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Unit Code: IMD900

Unit Name: Internal Medicine IV

Description: IMD900 is the final year of the Masters 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 first two years of the formal Masters of Medicine Internal Medicine (IMD820 and 830) to enable the candidate to function as a trainee specialist. This course is offered to be flexible such that candidates can be apprentices to specialists either in Fiji, or in their home countries where a suitable supervisor is available, or in an overseas location approved by FNU. Embedded within the final year is a research project MED812 which the candidate must successfully complete to pass IMD900. 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.

Learning Target Outcomes: On successful completion of this course, the students will be able to: 1. Evaluate and manage the complex acute and chronic adult medical problems within their own jurisdiction competently and confidently. 2. Support and provide counselling to patients, families and carers about the illness using effective verbal and nonverbal communication. 3. Role-model professional conduct, compassion, and cultural sensitivity in daily practice. 4. Demonstrate safe and ethical practice. 5. Facilitate and support on-going learning and professional development by encouraging continuing medical education (CME) and by imparting adult medical knowledge to fellow workers including other doctors, medical students, nurses, health educators and also to the general public in activities such as community education at level 5 clinical supervision. 6. Construct their own network of support/resource people for consultations and know when to use them. 7. Organize, manage, implement and evaluate the adult health programmes within their own countries. 8. Collaborate with policy makers on the varied issues pertaining to adult health. 9. Demonstrate level B (unassisted) competence in performing the following procedures: colonoscopy, rapid sequence intubation, diagnostic colonoscopy, pericardiocentesis, exercise stress test; and level A (assisted) competence in femoral line insertion, intrajugular catheterization, ventilator set-up, central venous (CV) line insertion, Focused Assessment with Sonography for Trauma (FAST) abdominal scan.

Prerequisite: IMD830 & MED811

Prerequisite Sentence: N/A

Credit Point: 120

Offered In: Semester 1,2