Australia competency
based
Domains of General Practice
The five domains of General Practice are set out below. They represent the
areas of knowledge, skills and attributes necessary for competent unsupervised
General Practice. They are relevant to every patient consultation.
All teaching and learning in the Training Program is based on these domains:
-
Communication Skills and the Patient-Doctor Relationship
- Applied Professional
Knowledge and Skills
-
Professional Health and the Context of General Practice
- Professional and Ethical Role
- Organisational and Legal
Dimensions
Good communication skills are fundamental to
good General Practice. They enable General Practitioners to develop a meaningful
and understanding relationship with their patients so as to understand both the
illness and the patient's experiences of that illness. They also allow the
registrar to move freely between clinical problem-solving and patient experience
of the problem, as well as to educate and involve patients in their own health
care.
Registrars who are competent in this domain will
demonstrate:
 |
a critical appreciation
of the nature of the relationship between patient and doctor, and its
therapeutic potential; |
|
an understanding of
different consultation models; |
|
a patient-centred
approach; |
|
the communication skills
and attributes needed to foster effective whole-person care; |
|
the skills to undertake
effective individualistic and opportunistic health education and promotion;
and |
|
the skills required to
involve patients in their own health care. |
The application of professional knowledge and
skills requires a comprehensive, patient-centred approach. This applies not only
to health and disease, but also to the individual’s experience of illness in
terms of their culture, their family, and their community. This approach
includes analysis of the appropriateness and costeffectiveness of all clinical
interactions.
Registrars who are competent in this domain will
demonstrate:
|
a knowledge of significant medical conditions
and approaches to undifferentiated problems; |
|
skills in information gathering, physical
examination, undertaking procedures, and clinical decision-making; |
|
a critical appreciation of the need for
continuity and integration of care, cost-effective investigations, and
rational prescribing; and |
|
the need to continually undertake critical
self-appraisal. |
Population health, in the context of General
Practice, is an essential component of primary health care. The General
Practitioner has an evolving role, with the potential to influence change at the
individual patient, practice, and community levels within the health care
system. This requires knowledge of the socio-political, economic, geographical,
cultural, and family influences on the health of patient groups in their
communities.
Registrars who are competent in this domain
will:
|
have an understanding of demographics,
epidemiology, public health problems, and the health needs of special groups;
|
|
be aware of the patterns and prevalence of
disease, and be able to participate in population-based preventative
strategies; |
|
have a critical appreciation of the impact of
the health of the patient and their socio-political, economic, work,
spiritual, and cultural background and needs, and their relationships with |
|
family and significant others; |
|
possess skills in advocacy and in using
community resources; and |
|
appreciate the importance of a public health
perspective in General Practice. |
The General Practitioner’s professional and
ethical role relates to their behaviour with respect to patients, colleagues,
and the community. Professional ethics are based on belief systems of the
profession and the community.
There are three major components to this domain:
-
A special duty of care arises when a
patient-doctor relationship is established and the patient’s needs involve the
risk of injury.
Doctors have a duty of care to exercise due care and skill to avoid any such
injury, and will become legally liable for the consequences of their own
negligence.
-
Reflective skills and self-appraisal.
-
Maintenance of professional standards implies
that all doctors have an obligation to keep abreast of, and be informed about,
technical advances, new techniques, and new therapies appropriate to their
field of medicine (or in which they profess to have special skills).†
Registrars who are competent in this domain
will:
|
exercise a special duty of care at all times; |
|
strive to maintain professional standards of
practice according to contemporary ethical principles; |
|
have skills in reflection and professional
self-appraisal, and be committed to lifelong learning and continuous
professional improvement; |
|
have the skills to fulfil their role as
teacher, leader and change agent; |
|
have an understanding of research, evaluation
and audit skills; and |
|
develop professional networks and maintain the
well-being of themselves and their families. |
The organisational and legal dimensions of
General Practice requires that each practice be considered as an entity that
delivers a clinical service to patients in its practice population and the
community. There are a wide variety of practice types, with common essential
components. There are legal obligations that must be observed from both the
business and service perspective.
Registrars who are competent in this domain
will:
|
ensure adequate arrangements are made for the
availability and accessibility of care; |
|
ensure safety netting, screening, and recall
systems are in place; |
|
have a critical appreciation of patient and
practice information technology and management requirements, medical records,
legal responsibilities, reporting, certification, and confidentiality
requirements; and |
|
understand effective practice management
principles and processes. |
Curriculum
statements
Against these domains, the curriculum document
defines a number of curriculum statements,
which are:
|
Aboriginal health |
|
Acute serious conditions and traumatic
conditions |
|
Aged care |
|
Children and young people’s health |
|
Chronic conditions |
|
Conceptual basis of General Practice |
|
Critical thinking and research |
|
Ethnic health |
|
Men’s health |
|
Mental health |
|
Practice management |
|
Women’s health |
Additional sections within the curriculum define
teaching, learning, and resources (and how to find them), as well as feedback,
assessment, and examination.
 |
