Graduates of College of Medicine – University of Sulaimani must be competent in wide range of clinical skills including taking medical history, performing clinical examination, recording and presenting medical information’s, performing practical procedures and some laboratory tests on the basis of a given standards.
A. Taking medical history from patient, family or care givers:
- Taking detail history in different age groups.
- Taking focused medical history based on chief complaint.
- Provide explanation, advice, re assurance and support.
B. Clinical examination:
- Performing general clinical examination and comprehensive systemic examination in different age groups.
- Performing focused clinical examination based on chief complaint in emergency and non emergency situations.
- Taking and measuring vital signs by using different tools.
C. Record and present the information obtained:
- Recording medical information obtained from the history and examinations.
- Presenting them in written or verbal forms; which includes:
. Writing patient file.
. Writing discharge summary
. Writing police report.
. Writing death certificate and note.
. Writing consultation and referral papers.
. Explanation of procedures.
D. Performing diagnostic and therapeutic procedures:
Attend and be able to perform clinical procedures and explain them; this includes (appendix 1):
- Taking blood samples in different situations.
- Obtaining peripheral venous access.
- Inserting catheters and performing aspiration procedures.
- Performing basic suturing and wound care.
- Performing basic (diagnostics and therapeutic) procedures in gynecological and obstetric cases.
- Performing basic (diagnostics and therapeutic) procedures in medical and surgical patients.
E. Conducting diagnostic and laboratory tests (Appendix 1):
Perform routine diagnostic and laboratory tests. Indications, limitations and interpretation are mandatory to be learned.
This includes:
- ECG, X-Ray and contrast study.
- Urine analysis
- Swabs
- Special diagnostic tests (tuberculin, lumber puncture…)
- Hematological tests.
A. Communicate appropriately and effectively with patient, relatives and family member in a medical context including breaking bad news, putting patient dignity the priority.
B. Communicate with the colleagues, staff members verbally, written and electronically about patient problem.
C. Communicate with interested communities in appropriate ways such as with Medias and have good knowledge about writing scientific papers.
General principle of patient management
1- They should be able to differentiate urgent and non- urgent situations and provide appropriate healthcare procedures based on patients’ condition
2- Assessing the patient, taking into account the history, the patient’s views, and an appropriate physical examination. The history includes relevant psychological and cultural aspects.
3- Justify the selection of appropriate investigations for common clinical cases and explain the fundamental principles underling such investigative technique.
4- They should be able to prepare a list of problems and differential diagnosis based on the findings through patient’s medical history and examination records in order to relate them to an etiological or pathogenic factor.
5- Formulate a plan for treatment, management and discharge, according to established principles and best evidence, in partnership with the patient, their careers, and other health professionals as appropriate. Respond to patient’s concerns and preference, obtain informed consent, and respect the rights of patients to reach decisions with their doctor about their treatment and care and to refuse or limit treatment.
6- Consider the team work practice as consult or refer if this serves the patient’s need.
Drugs
1- knowledge of prescribing regarding age and sex
2- select method of delivery
3- calculating dosages
4- consideration of interactions and adverse effect
Surgery
1-recognition of indication for interventions and the available surgical interventions
2- appropriate use of informed consent
3- understanding of principles of pre-, peri and post-operative care
Psychological
Recognition of interventions available and their use
Social
1- consideration of patient ‘s social circumstance, work, family etc…when determining treatment options and available interventions
2- The role of other organizations
Nutrition
1- Understanding the role of nutrition as a major non-drug therapy in some non -medical
2- Selecting appropriate method of ensuring adequate nutrition to meet individual patients’ need
Supportive and palliative care
recognition of what palliative care can offer, where it can be delivered and by whom
Rehabilitation
Understanding of the integral role of rehabilitation in recovery according to the patient’s condition and role of other healthcare professionals in providing this
Alternatives and complementary medicine
Demonstrate awareness that many patients use complementary and alternative therapies, and awareness of the existence and range of these therapies, why patients use them, and how this might affect other types of treatment that patients are receiving.
Graduate students should be able to understand health concept, determinants of health, risk factors, causes of diseases, and ways of control and prevention of diseases. Also they should know components of health system, functions of the system as well as health education and promotion developments.
