General and Family Medicine (Clinical Practice)
To practice a person-centered approach
o Collect a comprehensive clinical history
o Incorporate psychosocial, cultural, and familial data into the patient´s follow-up plan
o Correctly identify patients problems
o Communicate effectively with patients using the patient-centered clinical method
Identify and manage the most common health problems in the community
o Use probabilistic estimation in diagnostic reasoning
o Use adequate strategies to explore differential diagnosis
o Use the time as a diagnostic resource
o Perform directed clinical examinations
o Be familiar with the indications for the most frequent diagnostic tests and know how to interpret them
Recognize the role of the family physician in healthcare coordination
o Identify health resources available in the community
o Coordinate care provided by different healthcare workers
Make therapeutic decisions that consider the limitations of clinical data and cost-benefit relationships
o Appropriately prescribe the most commonly used drugs
o Know how to define criteria to select the most appropriate treatment for each person
Identify health risks in certain patients and families and perform the adequate preventive health measures
o Identify groups of vulnerable people and risk factors for the most common health conditions
o Know familial patterns of disease transmission, both through genes and behaviors
o Know how to apply prevention and risk minimization measures
Use scientific evidence in primary, secondary, tertiary and quaternary prevention
o Know the principles of evidence-based medicine
o Identify resources for continuous medical education
o Distinguish the different kinds of prevention and know when they apply
Demonstrate adequate professional behavior
o Know the Medical Association deontological statute
o Apply the fundamental principles of medical ethics in clinical practice
Prof.ª Doutor Daniel Pinto
Weekly - Available soon
Total - Available soon
Freeman T, McWhinney IR. McWhinneys textbook of family medicine. 4th edition. Oxford; New York: Oxford University Press; 2016. 520 p. Capítulos 1 a 10. [Exemplares disponíveis na biblioteca]
Murtagh J, Rosenblatt J, Coleman J, Murtagh C. John Murtaghs general practice. 7th ed. McGraw-Hill Education; 2018.
World Health Organization, Reproductive Health and Research, K4Health. Family planning: a global handbook for providers: evidence-based guidance developed through worldwide collaboration. Geneva; Baltimore: WHO, Department of Reproductive Health and Research; John Hopkins Bloomberg School of Public Health, Center for Communication programs, Knowledge for Health Project; 2018. [https://tinyurl.com/y2thmmum]
World Organization of Family Doctors (WONCA). European definition of general practice family medicine. 3rd ed. WONCA Europe. 2011. [https://tinyurl.com/y3sr6uzw]
Ordem dos Médicos. Regulamento n.º 707/2016 - Regulamento de Deontologia Médica - Diário da República n.º 139/2016, II Série de 2016-07-21.
Artigos em revistas científicas
Ramos V. A consulta em 7 passos. Execução e análise crítica de consultas em Medicina Geral e Familiar. Rev Port Clin Geral. 2009;25:208-20.
Barreto JV, Paiva, P. O registo clínico orientado por problemas. Revista Medicina Interna. 2008; 15(3):201-6.
Pinto D. O que classificar nos registos clínicos com a Classificação Internacional de Cuidados Primários? Rev Port Med Geral Fam;30:328-34.
Alberta College of Family Physicians - Tools for Practice [https://gomainpro.ca/tools-for-practice/]
Canadian Task Force on Preventive Health Care [https://canadiantaskforce.ca]
Choosing Wisely Portugal [https://ordemdosmedicos.pt/choosing-wisely-portugal-escolhas-criteriosas-em-saude/]
Cochrane Library [https://www.cochranelibrary.com]
Comissão de Farmácia e Terapêutica da Administração Regional de Saúde de Lisboa e Vale do Tejo Boletins Terapêuticos [https://www.arslvt.min-saude.pt/pages/67]
Direcção-Geral da Saúde [http://www.dgs.pt]
Dynamed (acesso disponibilizado pela ARSLVT peça as credenciais ao seu tutor)
Infarmed Infomed [https://extranet.infarmed.pt/INFOMED-fo/]
Infarmed Prontuário Terapêutico [https://app10.infarmed.pt/prontuario/index.php]
National Institute for Health and Care Excellence [https://www.nice.org.uk/]
semFYC Programa de actividades preventivas y de promoción de la salud [https://papps.es/]
Therapeutics Initiative - Therapeutics Letter [https://www.ti.ubc.ca/therapeutics-letter/]
U.S. Preventive Services Task Force [https://www.uspreventiveservicestaskforce.org/uspstf/]
Podcasts (procure na sua aplicação de podcasts preferida | search in your favorite podcasts app)
o American Family Physician
o Best Science Medicine
o Evidentia Médica
o POEM of the Week Podcast
o TT Healthwatch
The teaching methodology is a supervised clerkship. Students will learn by doing. Most of the work will be clinical, participating in the care of ill and healthy patients in the placement health units. Students must master the Portuguese language, both spoken and written. Throughout the clerkship students will need to document their learning, recording their experiences. These records will allow for self-assessment and they will support assessment by the teaching staff.
