Training Program

General Objectives

Objectives Relating to Skills

These skills are essential to consultant physician practice in adult nternal medicine and its subspecialities. They are further developed during advanced training.

Clinical Skills

• General verbal communication skills. These include the establishment of professional relationships with patients and their relatives or caregivers, in order to obtain a history from the patient, conduct a physical examination and provide appropriate management of inpatients with multiple medical problems. This includes the ability to judge which condition or conditions take priority over others with respect to investigation and management. Verbal presentation using appropriate language at the bedside, in a seminar or classroom is also important and to know when and how to communicate urgently with a general practitioner by telephone. In summary it is the ability to communicate clearly, considerately and sensitively with patients, relatives, other health professionals and the public.
  
• General physical examination skills. The physical examination of all systems should include an ability to interpret the physical signs. The ability to perform an accurate physical and mental state examination in complex medical problems, often involving multiple systems is important.
  
• General written communication skills. The patient's problems should be clearly, concisely and accurately recorded by a written medical record that is regularly updated. The trainee should be able to form and record a clear management plan after the initial history and clinical examination. It is also important to learn how to write a complete discharge summary and a competent letter for outpatients after referral from a general practitioner.
  
• Patient management skills. Problem solving, including problem identification, analysis and management by the use of appropriate resources, interpretation of laboratory results and the importance of avoiding unnecessary investigation and hospitalisation. This also includes the ability to prioritise different problems within a specified time frame. All this should be in concert with the patient, the patient's caregivers and other health professionals and should take into consideration the risks and benefits of the treatment. The ability to interpret and integrate the history and examination findings and arrive at an appropriate diagnosis(es), or differential diagnosis.
  
• Skills in relation to medical ethics. Ethical issues, including confidentiality and confidential computerised record keeping, ethics and medico-legal aspects of informed consent. Ethical issues are of considerable importance, especially with respect to the elderly and mentally incapable.

Professional Etiquette

• Learning how to handle complaints including self-criticism or criticism by colleagues or by patients.
  
• Understanding the importance of a second opinion.

Management of Terminal Illness and Bereavement

• Care of the dying.
  
• Conveying bad news, answering questions from patients and relatives and handling the emotional aspects,
  
• Decisions concerning resuscitation.
  
• Immediate management of bereavement,
  
• Requests for organ donation.

• Venepuncture, venesection and cannulation and intravenous infusion.
  
• Arterial access including blood gas sampling.
  
• Injection techniques.
  
• Cardiopulmonary resuscitation.
  
• Urinary catheterisation, male and female, and urine analysis and microscopy.
  
• Lumbar puncture.
  
• Insertion of chest tubes.

• Objectives Relating to Knowledge and Understanding
  
• Objectives Relating to Attitudes
  
• Allied Skills

[ Back to Basic Training Menu ]

[ Home ] [ General Information ] [ Basic Training ] [ Advanced Training ]
[ Advanced Vocational Training ] [ Training outside Australia & New Zealand ]
[ Return to RACP Homepage ]