1- Understanding of health system function, it is components, activities and process of health system.
2- Understanding the general principles of public and preventive medicine like levels of preventions especially health education, promotion and screening programs
3- Discuss basic principles of health improvement, including determinants of health, health inequalities, health risk factors and diseases surveillance with obligation in notification of notifiable diseases.
4- Identification unhealthy life styles and acting effectively to promote healthy life styles among individuals and population
5- Able in identifying natural course of health events among individuals.
6- Familiar to work in their practice within health system to reduce error and improve patient safety, and to protect patient rights.
7- Understanding appropriate health intervention s in order to prevent and control common health problems as cardiovascular diseases, accidents, communicable diseases, cancer and mental health problems in community.
8- Recognize the role of environmental and occupational hazards in health and ways to limit these adverse effects.
9- Know and apply epidemiological data in managing health care for individuals and population at the level of community.
10- Discuss the role of nutrition in relation with health of individual and population.
11- To know general principles of biostatistics and it is application in research and health as a general.
12- To be familiar with general principles of research methodology and steps in conduction research.
13- Explain sociological factors that contribute to the illness, the course of diseases, and the success of treatment.
Students will be encouraged to look after their own health and appreciate the importance of the personal growth including self-care promotion, psychological, social, and economic and job related abilities. This includes seeking an appropriate work life balance.
A. Physical development;
1- Students should adopt the healthy lifestyle standards, like; exercise, nutrition, relaxation, avoiding risk behavior or abusing drugs or substances.
2- Students should seek for advice when he or she needs medical care and being aware of not relying on self-diagnosis and self-treatment.
3- Making sure that she or he are immunized against communicable disease.
4- If students know that they have a serious condition which could be passed on to patients, or that their judgment or performance could be significantly affected by an illness or its treatment, they must take and follow advice from a consultant.
B. Psychological development;
1- Students should have the ability to identify oneself as a reflective and accountable practitioner, knowing their abilities and weakness, and face them appropriately.
2- They should be able to manage their own learning (self-learning), by searching and selecting appropriate tools and methods of available information technology.
3- Students should identify short and long term career and personal plans, adopt goal setting and planning principles; participate fully in life of the professional community.
4- Students should recognize key personal motivating factors, positive attitude, religion and spirituality, and their importance in sustaining a high level of motivation.
5- Students should be able to use economic management principles to improve their financial situation while considering professional ethics.
6- Students should have the ability of time management and leadership principles in their life.
C. Scientific development
1. Student should improve their skills in effective self-learning
2. Students must learn how to use reflection as a tool for improving their learning skills
3. Students must learn how to access evidence based scientific information and be able to critically appraise that information.
The graduates of medical college must acknowledge the values, characteristics, and behaviors that underpin the society trust to the medical profession and demonstrate commitment to them in his or her medical practice. They must be able to recognize and analyze ethical issues, while adhering to professional values and considering legal and ethical obligations with respect to the beliefs and culture of serving community.
A) Self-sacrifices and self-denial (Altruism):
1- Making the safety and benefit of the patient in every diagnostic and therapeutic intervention their first concern
2- They should provide enough time for the patients and their companion for counseling
3- Should not hide their knowledge and experience whenever there is an ask for their consultation.
B) Respect:
1- Respect the patients right regarding:
a. Expressing his or her beliefs, opinions, values, and worries
b. Confidentiality and privacy.
2- Respect to the colleagues, teachers, and health staff role in patient management.
C) Responsibility:
1- Should show responsibility and reliability in delivering the best quality service to the patient via appropriate teamwork and collaboration
2- Making a balance between personal responsibilities and professional duties
D) Morality:
1- Should be rational, accept criticism, and accept the truths
2- Keeping their knowledge up to date continuously via self-learning commitment
3- Should be able to recognize his knowledge limitation and seek for professional help whenever it is necessary
4- Should not use their professional position to pursue a sexual or improper emotional relationship with a patient or someone close to them
5- Should not express their personal belief (political, religious, and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress.
