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

  1. Perform comprehensive history taking, physical examination and investigations and give due consideration of personal factors of the CYP

  2.  Devise a safe management plan of common paediatric problems at hospital and community settings based on knowledge and sound clinical reasoning

  3.  Refine differential diagnosis and tailor management plans in response to the patient’s needs and clinical progress

Key Capabilities

  1. Recognize emergency and serious situations in CYP and intervene appropriately

  2.  Apply local and international guidelines in the management of common paediatric problems

  3.  Adapt the best evidence-based clinical practice for paediatric problems if guideline is lacking

Illustrations

  1. Demonstrate the accurate formulation of problems, recognizing the breadth of different presentations of disorders.

  2. Present and discuss patient management in a team to demonstrate understanding of the patient’s situation

  3. Interpret common laboratory and radiological findings and explain them to the parents.

  4. 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.

  5. Recognize maltreatment of children

Higher Training

Learning Objectives

  1. Recognize, investigate, initiate and continue the management of a wider range of acute and chronic conditions in the outpatient setting when possible

  2.  Consider a wider range of treatment and management options available, including new therapies, relevant to paediatrics and their chosen subspecialties

  3.  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

  1. Collaborate with other clinicians, specialists, allied health professionals and health-related agencies in patient management in a multidisciplinary setting

  2.  Plan the return of patients with medical complexities to community and home care

Illustrations

  1. 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. 

  2. Recognize rare but important emergency conditions in various subspecialties, especially in the subspecialty of the trainee’s choice.

  3. Explain the rationale to consider escalation of treatment to the family when the need arises

  4. Work with nurses and other professionals in the arrangement of home care of chronic patients.