Family Medicine
First Semester
MODULE 1: FOUNDATIONS AND BASIC CONCEPTS OF FAMILY MEDICINE (FM)
- Family Medicine: Evolution of Concepts
- Profile and List of Competencies for Family Physicians in Tunisia
- Primary Care Practice and the Role of Family Physicians
- Determinants of Health
- Reasons for Contact and Diagnosed Morbidity in Primary Care
MODULE 2: PUBLIC HEALTH ISSUES
- Public Health: Concept of Risk, Epidemiology, Intervention Strategies, Health Promotion
- Periodic Health Examinations for Asymptomatic Adults
- Screening for Cancers in Public Health (Cervical, Breast, Colon, Prostate)
- Epidemiology and Prevention of Cardiovascular Diseases
- Addiction (Tobacco, Alcohol, Drugs, and Behavioral)
- Palliative Care and End-of-Life Patients
- Health Planning
- Key National Programs: Tuberculosis, Vaccination, STIs/AIDS, Rabies, Scorpion Control, Diabetes, Hypertension, Cutaneous Leishmaniasis, Breast Cancer, Cervical Cancer, Brucellosis
- Epidemiological Surveillance
MODULE 3: MEDICAL CONSULTATION IN FAMILY MEDICINE
- First-line Medical Record
- Classification of Diseases (CISP)
- Clinical Reasoning: From Symptoms to Appropriate Therapy
- Management of Uncertainty, Medical Decision Making
- Model of Medical Interview: Biomedical, Bio-Psycho-Social, Patient-Centered Approach
- Calgary-Cambridge Guide for the Structure of Medical Consultation.
MODULE 4: PHYSICIAN-PATIENT COMMUNICATION
ANATOMY
- Anatomy of the Respiratory System
HISTOLOGY-EMBRYOLOGY
- Respiratory System
- Development of the Respiratory System
PHYSIOLOGY
- Physiology of Respiration
- Cardio-Respiratory Adaptations to Exercise
BIOCHEMISTRY
- Metabolism of Hemoglobin and Iron
SEMIOLOGY
- Respiratory Semiology
MODULE 5: INITIATION TO RESEARCH IN FIRST LINE
- Research Methodology.
- Literature Search (PubMed and other sources).
- Writing a Research Work (Thesis, Dissertation, Article…).
- Critical Reading of a Scientific Article.
MODULE 6: HEALTHCARE SYSTEMS-PROFESSIONAL PRACTICE
- Healthcare System and Care System in Tunisia
- Health Insurance System Concepts of Hygiene and Patient Safety
- Quality of Care
- Evaluation of Professional Practices
- Establishment of a Family Physician: Managing a Practice/Clinic
- Management of a Primary Health Care Center
MODULE 7: EMERGENCIES IN AMBULATORY PRACTICE
- Pediatric Emergencies
- Psychiatric Emergencies
- Ophthalmic Emergencies: Sudden Loss of Visual Acuity, Foreign Bodies, Eye Trauma
- Oncological Emergencies (Spinal Cord Compression, Intracranial Hypertension, Superior Vena Cava Syndrome, Infections during Aplasia, Hypercalcemia…)
- Cardiac Arrest
- Traumatology: Mild Head Trauma, Severe Trauma, Benign Musculoskeletal Trauma, Polytrauma
- Loss of Consciousness (Syncope, Coma)
- Acute Circulatory Failure
- Acute Intoxication
- Non-Traumatic Accidental Pathology (Drowning, Electrocution, Envenomation)
- Seizures
- Acute Glycemic Imbalances (Hypoglycemia, Diabetic Ketoacidosis, Hyperosmolar States)
- Acute Chest Pain
- Cardiac Arrhythmias
- Acute Heart Failure Syndrome
- Acute Dyspnea
- Acute Non-Traumatic Abdominal Pain
- Family Medicine Development and Promotion Group, Page 3
- Neuro-meningeal Infections
- Stroke/Transient Ischemic Attacks
- Digestive Hemorrhages
- Hemoptysis
- Heatstroke
- Amputation
- Epistaxis (Nosebleed)
- Urinary Retention
- Acute Lower Limb Ischemia
- Hematuria
MODULE 8: COMMON COMPLAINTS AND PATHOLOGICAL SITUATIONS
- APPROACH to: (EBM and decision-making)
- Dizziness
- Faintness
- Headaches
- Fatigue and weight loss
- Cough
- Fever
- Shortness of breath
- Red eye
- Lower limb edema
- Low back pain
- Joint pain
- Tremors
- Facial paralysis
- Common dermatoses
- Lower respiratory tract infections
- Upper respiratory tract infections
- Urinary tract infections
- Common digestive problems: GERD, epigastric pain, constipation, functional bowel disorders, diarrhea, hemorrhoidal flare-ups.
- Jaundice
- Hepatitis
- Common hematological disorders: anemia, hemostatic disorders
- Lymphadenopathies
- Iatrogenic pathology
- Carpal tunnel syndrome
- Snoring
- Sexual dysfunctions
- Family Medicine Development and Promotion Group, Page 4
- Vomiting
- Paresthesias
MODULE 9: CHRONIC DISEASES
- APPROACH to:
- Diabetes
- Hypertension
- Dyslipidemia
- Osteoarthritis
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
- Thyroid disorders
- Management of patients with stabilized chronic conditions (chronic renal insufficiency, patients stabilized on psychotropic medications, patients on oral anticoagulants, and cancer patients undergoing treatment).
MODULE 10: COMMON PSYCHIATRIC DISORDERS IN ADULTS
- APPROACH to:
- Mood disorders (depression and others)
- Anxiety disorders
- Acute and chronic psychotic disorders
- Impulse control disorders: sleep, sexual, and eating disorders
- Somatoform disorders
- Addictions (tobacco, alcoholism, substance abuse)
- Modalities of psychiatric hospitalization
MODULE 11: COMMON PSYCHIATRIC DISORDERS IN CHILDREN AND ADOLESCENTS
- Depression in children and adolescents
- Autism
- Separation anxiety
- Language delay
- Attention deficit hyperactivity disorder (ADHD)
- Sphincter control disorders (Enuresis and Encopresis)
- Family Medicine Development and Promotion Group, Page 5
MODULE 12: PERINATAL CARE AND REPRODUCTIVE HEALTH
- Perinatal care:
- Preconception care
- Prenatal and postnatal care
- Delivery and management of the newborn in the delivery room
- Breastfeeding
- Family planning
- Menopause
- Common gynecological problems
MODULE 13: CHILD HEALTH
- Feeding of newborns and infants
- Psychomotor development and growth
- Psychoemotional development and personality traits
- Vaccinations in infants
- Bronchiolitis in infants
- Acute diarrhea in infants
- Upper respiratory tract infections in children
MODULE 14: HEALTH PROBLEMS IN THE ELDERLY
- Standardized geriatric assessment
- Frailty
- Falls
- Iatrogenic effects in the elderly
- Loss of autonomy/Immobilization syndrome
- Urinary incontinence
- Mental confusion
- Dementia
- Aging in place/ Home care
MODULE 15: MEDICO-LEGAL AND ETHICAL ASPECTS
- Professional liability
- Medical errors
- Medical certificates
- Medico-legal issues
- Abuse
- Family Medicine Development and Promotion Group, Page 6
MODULE 16: ETHICS, PROFESSIONALISM
- Major ethical principles – Human rights
- Conflicts of interest
MODULE 17: INTERPRETATION OF THE MOST COMMON DIAGNOSTIC TESTS
Interpretation of common imaging tests:
For example:
- Interpretation of standard radiographs
- ECG
- Coagulation profile…
MODULE 18: SCHOOL AND UNIVERSITY HEALTH
- Main components of school medicine
- The national program for adolescent health:
- The mental health program
- The reproductive health program. It is structured around four components:
-Physical health (puberty development, growth…)
-Mental health and risky behaviors
-Reproductive health
-Health education
- Learning disorders and academic difficulties