6- They should be clear and honest to the patient when things go wrong. If the patient under their care has suffered a harm or distress, they should:
a. Put matters right (if it is possible)
b. Offer apology
c. Explain fully and promptly what has happened and the possible short term and long term effects
E) Justice:
1- Giving the priority to the patients on the basis on their clinical needs
2- The investigations and treatment that provided to the patient based on their assessment priorities and clinical judgment about the effectiveness of the treatment option
3- They should not deny treatment to the patient because of their medical situation put them at risk. If the patient’s condition poses a risk to their health or safety they should take all available steps to minimize the risk before providing treatment or making other suitable alternative arrangement for providing treatment
4- They should avoid all kinds of discrimination on the basis of gender, ethnicity, religion, socioeconomic status, medical condition, and personal habit
F) Honor and integrity:
1- They should be polite, disciplined, and present a professional appearance, speech, and manner
2- They should act according to professional standards when they facing an unprofessional behavior from their colleagues
G) Medical law:
1- They should know the rules and laws of medical profession, implement, and respect them (Death certificate, police report, medical report, compulsory admission etc.)
2- They should have a good knowledge about ethical concept in medicine and how to be used in their practice and communication with their colleagues when there is a problem need an ethically considered decision.
3- They must keep records that contain personal information about patients, colleagues or others securely, and in line with any data protection law requirements. Clinical records should include:
a. Relevant clinical finding
b. The decisions made and actions agreed, and who is making the decisions and agreeing the actions
c. The information given to the patients
d. Investigations, treatments, and drugs
e. Who is making the record and when
4- They must take a prompt action if they think that patient safety , dignity , or comfort is or may be seriously compromised
5- They should be honest in financial and commercial dealing with patients, employers, and other organizations or individuals
6- They should not allow their interests affect the way of dealing with the patients
7- They should not ask for or accept- from patients, colleagues, or others- any gift, inducement or hospitality that may affect or be seen to affect the way they deal with the patients.
The graduates of medical college should be able to recognize the dimensions of each problem, search and collect the best available literatures related to that problem in order to understand all its aspects. Based on logical reasoning critically appraise the problem and accordingly search for ways and methods of solving that problem, then choose the best option (for its solution) based on the available resources.
A. Critical thinking:
1- They should be able to notice each problem, evaluate it, identify its dimensions, strengths and limitations to provide the whole picture of the problem
2- They should be able to perform a logical reasoning
B. Problem solving:
1- They should be able to identify the problems related to their area of activity
2- They should be able to analyze the problem and convert it to answerable questions
3- They should have the ability to provide the practical solutions
4- They should have the ability to evaluate the suggested solutions for strengths and weaknesses based on available facilities and services
5- They should be able to evaluate the available results of decisions and possible failure or poor consequences
C. Evidence based medicine:
1- Should be able to identify strengths, deficiencies , and limitation in their knowledge and expertise’s
2- Set learning and improvement goals
3- Use information technology to optimize learning
4- Locate, appraise, and assimilate evidence from scientific studies related to the problem
5- Incorporate feedback into daily practice
The graduates of medical college should be able to contribute in the health care system in an effective way as physician, researcher, teacher, manager, and health advocate.
A) Primary care provider:
1- They should be know the health care framework in his country very well, and the alternative systems in other countries as well
2- They should know the guideline instruction for providing the health service in each situation
3- They should be prepared to take the responsibility of promoting the health of the community through disease prevention and control, education and screening. Good medical practice involve:
a. Understanding the principles of public health, including health education, health promotion, disease prevention and control , and screening
b. Participating in efforts to promote the health of community and being aware of their obligations in disease prevention, screening , and reporting notifiable diseases
4- Perform a necessary coordination and follow up of patient management inside the health provider team
B) Training provider:
1- They should contribute in teaching a healthy lifestyle to the recipients and his/her family
2- They should contribute in awareness of population about the care of themselves
3- They should provide counselling to the health provider team members
4- They should participate in education of patients, families, trainees , and other health professionals
C) Researcher:
1- Should be consider themselves as a physician, as well as a researcher , so he has to contribute in research process
D) Head of health service unit:
1- They should have a knowledge about principles of administration to analyse the resources of his unit and using them in an appropriate way to solve the problem in a cost effective way
E) Health advocate:
1- They should be able to attract the other related sectors via making a good inter-sectoral collaboration for supporting the health of the community
2- They should be able to communicate with other related sectors to improve their capabilities in providing the service to the beneficiaries
