Year GEP 1 MedSoc(GEP: Medicine in Society (GEP)

Lecture: Introduction to Medicine in Society

1. Identify the background to Medicine in Society
2. Recall the Aims and Objectives of the Medicine in Society Course
3. Recognise how to act professionally while on clinical placements
4. Apply some core communication skills
5. List the assessment criteria for this unit
6. Follow the guidelines for placements

Medsoc Primary Care Day 1: Social Issues in Primary Care

1. List some of the social issues that impact on patient’s health and their experience of heath care
2. Demonstrate an awareness of the importance of considering social factors when treating patients
3. Describe the impact social issues can have on the work of the GP and the PHCT (Primary healthcare team)
4. Discuss the role of the PHCT in support and treatment of patients whose social circumstances impact on their health

Medsoc Primary Care Day 2: Back Pain and other Chronic Pain

1. Describe the factors that are important in the development of chronic, disabling pain
2. Summarise the socio-economic impact on individuals, the community and the health services of this condition
3. Discuss the effect of chronic pain that the doctor cannot ‘cure’ on the relationship between the doctor and the patient
4. Identify and describe a range of orthodox and complementary therapies used to deal with chronic pain

Medsoc Primary Care Day 3: Stroke

1. Discuss the impact of stroke on an individual and their family/carers and the role of voluntary agencies in providing support
2. Demonstrate an understanding of the effect of poor mobility on the individual; and the changes needed within the community e.g. access to public buildings and public transport, improvements to pavements etc.
3. Identify the member of the MDT that are important in assessment and care of patients with impaired mobility
4. Describe a health promotion intervention that can reduce the risk of stroke in an individual at risk e.g. blood pressure management, warfarin / aspirin in patients with atrial fibrillation.

Medsoc Primary Care Day 4: Mental Health

1. Identify local and national strategies to improve mental health
2. Discuss the national and practice prevalence of mental illness
3. Describe the local support services for people with mental illness
4. Discuss the different needs of patients with acute and chronic mental health problems

Medsoc Primary Care Day 5: Addiction

1. Identify the addictions commonly encountered within the practice
2. Describe the range of services, people and agencies involved in the care of people with addictions in the local area
3. Discuss smoking cessation strategies in place locally
4. Identify and describe some of the health promotion models used in treating people with addiction
5. Discuss the impact of addictions on the health of the practice population and on public health

Medsoc Primary Care Day 6: CHD prevalence, inpact and prevention

1. Explain the process of development of CHD
2. Outline the impact of CHD on individuals and on population morbidity and mortality
3. Describe key health promotion interventions to reduce morbidity and mortality due to CHD
4. Discuss the impact of CHD on an individual patent
5. Identify key policy documents relating to CHD

Medsoc Primary Care Day 7: Respiratory disease

1. List common respiratory illnesses in children and adults that are seen in primary care
2. Describe the basic assessment of a child with an upper respiratory tract illness (URTI)
3. Describe and reflect on the impact of chronic respiratory disease from a patient’s perspective, focusing on the issues of loss of function, autonomy, and well-being and its impact on daily life
4. Outline the health promotion interventions, interventions, provided by the practice team to prevent or manage respiratory illness
5. Demonstrate a basic examination of the respiratory system
6. Demonstrate the measurement and interpretation of peak expiratory flow

Medsoc Primary Care Day 8: Diabetes

1. Describe the incidence and prevalence of Type 1 and Type 2 diabetes and the impact of diabetes on the general practice workload
2. Discuss some factors that may be contributing to the rise in prevalence of type 2 diabetes
3. Describe theories of pathogenesis for Type 1 and Type 2 diabetes
4. Describe the impact of diabetes on an individual
5. Describe some health promotion interventions to reduce the prevalence of Type 2 diabetes

Medsoc Primary Care Day 10: The Older Person

1. Recognise ageing is a natural, developmental process
2. Describe some of the different ways that the elderly are regarded within different groups and communities
3. Describe the range of services; people and agencies are involved in the support of the older patient in the local community
4. Explain some of the implications for the health and social services of an increasingly elderly population
5. Identify key policy documents relating to care of older people

Medsoc Primary Care Day 11: Pregnancy and Childbirth

1. Recognise pregnancy and childbirth as normal processes
2. List the possible choices that women can make in relation to antenatal care and place of birth
3. Discuss the potential impact of pregnancy and childbirth on partners or husbands
4. To consider the different factors e.g. access, support from GP, independent midwives etc which influence women’s choices in pregnancy and childbirth
5. To give students an opportunity to meet a pregnant woman

Medsoc Primary Care Day 12: The young child

1. Describe some of the health promotion services provided by the practice for mothers and their babies
2. Describe some of their experiences communicating and engaging with the children they have met
3. Examine the most significant changes parents have to deal with after the birth of a child
4. Discuss the impact of the child on the relationship and life of its parents

MedSoc Secondary Care Day 1: Basic Training

MedSoc Secondary Care Day 2: Musculoskeletal

1. Explain why the Physiotherapist is vital in both rheumatology and orthopaedics
2. Describe the roles of the other members of the MDT in the management of elective and acute orthopaedic patients
3. Describe the unique and common clinical skills used by the Plaster technician
4. Describe experiences of the patients you have met today regarding their inpatient and outpatient care

