1)To describe the organization of primary healthcare in Portugal.
2)To describe the characteristics of family medicine.
3)To describe which are the most common problem-solving strategies used in primary healthcare.
4)To translate the concepts of primary, secondary, tertiary and quaternary prevention into clinical practice.
5)To describe the characteristics of healthcare to different population groups. This includes family planning, pregnancy, child and juvenile care, and elderly care.
6)To demonstrate how to diagnose symptoms that are commonly presented in primary healthcare.
7)To describe which are the treatment options and referral criteria for common health problems found in primary healthcare.
1)To communicate with patient under supervision.
2)To communicate with healthcare professionals under supervision.
3)To autonomously perform simple medical procedures.
Prof. Doutor Bruno Heleno
Weekly - Available soon
Total - Available soon
There are four main references:
1)Murtagh J, Rosenblatt J. Murtaghs General Practice. 6.ª Edição. North Ryde. McGraw-Hill Education. 2015.
2)UpToDate, Post TW (Ed), UpToDate, Waltham, MA.
3)Freeman TR, editor. McWhinneys Textbook of Family Medicine.4 edition. Oxford; New York: Oxford University Press; 2016.
4)Family practice formulary.
This curricular unit spans through 5 weeks. In the first week, students will have 6 seminars and 2 non-clinical practical classes. From the second to the fourth weeks, students will have clinical practice in a primary care practice. They will need to attend a minimum of 60h clinical experience with their tutors. During this component of the curricular unit, students will need to fill in consultation observation worksheets, which common health problems in family medicine. In the fourth week there are two non-clinical practical classes. In the fifth week, students will have 6 seminars and 1 non-clinical practical class. The detailed schedule of the is described in the annex.
Seminars will be offered to groups of approximately 20 students and they may have one or more teachers. The two main teaching methods are mentoring/ supervision and flipped learning. Teachers mentor the students by providing a detailed reference list or other educational resources (for example, texts, consultation worksheets and videos) for each item in the syllabus. In flipped learning, we encourage students to acquire the theoretical knowledge before the class, at their own pace. This allows students to use the seminars to practice clinical reasoning and knowledge application. In the seminars, teachers will supervise the students clinical reasoning.
Non-clinical practical classes will be offered to groups of approximately 20 students and they may have one or more teachers. Students will be able to train, in a safe environment, consultation techniques, lifestyle counselling, and simple clinical procedures. Teachers will mentor and supervise students while they practice these techniques.
Clinical practice in a primary care practice will be offered in a maximum ration of 1 tutor for each 3 students. The main teaching methods are workplace based learning and mentoring and supervision. During workplace based learning there is a process of legitimate peripheral participation where students start from observing their tutors practice, to performing simple procedures or to communicate with patients for specific parts of the consultation. In their workplace, students will see all components of the syllabus being applied to the care that is provided to primary care patients. Their tutors will function as role-models, which will allow students to acquire communication skills and procedural techniques. During this period, students will also have the opportunity of performing some procedures under the mentorship and supervision of their tutors.
There will be no lectures.
Teaching will be in Portuguese. Study material may be in Portuguese or English.
Approval at the curricular unit has three requirements:
1.Proof that students acquired the topics from seminars and non-clinical practical classes. This will consist of an oral examination marked as approved / not approved. Oral examination will be waived if students attend at least 11 of the 17 seminars and non-clinical practical classes.
2.Proof that students acquired the topics from clinical classes. This assessment depends on attending at least 40h/60h of the clinical rotation and having positive assessment of medical professionalism. There is no supplemental regime for students who do not attend the minimal number of clinical practical classes.
3.Written test with at least 50% correct answers.
The final assessment will have four components:
1 - Individual written test, marked for 12 points, and composed of 60 questions (multiple choice questions, short answer questions, true/false, and matching blocks).
3 8 worksheets (5 points in total). These worksheets are individual assignments. If different students present a worksheet about the same patient, they will be marked with 0 points.
4 Assessment of medical professionalism by the clinical tutor, with input from the teaching staff of the curricular unit (3 points).
The written test may include questions about any of the syllabus topics. In other words, the written test will include content that will not be covered in the group work classes or during clinical case discussions.
Procedures for grade reassessment or grade improvement are described in the annex. The assessment from non-clinical practical classes, worksheets and professionalism is valid until the end of the school year.
1)Organization of primary healthcare in Portugal:
a)The role of different healthcare professionals in primary healthcare.
b)Quality improvement plans in healthcare.
2)Main features of the discipline of family medicine:
a)What distinguishes this discipline from other specialities
b)Continuity of care
c)Cumulative knowledge about the patients
d)The role of generalist
e)Reasons for encounters and their determinants.
3)Principles of clinical reasoning in primary healthcare:
a)Clinical reasoning in family medicine
b)The impact of somatic, psychological and social factors in health and disease
c)Family function and dysfunction
d)The family life-cycle phases and their role in clinical practice
e)The interpretation of the results of studies about treatment and prevention
4)Primary, secondary, tertiary and quaternary prevention
5)Strategies of prevention in family medicine:
c)Children and young people
6)Common symptoms in family medicine, including:
i)Low back pain
k)Unintentional weight loss
n)Cough, nasal discharge, upper respiratory tract symptoms
7)Common health problems in primary healthcare:
a)Headache (tension headache and migraine)
c)Common chronic respiratory diseases (asthma and COPD)
v)Upper respiratory tract infections (tonsillitis, common cold, influenza, acute sinusitis, acute otitis media)
vi)Lower respiratory tract infections (acute bronchitis, community-acquired pneumonia)
vii)Urinary tract infections (cystitis and pyelonephritis)
viii)STI: Trychomonas, Chlamydia, gonorrhoea
ix)Vulvovaginal candidiasis and vaginosis
e)Mental health problems (depression, anxiety and somatoform disorders)
f)Lifestyle-related health problems (smoking, alcohol abuse, sedentary lifestyle, overweight and obesity)
g)Degenerative musculoskeletal conditions (lumbar sprain, neck sprain, knee osteoarthritis, rotator cuff injury)
h)Cardiovascular risk (hypertension, dyslipidemia)
1)Supervised communication with patients:
a)How to identify the expectations of people that come to a medical consultation
b)How to apply strategies that foster a person-centred approach
c)How to promote behaviours that lead to healthy lifestyles, considering the preferences of the person or patient
2)Supervised communication with health professionals:
a)How to keep appropriate medical records in family medicine
b)How to write referral letters
a)Assessment of the feet of people with diabetes
b)Teaching patients and their relatives on how to use insulin pens
Programs where the course is taught: