The Condensed Curriculum Guide: The core competences explained

In the fifth of our series of extracts from The Condensed Curriculum Guide, Dr Ben Riley and Dr Jayne Haynes explain the core competences of general practice.

The core statement of the curriculum, 'Being a General Practitioner', describes the core knowledge, skill and attitudes a doctor needs to be a competent GP. This is organised in a framework of six core competences and three essential application features from which it can be learned.

The core competences
The first three core competences focus on the GP consultation. 'Primary care management' refers to the first contact with the patient in primary care. It includes addressing patient's unselected problems, co-ordinating care with other healthcare professionals, providing appropriate care and making effective use of the health service.

'Person-centred care' looks at the establishment of an effective doctor-patient relationship. A GP should demonstrate respect for patient autonomy, an ability to set priorities and act in partnership with patients, provide continuity of care and co-ordinate care.

'Specific GP problem-solving skills' includes taking a selective history, performing physical examinations and investigations, formulating an appropriate and effective management plan, dealing with conditions that present early in the course of an illness, making diagnoses related to the incidence and prevalence of conditions in the community, using appropriate GP techniques (such as 'time as a diagnostic tool' and 'tolerating uncertainty'), and spotting symptoms that may be serious, with urgent intervention when required.

The remaining three core competences look at more than just the immediate issues arising in the consultation.

'A comprehensive approach' involves managing multiple complaints and pathologies in one patient, including both acute and chronic health problems, while successfully promoting health and implementing disease prevention strategies.

'Community orientation' describes the ability to reconcile the health needs of individual patients with the health needs of their community, accounting for the resources available.

'An holistic approach' involves caring for the whole person in the context of the person's values and considering a range of therapies based on the evidence of their benefits and cost.

The essential application features
The three essential application features describe factors present in the background of every consultation that strongly affect how a GP applies their knowledge and skills.

'Contextual aspects of care' means having an awareness of the environment in which a GP practices.

'Attitudinal aspects of care' requires the GP to be aware of their own attitudes and professional capabilities, to identify ethical aspects of clinical practice, to understand their personal ethics and values, and achieve a good work-life balance.

'Scientific aspects of care' involves the GP adopting a critical and evidence-based approach to daily practice and maintaining this through continued learning.

Learning and teaching the core competences
The Condensed Curriculum Guide divides the core competences into a number of professional tasks and breaks these down into learning outcomes. As well as the core competences, the curriculum contains a broad syllabus of knowledge. We will explain how to prioritise and learn this knowledge in next week's article.

Dr Riley is a GP in Oxfordshire and RCGP curriculum development fellow and Dr Haynes is also a GP in Oxfordshire

Learning points
Understanding the core competences

  1. The core statement of the curriculum includes six core competences and three essential application features.
  2. The first three core competences - primary care management, person-centred care and specific GP problem-solving skills - are focused on the consultation.
  3. The remaining three core competences - a comprehensive approach, community orientation and a holistic approach - take a wider perspective than the immediate medical issues.
  4. The essential application features - contextual, attitudinal and scientific - are present in every consultation and affect how a GP applies their knowledge and skills.

 A breakdown of the competence: primary care management
 The task Managing primary contact with patients and dealing with unselected problems.
 A related outcome Knowledge of the epidemiology of problems presenting in primary care.
 Tips for learning

 To learn about epidemiology in primary care:

  • Read 'The Essential Knowledge' chapter of The Condensed Curriculum Guide, which lists the common and important conditions.
  • Do computer searches of your practice's chronic disease registers.
  • Keep a log of patients you see to identify what problems tend to come up and how they first present.
  • Review information published by reputable bodies (for example, Cancer Research UK: www.cancerresearchuk.org).

 


Resources

The Condensed Curriculum Guide, RCGP 2007

by Dr Ben Riley, Dr Jayne Haynes and Professor Steve Field

The Condensed Curriculum Guide is the official guidebook to the RCGP curriculum.

It is available from the RCGP Bookshop. Online: www.rcgp.org.uk/acatalog; phone: (020) 7581 3232; fax: (020) 7581 8154. RCGP members and associates receive a 10 per cent discount when ordering this book.

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