MedSoc Secondary Care Day 3: Stroke

1. Compare the care of the stroke patients in various settings
2. Understand the features of good rehabilitation common to these settings
3. Describe the activities of daily living (ADL) assessed by the MDT
4. Understand the role of the doctor in the care of the stroke patient in: (a) acute setting; (b) rehabilitation setting
5. List the secondary risk factors which should be addressed on admission of stroke patients
6. List three drugs that such patients may be on

MedSoc Secondary Care Day 4: Adult Psychiatry

1. Describe the role of a liaison psychiatrist
2. Know who is involved in the psychiatric multi-disciplinary team
3. Know why substance misuse (including alcohol misuse) is so prevalent in East London
4. Understand the problems faced by patients with mental health issues when they are on an acute hospital ward

MedSoc Secondary Care Day 5: Chest Pain and IHD

1. Know how to take a history from someone with chest pain
2. Know what primary angioplasty is and how this service is organised at the London Chest Hospital
3. Know the risk factors for coronary heart disease
4. Understand the concerns of the patient or his family after a heart attack
5. Specify what should be given to the patient after a heart attack
6. Know the roles of the multidisciplinary team in the investigation and care of an inpatient with CHD
7. Know the DVLA regulations for a person who has had acute coronary syndrome

MedSoc Secondary Care Day 6: IHD – In-patient Investigation and Management

1. Specify the objective parameters which may be used to stratify patients’ risk of further cardiac events
2. Advise what blood tests should be requested for a patient admitted with an acute coronary syndrome
3. Explain who should be considered for further investigation and what might exclude a patient from further investigation
4. Know the indications and contra-indications for an exercise stress test (EST) and explain the reasons why a EST may be stopped prematurely
5. Describe the major and minor risks of coronary angiography and recall the risks that your patients were aware of
6. Explain the indications of coronary angioplasty stenting and indicate any long term benefits over operative intervention
7. Describe the major problems faced by your patients post coronary artery bypass surgery and how they were dealt with by the care team and the patient

MedSoc Secondary Care Day 8: Secondary Care of the Patient with Diabetes

1. State the WHO definition of diabetes mellitus
2. Describe the theories of pathogenesis are given for Type 1 and Type 2 diabetes
3. Explain what Impaired Glucose Tolerance (IGT) is and what prognostic significance it has
4. Explain the common complications that arise in diabetes mellitus and how they are classified or subdivided
5. Explain the value of having an annual diabetic review and who should be involved in this review
6. Explain why the incidence of Diabetes mellitus is increasing in the UK and why the incidence of Type 2 diabetes increasing in the under 40s
7. Describe how you would educate a patient with newly diagnosed diabetes and the topics you would cover
8. Explain the DVLA regulations for a person with diabetes

MedSoc Secondary Care Day 9: Gastroenterology

1. Describe how you would take a history from someone with diarrhoea
2. Explain the causes of bloody diarrhoea
3. Understand how inflammatory bowel disease may affect one’s work, life and family
4. Identify what patient support groups are available for inflammatory bowel disease
5. Describe what common blood tests are performed on patients with abdominal conditions
6. Explain what medical conditions require upper and lower GI endoscopy
7. Explain what an ERCP is and what its indications are
8. Describe the role of the Endoscopy Nurse and the clinical skills they utilise
9. Explain who is involved and what the stages of patient transfer are from the wards to the operating theatres and from Recovery to the ward, and the potential hazards of this transfer

MedSoc Secondary Care Day 11: Obstetrics & Gynaecology/Paediatrics

1. Explain the difference between gynaecological and obstetric history taking
2. Explain what would need to be considered before taking a sexual history
3. Explain what the take up rate for cervical cancer screening is in East London and how it compares with the National average

MedSoc Secondary Care Day 12: The Older Patient in the Hospital Setting

1. Describe how the care of older patients differ in the various settings
2. Describe what the patients and their relatives feel about their care
3. Describe good features of older patient care
4. Explain how the care of older patients may differ to that of younger adults in the hospital setting
5. Explain why older patients may be advantaged and disadvantaged by admission to an acute care of the elderly ward

MedSoc Secondary Care Day 10: Nutrition and Feeding in the In-patient setting

1. Know how much the NHS spends on food for each patient per day
2. Know which nutritional supplements are commonly used on the wards and their nutritional contents
3. Know what are NG, PEG and TPN feeding approaches and the risks and benefits of each
4. Know what disorders commonly stop patients eating
5. Know which members of the MDT are essential when assessing a patient’s swallow
6. Explain why may pulse oximetry be used when assessing a patient’s swallow

Medsoc Primary Care Day 9: Nutrition and GI disorders

1. Describe the components of a ‘healthy diet’
2. List the current recommendations for daily exercise
3. Describe some of the broad spectrum of symptoms that relate to the GI tract
4. Describe the impact of a chronic bowel disorder on a patient’s life
5. Discuss how symptoms seen as embarrassing might influence people’s decision to visit their doctor
6. Discuss the role of the primary care team in encouraging people to lead healthier lives

MedSoc Secondary Care Day 7: Lung Cancer – Diagnosis and Treatment

1. Describe how someone with lung cancer may present themselves
2. Describe the possible abnormalities seen on the chest radiograph of a patient with lung cancer
3. Explain which members of the MDT are involved in support and counselling of the patients prior to, and after the confirmation of their diagnosis
4. Explain the roles of the oncologist and the radiotherapist in the treatment of lung cancer
5. Explain why the overall prognosis of patients with lung cancer is so poor
6. Explain why the incidence of lung cancer is falling more slowly in women than in men
7. Describe methods you could use to reduce the nation’s smoking habit, particularly that of the younger women, with supporting evidence