Veidlapa Nr. M-3 (8)
Study Course Description

Internal Medicine

Main Study Course Information

Course Code
RGA_024
Branch of Science
Anatomy; Clinical medicine
ECTS
24.00
Target Audience
Medicine
LQF
Level 8

Study Course Implementer

Course Supervisor

Residency Speciality

Speciality
Supervisor of Medical Speciality
Contacts

-

About Study Course

Objective

To ensure acquisition of theoretical knowledge and practical skills in accordance with the requirements of the family doctor specialty regulation, prepare a specialist who is able to provide constant, uninterrupted and comprehensive care of the patient and their family members and help the patient make a choice between the offered health care services, ensuring the patient’s abilities for better physical, mental and social functioning, is able to assess the patient’s state of health, diagnose diseases and provide supportive treatment according to the defined competences. To prepare the doctor for certification in the specialty of family doctor, in accordance with the regulatory documents of the Republic of Latvia.

Learning Outcomes

Knowledge

1.Acute and chronic syndromes and diseases: diagnosis, treatment tactics, monitoring and referral to specialists. Has an idea, knowledge and understanding of the following: Respiratory and pulmonary diseases and syndromes: - acute respiratory infections, - acute pneumonia, - chronic obstructive pulmonary diseases, - chronic bronchitis, - pulmonary emphysema, - acute pneumonia, - bronchial asthma, - tuberculosis, - tumours, - acute and chronic respiratory failure, - pneumothorax, - pulmonary haemorrhage, - breathing disorders during sleep. Diseases of the cardiovascular system: - hypertension, - chronic heart failure, - ischemic heart disease, - myocardial infarction, - myocarditis, - pulmocardial insufficiency – cor pulmonale, - cardiomyopathy, - pericarditis, - peripheral vascular diseases. Syndromes and diseases of the digestive tract: - functional dyspepsia, - peptic ulcer, - irritable bowel syndrome, - reflux, - cholelithiasis, - acute and chronic hepatitis, - liver cirrhosis, - bleeding from the digestive tract, - stomach and intestinal tumours, precancerous conditions. Anaemias: - knowledge of differential diagnosis, - iron deficiency anaemia, - haemorrhagic anaemia, - Vitamin B12 deficiency anaemia. Syndromes and diseases of the endocrine system: - diabetes, - thyrotoxicosis, - hypothyroidism, - obesity. Knowledge and understanding of the profession of family doctor characteristic to creative thinking or research and activity at the conjunction of different fields. Understands the aspects of diagnosis (including laboratory, morphological, instrumental, non-instrumental and radiological diagnosis), differential diagnosis, medicinal (clinical pharmacology, pharmacotherapy) and non-medicinal (diet therapy, physiotherapy) treatment, rehabilitation and secondary prevention in the sub-branches of medicine and nosologies. Able to make decisions independently, solve complex situations related to health care, diagnosis and treatment. Able to organise research work in various areas of family medicine.

Skills

1.• evaluation of clinical and biochemical laboratory examination data, • ECG recording, evaluation (rhythm disturbances, conduction disturbances, signs of acute ischemia, overloads), EHO-KG, VEM evaluation, • to establish indications for invasive tactics, urgent and planned (coronarography, percutaneous coronary intervention), • application of treatment algorithms of acute conditions, • able to independently drive the improvement of one’s competences and specialisation, • to take responsibility for results of work of personnel groups and analysis thereof, • to perform work, do research or continue education in complex and unpredictable conditions and to transform them using new approaches, if required. During post-graduate training, the family doctor must learn the indications and contraindications for the following additional methods in the diagnosis of respiratory diseases: • in the assessment of the basic indicators of external respiratory functions, • functional tests (in the assessment of bronchial permeability), • bronchoscopy, • computed tomography, • blood gas test, • chest roentgenogram (must be able to evaluate the results), • aerosol inhalation technique, • peak expiratory flow.

Competences

1.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.

Assessment

Individual work

Title
% from total grade
Grade
1.

Individual work

-
-
Work in small groups – clinical case analysis. Preparation of a presentation – according to the topic of the rotation cycle. Educational work with different population groups (development of informative materials, lectures).

Examination

Title
% from total grade
Grade
1.

Examination

-
-
2.

Examination

-
-
Assessment of theoretical knowledge and practical skills at the end of the study course in a 10-point system.

