Domain 4
Patient Management
HK Doctors Core Competences mapped to this domain:
Clinical skills - Medical graduates should be competent in carrying out a range of clinical skills (e.g. history taking, physical and mental state examination, problem solving skill, making a diagnosis, etc.) independently and to an acceptable standard.
Patient investigation - Medical graduates should be able to demonstrate competence in the general principles of patient investigation and to undertake appropriate investigative procedures by themselves.
Patient management - Medical graduates are expected to have demonstrable knowledge of the important aspects of patient management and to make appropriate referrals
Decision making skills and clinical reasoning and judgment - Medical graduates should be able to develop decision making skills and display clinical reasoning based on medical evidence and humane judgment as basis for their actions.
Basic Training
Learning Objectives
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Perform comprehensive history taking, physical examination and investigations and give due consideration of personal factors of the CYP
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Devise a safe management plan of common paediatric problems at hospital and community settings based on knowledge and sound clinical reasoning
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Refine differential diagnosis and tailor management plans in response to the patient’s needs and clinical progress
Key Capabilities
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Recognize emergency and serious situations of physical and mental health in CYP and intervene appropriately
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Apply local and international guidelines in the management of common paediatric problems
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Adapt the best evidence-based clinical practice for paediatric problems if guideline is lacking
Illustrations
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Demonstrate the accurate formulation of problems, recognizing the breadth of different presentations of disorders.
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Present and discuss patient management in a team to demonstrate understanding of the patient’s situation
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Interpret common laboratory and radiological findings and explain them to the parents.
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Diagnose and manage the common important causes of mortality and morbidity in CYP, for instance, common airway and respiratory emergencies, shock, status epilepticus and cardiac arrhythmias.
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Recognize maltreatment of children
Higher Training
Learning Objectives
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Recognize, investigate, initiate and continue the management of a wider range of acute and chronic conditions in the outpatient setting when possible
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Consider a wider range of treatment and management options available, including new therapies, relevant to paediatrics and their chosen subspecialties
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Anticipate and determine the need for transition of patient to other specialties or treatment settings, including the transition to adult care, and plan accordingly
Key Capabilities
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Collaborate with other clinicians, specialists, allied health professionals and health-related agencies in patient management in a multidisciplinary setting
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Plan the return of patients with medical complexities to community and home care
Illustrations
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Explain and discuss with patients and families for the process of transition to adult care. Collaborate with adult physicians and concerned health discipline to facilitate the transition.
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Recognize rare but important emergency conditions in various subspecialties, especially in the subspecialty of the trainee’s choice.
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Explain the rationale to consider escalation of treatment to the family when the need arises
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Work with nurses and other professionals in the arrangement of home care of chronic patients.