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

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R Renal Curriculum and Urology for General Practice Renal and Urology Renal disease is exponentially expanding in New Zealand and is becoming something primary care will be required to manage more of as the health system tries to cope with the burden of more and more dialysis patients. Māori and Pacific people in particular are affected by this and need preventive and early intervention. Issues relating to the urinary tract extend from the kidneys to the end of the urethra. There is considerable overlap with the topics of women’s and men’s health, as well as sexual health and even diabetes, in particular with renal disease. The number of people requiring treatment for renal disease in New Zealand is expected to rise at a rate higher than would be attributable to the natural increase in the population. It is estimated that almost half of the total projected growth would be attributable to the increasing rates of type II diabetes associated with increasing rates of obesity. 1 Other conditions such as renal colic, haematuria and prostatic issues are common presentations in general practice and the effective management of these is essential. Prevention of chronic renal disease is one of the important roles of primary care. Renal failure deaths were 3.5 times more common among Māori than non-Māori in 2000-2005. 2 Knowledge of the preventable causes of renal disease is essential to improving health outcomes in this area. This curriculum statement links with: • Acute Care - Page 28 • Endocrinology - Page 59 • Long-term Conditions - Page 85 • Oncology - Page 115 1 National Renal Advisory Board. 2006. New Zealand’s Renal Services Towards a national strategic plan (scoping paper), www.health.govt.nz/system/files/ documents/.../nz-renal-services.pdf 2 Harwood M, Tipene-Leach D. 2007. Diabetes. In Robson B, Harris R. (eds), Hauora: Māori Standards of Health IV. A study of the years 2000-2005 160-167. Wellington: Te Rōpū Rangahau Hauora a Eru Pōmare. 128 Curriculum for General Practice
Renal and Urology R Communication The GP will demonstrate the ability to: • outline the rules and limits of confidentiality, including using translators when communicating with patients with renal conditions • provide accurate, honest explanation and education appropriate to the age and stage of the patient • use appropriate language that does not discriminate against age, gender, disability or ethnicity • provide evidence-based pre-test counselling for prostate screening where appropriate. • take an appropriate history for risk factors of chronic kidney disease Clinical Expertise The GP will demonstrate the ability to: • perform a focused examination, being sensitive to the privacy of the patient and any cultural requirements • prescribe medication for renal conditions and discuss the impact of various medications on renal function • recognise that using a chaperone is a safe practice for doctor and patient • have core knowledge of appropriate management and referral for the common and key renal and urological conditions seen in primary care • investigate renal conditions through ordering appropriate tests as well as demonstrate skill in taking samples when required • have an understanding of palliative care issues with end-stage renal disease. Professionalism The GP will demonstrate the ability to: • establish clear professional boundaries for confidentiality within the practice team, particularly in rural communities • be aware of patients’ attitudes, beliefs and reasons for choosing not to have dialysis or recommended treatments. • be sensitive towards patients who are in denial, or seem unwilling to engage in behaviour change recommended by the medical team www.rnzcgp.org.nz Curriculum for General Practice 129
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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
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Family Violence F Family Violence F
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Family Violence F Professionalism T
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Gastroenterology G Gastroenterology
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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
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Page 91 and 92: Māori Health M Māori Health The T
Page 93 and 94: Māori Health M Clinical Expertise
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Page 97 and 98: Men’s Health M However, in the sa
Page 99 and 100: Mental Health M Mental Health In 20
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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 and 122: Paediatrics and Immunisations P Pae
Page 123 and 124: Paediatrics and Immunisations P Com
Page 125 and 126: Paediatrics and Immunisations P Man
Page 127 and 128: Population and Public Health P Comm
Page 129: Population and Public Health P Mana
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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