What is General Practice? General Practice is a traditional method of bringing primary health care to the community.

is a medical discipline in its own right, linking the vast amount of accumulated medical knowledge with the art of communication. Definitions General Practice can be defined as that medical discipline which provides community based, continuing, comprehensive, preventive primary care , sometimes referred to as the CCCP model. The Royal Australian College of General Practitioners (RACGP) uses the following definitions of general practice and primary care. General Practice is that component of the health care system which provides initial, continuing, comprehensive and co-ordinated medical care for all individuals, families and communities and which integrated current biomedical, psychological and social understandings of health. General Practitioner is a medical practitioner with recognized generalist training, experience and skills he who provides and co-ordinates comprehensive medical care for individuals, families and communities. The Practitioner must be able to make a total assessment of the person s condition without subjecting the person to unnecessary investigations, procedure and treatment. The patient needs a caring focal health care provider who takes full responsibility for the welfare of the patient and intervenes on his or her behalf. Specialists also need highly competent generalists to whom they can entrust ongoing care PRIMARY CARE MEDICINE IS DELIVERED AND PRACTISED BY A GP Primary care involves the ability to take responsible action on any problem the patient presents, whether or not it forms part of an ongoing doctor patient relationship. In managing the patient, the general/family practitioner may make appropriate referral to other doctors, health care professionals and community services. General/Family Practice is the point of first contact for the majority of people seeking health care. In the provision of primary care, much ill-defined illness is seen; the general/family practitioner often deals with problem complexes rather than with established diseases.

UNIQUE FEATURES OF GENERAL PRACTICE The unique and important work of a General Practitioner is to provide availability and continuity of care,competence in the realm of diagnosis, care of acute and chronic illnesses,prompt treatment of emergencies and a holistic and preventive approach to health care. This therefore is different from specialist-based or hospital management. y y y y y y y y y y y y y It is First contact care,serving as appoint of entry to health care system Early diagnosis and care of life-threatening and serious disease e.g AMI, bleeding diathesis,subarachnoid haemorrhage, worsening asthma, heart failure, arrythmias Continuity and availability of care for acute and chronic illness-timely advice for transfer and follow up at hospital Emergencies at home and community e.g poisoning, overdose, collapse, stroke, burns Personalised care- to know the person fully Domiciliary care- take risks of ambulatory use of medicines Family care of all ages and both sexes- no choice, genetic counseling, marriage counseling, violence, child, women and old abuse abuse Preventive care e.g anaemia, infections, awareness about risk factors,cessation of smoking, obesity Holistic approach involving so many disciplines e.g DM Health care coordination with other health providers like specialists and physitherapists Palliative care e.g cancer pain and symtoms management End-of-life care and geriatric care Health promotion lifestyle modification, immunization,health education

Pereira Gray identifies six principles-primary care,family care,domiciliary care, preventive, continuing care and personalised care with a holistic care approach. A PROPOSED COURSE AND CONTENT FOR THE DIPLOMA AND MEMBERSHIP EXAMINATION OF THE COLLEGE Remember, it is a self paced and self study online or internet based course for General Practitioners and Family Physicians. The contents are only suggestions and not limitations and the candidates are expected to read extensively keeping in mind the length and breadth of this specialty and the local and international needs and standards. Modular examinations and contact periods are mandatory for those who register for modular tests. Workshops and CMEs are planned to intersperse throughout the period in any sequence and meant to enhance the capacity building of the GPs. The College and its faculty shall endeavor to bring quality and status to this specialty and status of the participants by providing assistance in learning and developing. The use of library and university resources could be utilized to some extent towards attaining these goals. CME access on DUHS website and contact periods on skype shall be facilitated under special circumstances.

