Men's Health - The Royal New Zealand College of General ...

Men’s HealthCommunicationClinical ExpertiseDomain 1: CommunicationThroughout vocational training a registrar will develop avariety of competencies and be expected to:• understand that men are less likely than women todiscuss their health problems with their doctor foremotional, cultural and gender reasons• understand that this difference may be exaggerated if thedoctor is of the opposite sex• understand that adolescent males have even moredifficulty in discussing issues, particularly those in thearea of mental health and sexuality• communicate the need to anticipate the onset ofcommon male health problems, such as cardiovasculardisease• demonstrate that they are comfortable discussingand creating objective measures of such issues ascardiovascular risk, alcohol consumption, sexual healthand mental health status with male patients of all ages,using language they can understandDomain 2: Clinical ExpertiseThroughout vocational training a registrar will develop avariety of competencies and be expected to:• discuss with peers and colleagues clinical cases relatedto genitourinary disorders in men• be able to discuss, evaluate and treat erectile dysfunction• understand and explain referral criteria for people withabnormal PSA results• recognise the indications for referral for further investigationof patients suspected to have prostate cancer• discuss investigations and management of menpresenting with urinary frequency and nocturia,haematuria and other urinary tract symptoms• explain the investigations and management recognisedas best practice in diagnosing sexually transmitteddiseases and a process by which contact tracing can becarried out• demonstrate that they can communicate results and theirinterpretation.• demonstrate a comprehensive knowledge of the optionsfor smoking cessation and their contraindications andavailability for patients.04Men’s Health

ProfessionalismScholarshipDomain 3: ProfessionalismThroughout vocational training a registrar will develop avariety of competencies and be expected to:• demonstrate a professional manner that ensures men ofall ages feel comfortable in discussing sensitive issues,recognising that men may be dismissive of their ownrisks and health problems• understand key male medical problems and lifestylerisks throughout the entire male lifecycle, including men’smental health and wellbeing• educate men about how their body functions and theirspecial health needs, especially the link between lifestylerisks and disease• understand the role of men in the family and theworkplace, particularly the problems caused byunemployment among men and how this is associatedwith higher health risks.Domain 4: ScholarshipThroughout vocational training a registrar will develop avariety of competencies and be expected to:• demonstrate commitment to their own professionaldevelopment and plan accordingly• demonstrate competence in accessing and applyingcurrent evidence in relation to best practice• facilitate and be actively involved in the learning of juniorand allied health professionals• evaluate prevention strategies and clinical outcomesusing research and audit tools, such as smokingcessation statistics and intervention with mental healthissues, alcohol consumption and drug use• share with peers the recent journal articles or WEBSsummaries presented in seminars, learning groups andpeer review groups• undertake postgraduate university-level study or researchthat relates to men’s health issues• construct a vignette or MATCH question on an importantclinical issue related to men’s health.www.rnzcgp.org.nzMen’s Health05

Men’s HealthContext ofGeneral PracticeManagementDomain 5: Context of General PracticeThroughout vocational training a registrar will develop avariety of competencies and be expected to:• discuss the prevalence of common male genitourinaryconditions in the local community and population asa wholeDomain 6: ManagementThroughout vocational training a registrar will develop avariety of competencies and be expected to:• identify men who attend the practice less frequentlyas an opportunity for lifestyle risk assessment andhealth promotion• coordinate care with local allied health providers to betterdiagnose, manage and support men with mental healthand addiction problems• create male-friendly environments, for example by usingmen’s health posters and displays of information relatingto men• adopt an advocacy role in men’s health among the localcommunity by addressing groups and clubs on thenecessity of men taking care of their health• develop and maintain relationships with local smokingcessation and alcoholism support services, and advocatefor smoking cessation and alcohol and drug educationprogrammes in the community• promote awareness of the problem of male youth suicidein the community.• promote a practice culture that acknowledges men’sproblems with appointments and waiting times, forexample by providing evening clinics or appointmentschedules that accommodate those working shifts orcommuting over distances• discuss the desirability of providing special services formen who have sex with men, men with mental illnessor a disability, and young adolescent males• identify when a male patient may prefer to see a maledoctor, respect this choice and arrange this when practical• offer services, where appropriate, in areas where mencongregate, such as sports venues, workplaces orentertainment areas.06Men’s Health

Year 3+ Learning experiences AssessmentClinicalEducationalAs for Year 2, plus:Training under vocational scopes – if applicableManagement of men’s health presentations in:• Outpatient clinics – cardiovascular and urology• Community-based servicesWork with allied health professionals involved inmen’s health• Rehabilitation services• Occupational health workers• Social workers• Multidisciplinary team meetingsInvestigation of men’s health conditions• Motivational interviewing skills• Outpatient services• One-on-one teaching• Departmental teaching• Journal clubs• Peer groupsMedical educator visitsAuditAcademic outputMini CEXLearning logSupervisor reportsMulti-source feedbackPrevious summative assessmentsif not completedFellowship Assessmentwww.rnzcgp.org.nzMen’s Health09

Men’s HealthReferences/resourcesBeaglehole, R. ‘Men’s health - Causes of men’s death,disease and injury’, Te Ara - the Encyclopedia of NewZealand, updated 11 March 2011. www.TeAra.govt.nz/en/mens-health/2Williams, D R. 2008. The Health of Men: StructuredInequalities and OpportunitiesAm, J Public Health. September; 98 (Supplement 1):S150–S157.Jatrana, S and Crampton, 2009. P. Gender differencesin general practice utilization in New Zealand. Journalof Primary Health Care 1:261-269.Kalben, B B. 2000. Why men die younger: causes ofmortality differences by sex. North American ActuarialJournal 4:83-11.Royal Australian College of General Practitioners. 2011.Men’s health. RACGP Curriculum for Australian GeneralPractice 2011. Melbourne, Australia.Vickers, A J et al. 2012. Screening for prostate cancer:Early detection or overdetection. Annual Review ofMedicine 63:161-170.Jordan, J et al. 2012. Providing meaningful care; Learningfrom the experiences of suicidal young men. QualitativeHealth Research 22: 1207-1219.Djulbegovic, M et al. 2010. Screening for prostate cancer;Systematic review and metanalysis of randomized controlledtrials. British Medical Journal. Sep 14; 341:c4543. doi:10.1136/bmj.c4543Hodgson, F et al. 2012. PSA testing in general practice.Journal of Primary Health Care 4: 199-204.Moyer, V F. 2012. Screening for prostate cancer:United States preventive taskforce recommendationstatement. Annals of Internal Medicine 157: 120-134.10Men’s Health

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