Curriculum for General Practice - The Royal New Zealand College ...

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P Curriculum Paediatrics for and General Immunisations Practice Acute rheumatic fever is a significant issue facing New Zealand children, particularly among Māori and Pacific populations. It is also has geographical disparities and is linked to areas with high social depravation. Rates have not decreased since the 1980s and remain among the highest in the developed world. The Government has implemented a prevention programme targeting seven high-risk rheumatic fever regions. 5 New Zealand has one of the highest rates of child abuse in the developed world. 6 Abuse comes in many forms from physical abuse to neglect for the child’s welfare and needs. The immediate effects are devastating for the child and the family/whānau and the physical and emotional harm will likely affect the behaviour of the child throughout their adolescence and through to adulthood. Child abuse has been linked to a number of negative outcomes for victims throughout their adolescence, including mental health issues, low self-esteem, sexual difficulties and interpersonal problems. 7 Sexual abuse in childhood is an issue in New Zealand with approximately 30 percent of women reporting sexual abuse and 10 percent of men. Child sexual abuse has been linked to higher numbers of sexual partners, higher contract rates of sexually transmitted infections and unhappy pregnancies and abortions in those who have been abused. 8 Māori are a young population with a median age of 23 years, compared to 36 years for the total population. In 2006, 35 percent of Māori were under 5 years of age and 53 percent under the age of 25 years. The impact of paediatric care is a significant factor in altering health outcomes for Māori. A 2009 study found the delivery of childhood immunisation is less effective for Māori children, who have lower levels of immunisation coverage. All-cause mortality rates for Māori children are significantly higher than those of non-Māori children and for many conditions hospitalisation rates for Māori children exceed those of non-Māori children. The report also suggested that primary care services to Māori children need to be improved to reduce the level of avoidable hospitalisations. 9 General practitioners are required to understand a wide range of issues involved in paediatric care and need to be able to recognise and effectively manage situations that require intervention to ensure the wellbeing and positive development of the child. 5 Jaine R, Baker M, Venugopal K. 2008. Epidemiology of acute rheumatic fever in New Zealand Wellington: Department of Public Health, University of Otago. 6 Every child counts. Child Abuse. http://www.everychildcounts.org.nz/resources/child-abuse/ 7 Mulle PE, Martin JL, Anderson JC, Romans SE, Herbison GP. 1996. The long-term impact of physical, emotional and sexual abuse of children: A community study, In Child Abuse and Neglect 20(1):7-21. 8 van Roode T, Dickson N, Herbison P, Paul C. 2009. Child sexual abuse and persistence of risky sexual behaviours and negative sexual outcomes over adulthood: Findings from a birth cohort. Child Abuse & Neglect 33(3):161-172. 9 Smylie J, Adomako P (eds). 2009. Health of Indigenous Children: Health Assessment in Action Keenan Research Centre – Research Programs. Centre for Research on Inner City Health. 120 Curriculum for General Practice
Paediatrics and Immunisations P Communication The GP will demonstrate the ability to: • elicit a comprehensive history from the family/whānau, carers and children to ascertain the full extent of the presentation • encourage and support parenting skills and healthy environments for children • communicate with children of all ages and their family/ whānau • manage complex consultations where the entire family/ whānau are present and/or more than one sibling is unwell. • discuss the immunisations available on the national schedule, recognising personal choice and discussing this in a non-judgemental manner Clinical Expertise The GP will demonstrate the ability to: • diagnose the common illnesses of childhood and manage them appropriately • recognise the signs of child abuse or neglect and refer appropriately • recognise disability in childhood and refer appropriately • undertake an age-appropriate examination of a child • respond to serious paediatric illness at an early stage • provide paediatric life support as required in their particular working environment • distinguish between normal and abnormal development • prescribe for children, recognising risks and harms associated with some treatments. • recognise common behavioural or mental health conditions that present in childhood www.rnzcgp.org.nz Curriculum for General Practice 121
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Curriculum for General Practice www
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Mihi E ngā mana, e ngā reo, e ng
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Acknowledgements Acknowledgements A
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Overarching Curriculum Curriculum S
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Part 2 - General practice in New Ze
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Improving Māori access to primary
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Part 4 - Delivering the curriculum
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Part 5 - Curriculum domains Part 5
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Core competencies Fellows of The Ro
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Further competencies As further exp
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Curriculum statements Curriculum st
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Acute Care A Communication The GP w
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Acute Care A Clinical Expertise Neu
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Acute Care A Management The GP will
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Addictions A Communication The GP w
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Addictions A Management The GP will
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Adolescent/Rangatahi/Youth Health A
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Adolescent/Rangatahi/Youth Health A
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Cardiovascular C We know that after
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Cardiovascular C Specific to rural
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Dermatology D Dermatology The skin
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Dermatology D Professionalism The G
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e-health E e-health The World Healt
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e-health E Professionalism The GP w
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End-of-life Care E End-of-life Care
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End-of-life Care E Clinical Experti
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Endocrinology E Endocrinology A wid
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Endocrinology E Clinical Expertise
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Ear, Nose and Throat E Ear, Nose an
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Ear, Nose and Throat E Professional
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Eyes E Communication The GP will de
Page 71 and 72: Family Violence F Family Violence F
Page 73 and 74: Family Violence F Professionalism T
Page 75 and 76: Gastroenterology G Gastroenterology
Page 77 and 78: Gastroenterology G Professionalism
Page 79 and 80: Genetics G Genetics With the mappin
Page 81 and 82: Genetics G Professionalism The GP w
Page 83 and 84: Health and Work H Inequality persis
Page 85 and 86: Health and Work H Scholarship The G
Page 87 and 88: Long-term Conditions L Long-term Co
Page 89 and 90: Long-term Conditions L Clinical Exp
Page 91 and 92: Māori Health M Māori Health The T
Page 93 and 94: Māori Health M Clinical Expertise
Page 95 and 96: Māori Health M Context of General
Page 97 and 98: Men’s Health M However, in the sa
Page 99 and 100: Mental Health M Mental Health In 20
Page 101 and 102: Mental Health M The following subto
Page 103 and 104: Mental Health M Professionalism The
Page 105 and 106: Musculoskeletal M Musculoskeletal M
Page 107 and 108: Musculoskeletal M Professionalism T
Page 109 and 110: Neurology N Neurology Neurological
Page 111 and 112: Neurology N Professionalism The GP
Page 113 and 114: Older People O Older People General
Page 115 and 116: Older People O Professionalism The
Page 117 and 118: Oncology O Oncology Cancer is one o
Page 119 and 120: Oncology O Professionalism The GP w
Page 121: Paediatrics and Immunisations P Pae
Page 125 and 126: Paediatrics and Immunisations P Man
Page 127 and 128: Population and Public Health P Comm
Page 129 and 130: Population and Public Health P Mana
Page 131 and 132: Renal and Urology R Communication T
Page 133 and 134: Respiratory Medicine R Respiratory
Page 135 and 136: Respiratory Medicine R Clinical Exp
Page 137 and 138: Rheumatology R Rheumatology Rheumat
Page 139 and 140: Rheumatology R Professionalism The
Page 141 and 142: Rural R Many rural general practiti
Page 143 and 144: Rural R Professionalism The GP will
Page 145 and 146: Sexual Health S Sexual Health ‘Se
Page 147 and 148: Sexual Health S Clinical Expertise
Page 149 and 150: Travel Medicine T Travel Medicine N
Page 151 and 152: Travel Medicine T Scholarship The G
Page 153 and 154: Women’s Health W Before 2007, gen
Page 155 and 156: Women’s Health W Context of Gener
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