The course contents have been divided broadly into twelve parts and 18-24 modules for convenience so that similar topics and subtopics can be studied together and covered in 22-24 months allowing sufficient time for the workshops, CMEs and contact time periods and for revision for the main exams. Initially only those candidates who attain workshops, CME levels, show progress and interest to be assessed and also meet the criteria for admission and testing of the course shall be sent to these exams. The examinations and modular tests can be in the form and pattern of that stimulate the learning process and at the same time assess the learning objectives. The good news is that CMEs and workshops shall be designed and conducted by the experts and persons holding some command and authority over the subject content and field. Part I 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. The basis of General Practice The nature and contents of General Practice The family The family physician and his role Consulting Skills Communication skills Counseling skills Difficult, demanding and angry patients Elderly patients Palliative care End of life care Prevention in General Practice Nutrition in Health and Illness Health Promotion and Health Education Pain and its management Holistic care Travel and tropical medicine Occupational Health Physical medicine and Rehabilitation Research and EBM Laboratory medicine

Part II Diagnostic perspectives in General Practice 1. 2. 3. 4. 5. Inspection as a clinical skill A safe diagnostic strategy Genetic disorders and conditions Depression and Anxiety Diabetes mellitus

6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19.

Anemia Obesity Hypertension Thyroid and other endocrinological disorders Back-pain and spinal dysfunctions Urogenital infections and disorders STDs Baffling bacterial infections Baffling viral infections Baffling Protozoal and Rickettesial infections Chronic kidney disease Malignant disease Connective tissue disorders and vasculitides Neurological dilemmas

PART III Problem solving in general practice 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. Abdominal pain Arthritis Anorectal disorders Low back pain Thoracic back pain Bruising and bleeding Chest pain Constipation Cough Deafness and hearing loss Diarrhea The disturbed patient Dizziness Dyspepsia (indigestion) Dysphagia Dyspnea The painful ear The red and tender eye Pain in the face Fever and chills Faints, fits and funny turns Hematemesis and melena Headache Hoarseness

25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46.

Jaundice Nasal disorders Nausea and vomiting Neck lumps Neck pain Shoulder pain Pain the arm and hand Hip and buttock pain` Pain in the leg The painful knee Pain the foot and ankle Walking difficulty Palpitations Sleep Disorders Sore mouth and Tongue Sore throat Tiredness The unconscious patient Urinary disorders Visual Failure Weight gain Weight loss

Part IV Child and Adolescent Health 1. 2. 3. 4. 5. 6. 7. 8. An approach to the child Specific Problems in of children Surgical problems in Children Common Childhood Infections Behavioural Disorders in children Child abuse Emergencies in Children Adolescent Health

Part V Woman s Health 1. 2. 3. 4. 5. Sexual characteristics Menarche,Normal Menstruation and Premenstrual tension Lower abdomen and pelvic pain in women Abnormal uterine bleeding Vaginal Discharge

6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17.

Vulval disorders Pregnancy and Basic Antenatal care Pregnancy and Infections Pregnancy and systemic disease High-risk Pregnancies Postnatal care Family Planning Breast pain Lumps in the breast Cervical and Uterine cancers Violence against women Working women issues

Part VI Men s health 1. 2. 3. 4. 5. 6. Overview Scrotal Pain Inguino-scrotal lumps Disorders of penis Disorders of prostate Family Planning

Part VIII Sex-Related Problems 1. Sexual Health 2. Sub-fertile couple 3. STIs and HIV

Part IX Chronic Disorders and Continuing care 1. 2. 3. 4. 5. 6. 7. 8. 9. Asthma COPD Anemia Allergies Anxiety and Panic Disorders Depression and Psychosis End-stage Renal disease and dialyses Epilepsy Hepatitis B and C and CLD

10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.

Hypertension Ischemic Heart Disease Congestive Heart Failure Dyslipidemias Diabetes Mellitus Obesity TB and leprosy Smoking Drug dependence and substance abuse Alcoholism Palliative care

Part X Problems of the Skin 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Diagnostic approach and management Common skin conditions Pruritus Acute skin eruptions Skin ulcers Pigmentation disorders Hair disorders Nail Disorders Common lumps Cosmetic surgeries

Part XI Accident and Emergencies 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Emergency Care and Equipment Myocardial Infarction Acute Heart Failure Stroke and TIA Coma Shock Asthma and COPD Bleeding Dyscrasias Thrombosis and Embolism Injuries and wounds Gunshots Fractures and Dislocations MV and sport injuries

14. Accidental and suicidal poisoning 15. Burns 16. Home emergencies

Part XII Health Management 1. 2. 3. 4. 5. 6. 7. Health Plans Health Policies and Acts Health Systems Bioterrorism Disaster Management Plan Epidemic situations Floods, famine and wars