Unit Code: IMD830

Unit Name: Internal Medicine III

Description: IMD830 is the second year of the Master of Medicine in Internal Medicine programme developed to address the need for Specialist Physicians (internists) in the Pacific. It utilises the prior knowledge and skills attained during the study of the postgraduate Diploma in Internal Medicine (IMD801) and the completed years of the formal Master of Medicine Internal Medicine (IMD 820) to enable the candidate to function as a trainee specialist. There are 5 levels of clinical supervision to help facilitate a conversation between the supervisor and the trainee needs when performing a task. And the level of supervision depends on the level of training. Below is from the Royal Australasian College of Physicians’ curriculum for physician training. Level 1: Be present and observe Trainee to be present and observe what is expected of him/her at the next stage. Level 2: Act with direct supervision The trainee may carry out the full activity by himself/herself. The supervisor is in the room watching and can intervene or take over at any time deemed necessary. Also known as “proactive supervision\" or “ routine oversight” Level 3: Act with indirect supervision: The trainee may carry out full activity by himself /herself with a supervisor not present in the room but available within minutes. Also called” reactive supervision” or “responsive oversight. This includes the availability of supervision by telephone for advice. For example, a medical registrar sees a patient in special outpatient clinics with the consultant in another but nearby room for advice. Level 4: Act with supervision at a distance At this stage the learner may carry out the full activity by himself or herself with no supervisor available on short notice. The trainee reports post hoc the same or next day. This stage gradually extends into fully mature and unsupervised practice, but as long as he or she is in training, the learner acts under ‘clinical oversight’ or ‘backstage supervision’. This stage marks the degree of trust that would allow the learner to be entrusted with an activity e.g. When PG trainees go on-call, there is also an on-call consultant (either FNU staff or adjunct staff) with them as well. Level 5: Provide supervision This level is awarded when a senior trainee may act in a supervisory role for more junior trainees. Academic component: Teaching and learning within the IMD830 course is conducted both through formal structured tutorial sessions and through supervised clinical interactions as part of the performance of the candidate\'s practical duties as a medical registrar. The structured teaching is delivered in the form of a series of ten modules, each of three or four weeks\' duration. The learning modules run for about ten months. The first month of the Course is largely introductory and is used for familiarization with the School and the hospital system, learning standard protocols for management of various diseases and also for a compressed course on Emergency medicine that will prepare the MMED (IMD) for clinical work. The last month of the Course is used for revision and examinations. Full participation in and completion of all ten modules is compulsory, but in special circumstances (e.g. illness) at least eight of the modules must be completed to fulfil the course requirements. Each module will focus on one of the following medical subspecialties: · Endocrinology · Rheumatology · Renal Medicine · Haematology and Oncology · Clinical Pharmacology · Infectious Diseases · Gastroenterology · Respiratory Medicine · Neurology · Cardiology The details of the modules are outlined below, however these may vary slightly depending for example on the availability of visiting specialists who will be invited to present seminars and hold interactive discussions with candidates. The full curriculum for these modules for the complete MMED programme is further outlined in the IMD820 and this IMD830 course outlines. The modules are conducted in small group tutorials presented in various formats including didactic sessions, case discussions and Medical Knowledge Self Assessment Programme (MKSAP) questions. Where required, these may be conducted via teleconference. Appropriate resource material will be provided prior to the start of each module. In addition, each candidate is expected to undertake self-directed learning to expand their knowledge about the topics covered in the modules, and the clinical cases attended in their clinical work, by selecting additional information from textbooks, journals and on-line resources. For each module candidates will be expected to complete one written assignment based around a case relevant to that module\'s anticipated learning outcomes.

Learning Target Outcomes: On successful completion of this course, the students will be able to: 1. Synthesise and appropriately rank provisional diagnoses/problem list by integrating information obtained from comprehensive history and thorough examination of highly complex medical conditions accounting for interactions and impacts of comorbid conditions in inpatient, outpatient and emergency care setting. 2. Prioritize, organize and interpret investigations of highly complex medical conditions. 3. Formulate comprehensive acute and long -term management plans of highly complex medical conditions incorporating sound prescribing practices in collaboration with patient, families or carers and the attending medical team. 4. Assess and manage the acutely and critically unwell highly complex medical patients at a level 4 clinical supervision. 5. Practice effective verbal, non-verbal and written communication skills when dealing with patients, families, carers, colleagues and other health professionals. 6. Write summaries of patient care, comprehensive medical reports and correspondences to coordinate patient care. 7. Demonstrate level B (unassisted) competence in performing the following procedural skills: diagnostic gastroscopy, echocardiography, cardioversion, intra-articular injections, and Level A (assisted) competence in flexible sigmoidoscopy, Treadmill exercise test, pacemaker insertion, coronary angiogram, pericardiocentesis. 8. Demonstrate safe and ethical practice. 9. Show professional conduct, compassion, and cultural sensitivity in daily practice. 10. Integrate evidence based medicine in own practice. 11. Demonstrate critical thinking and the ability to be a life- long learner. 12. Evaluate one’s own practice with the intent of professional development and enhancing health care delivery.

Prerequisite: IMD820

Prerequisite Sentence: N/A

Credit Point: 120

Offered In: Semester 1,2