assessment consisting of: Multiple-choice question tests make up 40% of the final assessment of the study course: • 5% consists of 10 x tests with 4 questions before each practical lesson in the study course "Fundamentals of Family Medicine" (10 x 4 points, maximum number of points – 40) • 35% consists of 9 x tests with 10 questions after each practice session The examination (Clinical case) accounts for 60% of the final assessment of the study course. • Clinical Case - the written part of the exam with 10 questions, according to the topic of the study course Taking the final examination of the study course "Fundamentals of Family Medicine" in 2024/2025. will be held in person, METC - electronically, using information technology (hereinafter - IT) tools, according to the study plan |
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Study Course Theme Plan
FULL-TIME
Part 1
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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4
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Topics
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Vaccination – topicality and daily practice.
Description
Annotation: The aim of the practical class:
To acquire theoretical and practical knowledge while consulting patients with elevated body temperature in primary care
The main tasks:
To study the most often causes of fever in children and adults in primary care (including, upper and lower respiratory tract infections, viral and bacterial infections with rash, uncomplicated urinary tract infections, gastrointestinal infections)
To master consulting of out-patients with elevated body temperature in primary care
To understand the role of clinical, laboratory and visual diagnostic tools in differential diagnosis of acute fever an fever of unknown origin in primary care
To practice management of out-patients with elevated body temperature
Topics covered during the class: The list of knowledge and/or skills to be acquired:
Assessment of red flag signs and referral to hospital or further investigations
Differences in body temperature in different measurement sites and using different thermometers
Differential diagnostic steps, tactics during the first 3 days of illness and later.
Consultation specifics regarding elevated body temperature.
Symptomatic treatment indications and options in adults and children.
Indications and preferences for antibiotic use in most common infections.
Cooperation with other primary health care staff and secondary health care specialists.
Home tasks:
• To read the study guide of the practical class as well as recommended literature
To repeat infectious diseases course from previous study years
Literature: BOOKS /BOOK CHAPTERS
Harrison’s Principles of Internal Medicine. Part 2: cardinal manifestations and presentation of diseases. Section 2: Alterations in Body Temperature. McGraw-Hill Medical
Nield L, Kamat D. Book chapter: Fever. Nelson Textbook of Pediatrics. Elsevier, 2016. Chapter 176, 1277-1279.e1.
James E. Leggett. Book Chapter: Approach to Fever or Suspected Infection in the Normal Host. Goldman-Cecil Medicine. Elsevier, 2012. Chapter 280, 1849-1854.e2.
Weber R., Fontana A. Chapter 4 Fever. Siegenthaler’s Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis.. Thieme.2007
Nathan W. Mick Book Chapter: Pediatric Fever. Rosen's Emergency Medicine: Concepts and Clinical Practice. Elsevier, 2018. Chapter 166, 2058-2068.e2
Usatine R.P., Smith M.A., Chumley H.S, Mayeaux E.J. The Color Atlas of Family Medicine, 2e. McGraw-Hill Medical. 2013.
Tess A.V. Section II: General Symptoms. Chapter 8: Fever. The Patient History: An Evidence-Based Approach to Differential Diagnosis, 2e. McGraw-Hill Medical, 2012.
The Merck Manual of Diagnosis and Therapy. http://www.merckmanuals.com/professional/infectious_diseases.html
Lecture and workshop materials on infectious diseases of 3rd to 6th study years.
L.Vīksna un līdzautori. Infekcijas slimības. 2011.
ARTICLES AND GUIDELINES
Barbi E, Marzuillo P, et al. Fever in Children: Pearls and Pitfalls. Children. 2017;4(9). Available at: https://www.ncbi.nlm.nih.gov/pubmed/28862659
Thompson M, Van den Bruel A, et al. Systematic review and validation of prediction rules for identifying children with serious infections in emergency departments and urgent-access primary care. Health technology assessment (Winchester, England). 2012;16(15):1-100. Available at https://www.ncbi.nlm.nih.gov/pubmed/22452986
Mace SE, Gemme SR, Valente JH, et al. Clinical policy for well-appearing infants and children younger than 2 years of age presenting to the emergency department with fever. Ann Emerg Med. 2016 May;67
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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Auditorium
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4
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Topics
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SSNMF Geriatric consequences in family doctors practice
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Lecture
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Modality
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Location
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Contact hours
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Off site
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E-Studies platform
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2
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Topics
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Multimorbidity and polypharmacy in family medicine
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Lecture
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Modality
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Location
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Contact hours
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Off site
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E-Studies platform
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2
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Topics
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Reproductive health and family planning in primary health care.
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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-
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4
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Topics
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The competences, equipment and functionality of a family physician’s practice
Description
Annotation: Aim of the class:
To raise awareness of the management in a family physician’s practice, of the division of responsibilities between the members of a family physician’s team.
To raise awareness of the principles of cooperation: a family physician- a patient- a family.
To introduce with the manipulations carried out in a family physician’s practice and their practical application.
Main tasks:
➢ To get acquainted with a functioning of a family physician’s practice
➢ To get acquainted with the equipment of a family physician’s practice
➢ To acquire the application of specific manipulation devices in practice
Activities during the class:
Individual and group work on the topic
Introduction to practical manipulations, principles of their application in practice, independent work - mastering of manipulations
Topics covered during the class: Homework:
Understanding the structure of GP practice
The general principles of organization of GP practice
Family physician team members, the allocation of responsibilities among team members
Understanding the delegation of responsibilities between GP team members
The concept of a family doctor's practice practicable manipulation
The necessary background knowledge:
➢ Understanding about the organization of a family physician’s practice, the principles of action
➢ The idea about the principle of a team work in a family physician’s practice, about the division of responsibilities among the team members
➢ The idea about the delegation of responsibilities among the team members
Self-control questions:
1. What are the basic principles of family medicine
2. What is the family doctors working day plan and what it includes
3. What role does the patient play in the decision making process in GP practice
4. What is the optimal family doctor practice team model
5. What are the principles behind the collaboration between a family doctor and his or her team members
6. Optimal number of GPs premises and what it depends on
7. Equipment that should provide the family doctor's premises
8. Information to be placed in GP practice
Literature: 1. RSU Library Database: AccessMedicine: http://accessmedicine.mhmedical
2. Chantal Simon, Hazel Everitt, Francoise van Dorp. Oxford Handbook of General Practice, Third Edition, 2010. Section 3, Practice managment.
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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Auditorium
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4
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Topics
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Communication skills of a family physician and patient
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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-
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4
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Topics
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Cough syndrome in a family physician's practice
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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Auditorium
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4
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Topics
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Reproductive health and family planning in primary health care
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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-
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4
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Topics
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Screening of malignant tumors. Symptomatic treatment of cancer patients in a family physician’s practice.
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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-
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4
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Topics
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Elevated body temperature in primary care
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Lecture
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Modality
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Location
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Contact hours
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Off site
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E-Studies platform
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2
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Topics
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Primary, secondary, tertiary cancer prevention in family medicine.
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Lecture
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Modality
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Location
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Contact hours
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|---|---|---|
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Off site
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E-Studies platform
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2
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Topics
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Geriatric consequences in a family physician's practice SSNMF
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
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-
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4
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Topics
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Multimorbidity and polypharmacy in Family medicine
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Class/Seminar
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Modality
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Location
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Contact hours
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On site
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-
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4
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Topics
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Chest pain in primary care
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Total ECTS (Creditpoints):
4.00
Contact hours:
48 Academic Hours
Final Examination:
Exam (Written)
Bibliography
Required Reading
1.
Diagnosis & Treatment: Family Medicine. 5th Ed., 2020Suitable for English stream
2.
Practice Guidelines in Primary Care. 2024Suitable for English stream
3.
Esherick, Joseph S., Slater, Evan D., David, Jacob A. Practice Guidelines in Primary Care. 2024.Suitable for English stream
4.
Allen, J. Health Law & Medical Ethics for Healthcare Professionals. Boston, 2012 (akceptējams izdevums)Suitable for English stream
5.
Papadakis, Maxine A., McPhee, Stephen J., Rabow, Michael W. Current Medical Diagnosis & Treatment. 2024Suitable for English stream
6.
LeBlond, Richard F., Brown, Donald D., Suneja M., Szot, Joseph F. DeGowin’s Diagnostic Examination. 10th ed., by McGraw-Hill Education, 2020Suitable for English stream
7.
Murtagh, J. General Practice. 8th ed. Sydney: McGRAW Hill Book Company, 2021.Suitable for English stream
8.
Multimorbidity: clinical assessment and management NICE guideline [NG56]Suitable for English stream
9.
WHO Recommendation on immunization – summary tables Nr.1, Nr.2, Nr.3, Nr.4Suitable for English stream
Additional Reading
1.
Katzung, Bertram G. Basic & Clinical Pharmacology. 16th Ed., 2024Suitable for English stream
2.
Clinician's Pocket Reference: The Scut Monkey. 12th Ed., 2022Suitable for English stream
3.
LeBlond, Richard F., Brown, Donald D., Suneja, M., Szot, Joseph F. DeGowin’s Diagnostic Examination, 11th Ed., 2020Suitable for English stream
4.
Rudņeva, A., Zepa, D., Slokenberga, A. Plaušu simptomu diferenciālā diagnostika.
5.
Health in the Baltic Countries 2008. Riga, 2010
6.
Klīniskā medicīna. prof. A. Lejnieka redakcijā. 2010
7.
Kumar & Clark's. Clinical Medicine. Edinburgh, 2009Suitable for English stream
8.
Muguras lejas daļas sāpes primārajā veselības aprūpē, 25.02.2016. Nr. KV 01, 2021
9.
Current Diagnosis & Treatment: Geriatrics. 2nd ed. Brie A. Williams, Editor, A. Chang, C. Ahalt, H. Chen, R. Conant, C. Seth Landefeld, C. RitchieSuitable for English stream
10.
Diagnosis & Treatment: Family Medicine. 3rd ed., by McGraw-Hill Education, 2021Suitable for English stream
11.
Bates' guide to physical examination and history taking and skills of good interviewing. 12th Ed., 2017Suitable for English stream
12.
Racionālas farmakoterapijas rekomendācijas antibiotiku ambulatorai lietošanai bērniem. 2015
13.
Rekomendācijas empīriskai un etiotropai antimikrobiālai ārstēšanai. 2016
14.
Fever in under 5s: assessment and initial management Clinical guideline [CG160]Suitable for English stream
15.
Valsts organizētais vēža skrīnings, 7.pielikums MK noteikumiem 1529 Veselības aprūpes organizēšanas un finansēšanas kārtība
16.
Ļaundabīgo audzēju primārā diagnostika noteiktām lokalizācijām, 34. pielikums MK noteikumiem 1529 Veselības aprūpes organizēšanas un finansēšanas kārtība
17.
CVD Prevention in Clinical Practice (European Guidelines on) ESC Clinical Practice GuidelinesSuitable for English stream
18.
Arterial Hypertension (Management of) ESC Clinical Practice GuidelinesSuitable for English stream
19.
IDF Clinical Practice Recommendations for managing Type 2 Diabetes in Primary Care. International Diabetes Federation, 2017Suitable for English stream
20.
2. Tipa cukura diabēta ārstēšanas klīniskās rekomendācijas. Latvijas Endokrinologu asociācija, 2016
21.
GINA Report. Global Strategy for Asthma Management and Prevention. 2017Suitable for English stream
22.
Chest pain of recent onset: assessment and diagnosis Clinical guideline [CG95]Suitable for English stream
23.
Global Strategy for the Diagnosis, Management and Prevention of COPD. 2017Suitable for English stream
24.
MK noteikumi Nr 152, 2001.gada 3.aprīlī Darbnespējas lapu izsniegšanas un anulēšanas kārtība
25.
MK noteikumi Nr. 330 Vakcinācijas noteikumi (I daļa, 2. un 3. pielikums)
Other Information Sources
1.
Family Practice Management. American Academy of Family Physicians Practice Management Journal.Suitable for English stream
2.
Likums par prakses ārstiem.
3.
Ārstniecības likums.
4.
Veselības aprūpes organizēšanas un finansēšanas kārtība.
5.
No RSU e-resursiem:
6.
FamilyPractice.comSuitable for English stream
7.
Global Family Doctor. Wonca OnlineSuitable for English stream
8.
Family Practice NotebookSuitable for English stream
9.
AccessmedicineSuitable for English stream