There will be a daily dialogue between the student and the clinical instructor: discussing patient cases, questions that may arise during patient observation, tutorials and feedback. Students will write a pre-formatted portfolio called DSP. During the clerkship, students will participate in the different types of patient encounters and in other previously identified activities, and they are subject to continuously assessed regarding their professional attitudes and performance.
External validation of attainment of the learning objectives is done in a seminar to take place in the final week of the clerkship, where students present their analysis of a clinical decision and a clinical case and discuss them with teaching staff.
Before they begin their clerkship, students will download from Moodle the necessary documents: the attendance record sheet, DSP and DSP filling instructions.
To be graded, students must be present in at least 2/3 of the days assigned to the clerkship. Students with absences over 1/3 of the clerkship for legally justified reasons should request Divisão Académica to analyse their case according to general rules defined by NMS. At the end of the clerkship, it is the students responsibility to send the attendance record sheet, properly validated by his/her clinical instructor, to the curricular units secretariat.
The final grade results from averaging two components: the clinical instructors evaluation about performance during the clerkship and the discussion during the seminar with two members of the teaching staff. The clinical instructors assessment is based on the daily contact with the student and his/her appreciation of the DSP. The seminar assessment is based upon the previous evaluation of the clinical decision and clinical case submitted by the student, the presentation and the discussion during the seminar. In both cases, grading uses a 0 to 20 scale. To be approved in the clerkship, a positive grade in both components is required. Students obtaining a final grade less than 10 may request to perform an additional oral evaluation to discuss their DSP, which will determine a new final grade where all available evaluation elements will be considered.
The clinical decision analysis and clinical case report should be sent to the teaching staff responsible for the seminar, the curricular units secretariat, the other participating students in the same group and the clinical instructor by 5:00 p.m. on the last working day of the third week of the clerkship. The seminary takes place during the fourth week. The DSP should be written throughout the clerkship (as per the filling instructions) and shared with the clinical instructor. The final version of the DSP should be sent to the clinical instructor and the curricular units secretariat by 5:00 p.m. of the clerkships antepenultimate working day.
The detailed instructions for sending the documents are detailed in their respective filling instructions.
Not meeting any of the deadlines defined in the previous paragraphs will result in a penalty of one point in the final classification for each hour of delay up to a maximum of six points. Not sending the clinical decision analysis and / or the clinical case up to 48 hours before the seminar or not sending the DSP up to 24 hours before the end of the clerkship prevents the evaluation from taking place, resulting in failure. Not participating in the totality of the seminar of the respective group results in a penalty of one point in the final classification.
Given that the evaluation is based on performance during the clerkship and on presenting the seminar, no test revision or grade improvement is possible. If students believe there are valid reasons to consider their classification incorrect, they can request its grounds to the clerkship Coordinator through the secretariat. They can then submit a substantiated request for revision.
Due to the uncertainties generated by the COVID-19 pandemic situation, there could be the need, during the school year, to change the planed teaching methodology. For instance, due to changing of the recommendations issued by the Faculty, the University or even by the Government. If that happens, the necessary changes will be made, in accordance with the imposed limitations (which cannot be anticipated). Those adaptations may include a mixed model with distance learning, tasks to be done by the students at home, seminars, internet courses, written assignments, and other similar activities. In those circumstances, a revised version of this section of the curricular units program will be published.
During the four weeks of clerkship, students will practice:
The doctor-patient relationship
Collecting patient history (anamnesis)
Using time as a diagnostic resource
Prioritizing health problems
Planning patient care
Coordinating patient care
Making clinical records
Getting familiar with the electronic health record systems in use in the National Health Service
Programs where the course is taught: