L3 course program

L3 - Residential Course Program

Day 1 (Monday, First Week)

A/Primary health care

  • 1.Scientific and cultural foundations (Wonca)
  • 2.Definition of General Medicine (GM)
  • 3.Italian and English National Health Systems
  • 4.Concepts of Health and Primary Care

B/The general practitioner (GP)

  • 1.Motivation to undertake this professional activity
  • 2.GP – patient relationship
  • 3.Therapeutic alliance / negotiation / conflictuality
  • 4.Bio-psycho-social approach to the person, oriented by problems
  • 5.The employment relation of the General Practitioner in Italy
  • 6.Constraints of health / economic laws

C/The working model

  • 1.Continuity / extensiveness of care
  • 2.Outpatient / Home Care
  • 3.The System of Residential and Primary Health Care
  • 4.The organization of the Clinic of GM
      1. Technological / telematic equipment
        The Staff (Secretary / Nurse)
        Instrumental equipment
  • 5.The organization of the work of GP
      1. Association Medicine / Network / Group
        The Territorial Team of the GM
        The Community / Hospice Hospitals
  • 6.Relations with Specialist Care
      1. Relations with the hospital
        Communication (Reference and against reference)

Day 2 (Tuesday, First Week)

A/Professional aspects

  • 1.To know the population to be assisted by including ethnic, cultural, religious and value diversity. Establish an alliance.
  • 2.To know the resources of the Regional Health System (availability for the treatment path) and the organization and resources of the Health District
  • 3.To know Risk Factors (Absolute and Relative / Local)

B/Scientific Aspects

  • 1.Epidemiology of the population (prevalence / incidence, etc.)
  • 2.Importance of practices (low / high utility)
  • 3.Primary prevention / secondary prevention (NNT, NNH etc.)
  • 4.Screenings and concept of appropriateness / efficiency / effectiveness in GM
  • 5.The Clinical Method in GM
  • 6.Essential drugs / unnecessary drugs
  • 6.Practical exercise on organization of the GP's clinic

Day 3 (Wednesday, First Week)

A/Cardio Vascular diseases in GM

  • 1.Epidemiology: incidence, prevalence, mortality; health costs and social costs
  • 2.Risk factors and cardio vascular events
  • 3.Primary prevention and secondary prevention
  • 4.Practical exercise: ABI index measurement

B/Respiratory diseases in GM.

  • Epidemiology of asthma, chronic obstructive bronchopathy and chronic respiratory insufficiency
  • 2.Practical Guidelines for diagnosis, therapy and clinical and instrumental follow-up
  • 3.Practical exercises: Spirometry in GM

Day 4 (Thusday, First Week)

A/Metabolic diseases

  • 1.Epidemiology, diagnosis, therapy and management of diabetes mellitus
  • 2.Prevention and treatment of complications of Diabetes Mellitus
  • 3.Other metabolic diseases
  • 4.Practical exercise: organize an advanced clinic for the DM

B/Environmental health and infectious diseases in General Medicine

  • 1.Epidemiology of adult infectious diseases
  • 2.Hygienic-Environmental Prophylaxis
  • 3.The Vaccinal strategy
  • 4.Vaccinations that can be performed in the GP’clinic
  • 5.Appropriate use of antibiotics in GM
  • 6.Exercise: antibiograms and antibiotic therapy prescription

Day 5 (Friday, First Week)

A/Pediatric diagnosis and monitoring of the psycho-physical development of the infant, child and adolescent

  • 1.Stages of psychomotor development 0-5 years
  • 2.Early diagnosis of neurodevelopment disorders:
    • Infantile Cerebral Palsy
    • Language delay
  • 3.Autism
  • 4.Attention Deficit Hyperactivity Disorders and behavioral disorders

B/Pregnancy and gynecological problems in GM

  • 1.Contraception
  • 2.Menarche and Menopause
  • 3.Pathology of pregnancy
  • 4.Exercise: prescription tests and medications during pregnancy

Saturday and sunday of the first week free

Day 6 (Monday, Second Week)

A/Informatics in General Medicine

  • 1.Basic computer concepts
  • 2.The data base for GM: the registration of the clinical data
  • 3.Privacy and Security
  • 4.e-Health applications (GM research through data bases, GM Cloud Computing, electronic health record, synchronous and asynchronous clinical teleconsultation)

B/Neurological diseases in MG

  • 1.Anxiety, Dysthymia and Depression
  • 2.Evaluation and treatment of the dysthymic patient
  • 3.Clinical evaluation (Hamilton scale)
  • 4.Neurodegenerative diseases: diagnosis and assistance problems
  • 5.Practical exercise: neurological objective examination

Day 7 (Tuesday, Second Week)

A/Oncology diagnostics in General Medicine (and in remote areas)

  • 1.Epidemiology and oncology screening
  • 2.Early diagnosis / staging
  • 3.Shared management between GP and Oncologist
  • 4.The cancer patient Follow-up
  • 5.Exercise: follow-up prescription

B/Terminal Care in MG

  • 1.Evaluation and therapy of pain
  • 2.Palliative medicine in GM
  • 3.Hospices of General Medicine
  • 4.Medical – patient-family communication

Day 8 (Wednesday, Second Week)

A/Traumatology and small surgery

  • 1.Minimum provision of the clinic.
  • 2.Assessment of urgency and needs for hospital transfer
  • 3.Dressings of cut and ragged-bruised wounds
  • 4.Domestic burns
  • 5.Principles of the immobilization of traumatized limbs
  • 6. Hernias

B/Vertigo and diagnosis of the URT

  • 1.Examining the upper airways
  • 2.The most impacted pathologies and their therapy
  • 3.The vertiginous syndromes: approach in GM
  • 4.Practical exercise: The liberating maneuvers that can be performed by the GP

Day 9 (Thusday, Second Week)

A/Imaging Diagnostics in GM

  • 1.The appropriate prescription of imaging diagnostics

B/Clinical biochemistry exams

  • 1.When and why and how to avoid pre analythical sampling errors.
  • 2.Prescribing appropriateness of clinical biochemical diagnostic tests
  • 3.Biological markers and their clinical significance
  • 4.Safe management of small pharmacies.li>

Day 10 (Friday, Second Week)

Discussion on topics covered in the previous days, answers to questions, clarifications and practical exercises, also with the help of internet teleconference systems Visit to the facilities of the GM: Community Hospital / Hospice / Group Medicine (Castelfidardo / Loreto)

Day 11 (Saturday, Second Week only morning)

Application clarifications and final evaluation of learning through closed answers

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