Study Course Theme Plan

FULL-TIME
Part 1
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Differential diagnosis of joint diseases.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Cough. Diseases of the upper respiratory tract in the family doctor practice. Pathogenesis of temperature.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Prevention, therapy, teamwork in the care of patients with type 2 diabetes mellitus.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

More common endocrine diseases in the family doctor's practice. Family doctor tactics.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Arterial hypertension in the family doctor practice.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Gastroenterological diseases. Early diagnosis of tumours of the digestive organs.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Genitourinary infections in the family doctor practice.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Early and timely diagnosis of lung diseases (including oncological) in the practice of a family doctor. Case studies.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Deep respiratory tract diseases in the family doctor practice.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Modern tactics of diagnosis and treatment of chronic heart failure.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Chronic venous insufficiency, principles of diagnosis and treatment
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Differential diagnosis of urinary syndrome. Concept, stages, treatment of chronic kidney disease.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Differential diagnosis of inflammatory kidney diseases in the work of a family doctor.
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Cardiac stress tests, indications, methodology, interpretation of results.
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Anaemia diagnosis and therapeutic principles.
  1. Seminar

Modality
Location
On site
Specialized room

Topics

Diagnostic principles of haematological diseases.
  1. Seminar

Modality
Location
On site
-

Topics

Current development in cardiopulmonary resuscitation
  1. Seminar

Modality
Location
On site
Auditorium

Topics

Differential diagnosis of rash and further tactics in GP practice.
Total ECTS (Creditpoints):
24.00
Number of Residency Seminars:
18
Length (weeks):
20
Final Examination:
Residency exam (Theory and practice)

Bibliography

Required Reading

1.

Practice Guidelines in Primary Care 2021-2022. Jacob A. David. E-book Download Clinical Guidelines in Family Practice Full Online, 2020, Oralee348Ostrander, Format: PDF / EPUB / MOBI

2.

2019. ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). François Mach, Colin Baigent, Alberico L. Catapano, et.al.

3.

2018 ESC/ESH Guidelines for the management of arterial hypertension. Michel Azizi, Michel Burnier, Denis L Clement, et.al. ESC Scientific Document Group

4.

Kalvelis A., Lejnieks A. Galveno kardiovaskulāro slimību un izpausmju klīniskās formas un diagnozes formulējumi. Rīga, 2017.

5.

Latvijas Kardiologu biedrība. Hroniskas sirds mazspējas klīniskās vadlīnijas. Rīga, 2012.

6.

Jirgensons J., Kalējs O., Lejnieks A. (Sast.). Klīniskā medicīna. Pirmā grāmata, Rīga, 2010.

7.

William J. Bremner, Wellington Hung, C. Ronald Kahn. Family Practice Center, Houston, TX , USA. Medical Diagnosis & Treatment. Stephen McPhee, Maxine Papadakis, Lawrence Tierney, 2007.

8.

Ērglis A., Kalvelis A., Jirgensons J., u.c. Stabila stenokardija. Rīga, 2007.

9.

Kalvelis A., Kalniņš U. Kardiovaskulāro slimību profilakse. Rīga, 2007.

Additional Reading

1.

Family Practice Guidelines. 5th Edition, May 2020. Jill C. Cash, Cheryl A. Glass, Jenny Mullen. ISBN:978-0-8261-3583-4 (Print)

2.

Practice Guidelines in Primary Care 2021-2022. Jacob A. David E-book Download Clinical Guidelines in Family Practice Full Online, 2020, Oralee348Ostrander, Format: PDF / EPUB / MOBI

3.

Medscape. Family Medicine Clinical Practice Guidelines - 2019 Year in Review. Stay current with new guidelines and recommendations.

4.

New: global initiative for asthma 2021 executive summary on asthma management and prevention

5.

Pocket guide to copd diagnosis, management, and prevention. A Guide for Health Care Professionals 2021

6.

2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal. Volume 39, Issue 33, 1 September 2018. Pages 3021–3104

7.

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal (2016) 37,( 2893–2962).

8.

Kamzola G. Ehokardiogrāfijas loma sirds mazspējas difernciāldiagnostikā. Latvijas ārsts. 2016. februāris. (12.-20.lpp.)

9.

European Guidelines for Obesity Management in Adults, Obesity Facts. 2015 Dec; 8(6); 402-424

10.

Hroniskas Sirds mazspējas klīniskās vadlīnijas. Latvijas Kardiologu biedrība. Rīga. 2012.

Other Information Sources

1.

2018. gada 28. augusta Ministru kabineta noteikumi Nr. 555 "Veselības aprūpes pakalpojumu organizēšanas un samaksas kārtība". Latvijas Vēstnesis,. (176 (6262), 05.09.2018.)