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Paediatrics

Core syllabus for child health in general practice

Theme 1: Birth to eight weeks

Postnatal depression
Surveillance
Immunisation
Normal growth and development
Breastfeeding and nutrition
Teaching parenting skills, especially to young and first-time parents

Theme 2: Children at risk

Prevention of accidents
Recognising children at risk
Clinical features of child abuse and local arrangements for child protection
Assessment of needs, including the assessment framework
Local pathways of care
Recognising the needs of children with disabilities

Theme 3: Milestones and transitions

Normal development and growth
Problems with transitions from child to adolescent, and from adolescent to adult for
all children, but especially the vulnerable
Recognising and dealing with faltering growth

Theme 4: Behavioural problems and management

Enuresis, sleep disturbance, bullying, school refusal
Autistic spectrum disorder

Theme 5: Communication and teamwork

With parents
With children
With other healthcare professionals

Theme 6: Organising and assuring evidence-based care

The political context
Organisation of care and access to evidence-based interventions
Care pathways and local systems of care
Clinical governance and risk management

From: Child health: a core curriculum for general practice
 

Objectives of the Training of General Practitioners in Paediatrics

From a report of a Joint Working Party of the British Paediatric Association and the Royal College of General Practitioners

The Training of General Practitioners - Objectives

The working party set out, as its first task, to decide what knowledge, skills, and attitudes should belong to the doctor as he/she finishes his/her three year postgraduate training and starts as a principal in a general practice. It divides the educational aims into the five headings in The Future General Practitioner - Learning and Teaching generally accepted as suitable in any consideration of the content of training for this branch of the profession. However, for children, it seemed appropriate to make one change in the usual order:

1. Human development
2. Health and diseases
3. Human behaviour
4. Medicine and society
5. Practice organisation

1. Human Development

At the completion of this training the doctor should be able to demonstrate that:

(a)   he/she has knowledge of the important norms of physical, intellectual, emotional, and social development at different ages;

(b)   he/she can carry out the basic methods of assessment of these modes of development from birth up to, and including adolescence;

(c)   he/she can recognise common deviations from the normal;

(d)   he/she understands the role of the health visitor in developmental assessment;

(e)   he/she can recognise when there is a need for referral for more elaborate or specialised assessment.

2. Health and Diseases

1. Health

At the completion of his/her training the doctor should be able:

(a)   through his/her knowledge of the norms of development, physical, intellectual, emotional and social, to describe what characterises health in children;

(b)   to describe the needs of children at different ages and the factors, whether hereditary or environmental, which favour their health and happiness;

(c)   to demonstrate that he/she recognises the value of health education, whether about parenthood in general, or about feeding and physical care of children; and the value of disease education i.e. the prevention of certain diseases, the recognition and home management of common disorders and the use of health and social services.

2. Diseases

He/she should be able always to recognise and in many instances to treat the following conditions:

(c)   Acute conditions threatening life

·        In the newborn: infections, surgical conditions, some life-threatening congenital abnormalities, hypoglycaemia, and hypothermia

·        In infants: acute respiratory disorders, gastrointestinal infections, meningitis

·        In older children: asthma, the "acute abdomen", accidents (including self-poisoning)

·        In adolescents: suicidal behaviour

(b)   Conditions which, if not recognised early, can lead to disability or premature death:

·        In the newborn: infections, jaundice, congenital malformations not immediately apparent, renal conditions, metabolic errors. The recognition of prematurity and dysmaturity.

·        In infants and older children: malignant disease, respiratory infections with complications, epilepsy, abnormal relations in a family, including battering.

(c)   Common conditions

·        In the newborn: minor disorders e.g. birth marks, feeding problems.

·        In older children: minor injuries, epilepsy, migraine, behaviour and sleep problems, enuresis and faecal incontinence.

·        In adolescents: behaviour hypochondriasis, depression. problems,

(d)   Handicaps and their supervision

Asthma, congenital handicaps, including heart disease, diabetes, haemophilia, epilepsy, cerebral palsy, mental handicap, social disadvantage.

In relation to all these conditions listed in Diseases above, he/she should be able to demonstrate that the he has been concerned with some aspects in particular:

·        early diagnosis;

·        prevention, where possible;

·        management at home;

·        psychological and social aspects, where   important;

·        the sick child's individuality;

·        the indications for referral to a consultant or a social agency;

·        education of parents about common disorders and about the use of health services;

·        children who are specially vulnerable.

3. Human Behaviour

At the end of his/her training the doctor should be able to demonstrate his/her understanding:

(a)   of the ways in which the doctor's behaviour towards a child and/or his/her parents can influence the success or failure of a consultation and the solution of a problem;

(b)   of the ways in which the behaviour of a child, acutely or chronically ill, can influence the behaviour of the rest of the family;

(c)   of the ways in which the behaviour of the family, particularly the parents, can influence the health, happiness and social behaviour of a child (and the behaviour of a child that of his parents);

(d)   of the ways in which family relationships and attitudes, healthy and unhealthy, towards children may persist from one generation to another;

(e)   of the potential importance of the "milestones" or "normal crises" in a child's life (weaning, habit training, separation from mother, starting school, puberty, falling in love and early sexual experiences, as causes of persisting difficulty and indicators of family stress).

4. Medicine and Society

At the end of his/her training the doctor should be able to demonstrate that:

(a)   he/she understands the influence of culture and class on the incidence, presentation, and management of different illnesses;

(b)   he/she is aware of the prevalence of the different types of children's illnesses in his practice population;

(c)   he/she is aware of the contribution of epidemiology to understanding the causes of some disorders of children';

(d)   he/she understands the roles of health visitors, social workers, and other helping agencies in the care of children, whether well or ill;

(e)   he/she is aware of what is known about the incidence, cause and prevention of socio­medical problems such as smoking, alcoholism, drug addiction, pregnancy in girls still at school, and juvenile crime;

(f)     he/she understands the medical aspects of adoption.

5. Practice Organisation

At the end of his/her training the doctor should be able to:

(a)   demonstrate his/her knowledge of the organisation of paediatric services in this country and compare them with contrasting systems in other countries;

(b)   describe how practice organisation must meet the special challenges of sick children - the need for easy contact, quick appointments, and satisfactory emergency cover; the need for time for dealing with parental anxiety, for communicating with health visitors and social workers, for home visits; the need for suitable accommodation and equipment in the practice building;

(c)   describe the organisation of a well-baby clinic (screening, records, immunisation).

West Midlands

Consultation skills. 

Diagnosis and management 

a) Acute life threatening conditions

b) Other serious conditions

Common childhood conditions 

Miscellaneous 

Source: D Rapley Surviving GP Training (Download Word version)

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