Nottingham Vocational Training Scheme

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nMRCGP:

[ Guide to the nMRCGP and assessment ]

[ Curriculum ] [ Curriculum reference material ]

[ Workplaced Based Assessment (WBA) ] [ The CSA and AKT Examination ]

[ PMETB ] [ The RCGP website for nMRCGP ] [ nMRCGP examination dates and regulations ]
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nMRCGP Curriculum

The three year training program is based on the Royal College of General Practitioners Curriculum for General Practice

Curriculum

Reference material

Work Placed Based Assessment

The Examination: CSA&AKT

e-Portfolio

The full RCGP curriculum can be viewed  by clicking "RCGP Curriculum for General Practice"

The RCGP WPBA website can be viewed by clicking "RCGP WPBA"

Clinical psychomotor skills from the Curriculum statements have been collated into one document under the DOPS section of WBA. Click here to view

Locality based learning - the 12 Competencies The Core Curriculum statement  [Being a GP]

[Communication and Consultation Skills] [Practising Holistically] [Data Gathering and Interpretation] [Making a Diagnosis/Making Decisions] [Clinical Management]

[Managing Medical Complexity] [Primary Care Administration and Information Management and Technology] [Working with Colleagues and in Teams]

[Community Orientation] [Maintaining Performance, Learning and Teaching] [Maintaining an Ethical Approach to Practise] [Fitness to Practise]

Whole day learning - the Curriculum statements 

[Being a GP] [The GP consultation] [Clinical Ethics and Values] [Evidence based health care] [Clinical Governance] [Equality and diversity]

[Management in primary care] [Information technology] [Research and academic activity]     

[Patient Safety Management] [Healthy living] [Genetics] [Acutely ill People] [Children & Young People] [Older Adults] [Women's health] [Men's health]

[Sexual Health] [Cancer & Palliative Care] [Mental Health Problems] [Drugs and Alcohol] [Learning Disabilities] [Respiratory] [Cardiovascular] [Gastroenterology]

[Ophthalmology] [Neurology] [ENT & Facial] [Rheumatology and Trauma] [Dermatology] [Metabolic]

Trainers workshops

[Teaching, mentorship and clinical supervision]

Metabolic Direct link to the Metabolic reference material

Symptoms:

 

Patients with metabolic problems are frequently asymptomatic or have non-specific symptoms, such as tiredness, malaise, weight loss or gain, etc.
 

Certain symptoms raise clinical suspicion of metabolic problems:
   

Diabetes mellitus – tiredness, polydipsia, polyuria, weight loss, infections
   

Hypothyroidism – tiredness, weight gain, constipation, hoarse voice, dry skin and hair, menorrhagia
   

Hyperthyroidism – weight loss, tremor, palpitations, hyperactivity, exophthalmos, double vision
   

Hyperlipidaemia – xanthelasma
   

Hyperuricaemia – gout

Common and/or important conditions: 

 

Obesity
 

Diabetes mellitus – Type 1 and 2 Impaired glucose tolerance
 

Thyroid disorders – hypothyroidism, hyperthyroidism, goitre, nodules
 

Hyperlipidaemia
 

Hyperuricaemia
 

Endocrine problems – pituitary disease (e.g. prolactinoma, acromegaly, diabetes insipidus), adrenal disease (e.g. Cushing’s syndrome, hyperaldosteronism, Addison’s disease, phaeochromocytoma) and parathyroid disease

Investigations: 

 

Body mass index calculation WHO diagnostic criteria for diabetes mellitus
 

Near patient capillary glucose measurement (including patient self-monitoring)
 

HbA1c and fructosamine to assess glycaemic control
 

Albumin: creatinine ratio or dipstick for microalbuminuria
 

Interpret serum electrolyte and urate results
 

Interpret thyroid function tests and understand their limitations – TSH, T4, free T4, T3, auto-antibodies
 

Interpret lipid profile tests – total cholesterol, HDL, LDL, triglycerides
 

Visual acuity and retinal photography
 

Knowledge of secondary care investigations including the glucose tolerance test, thyroid ultrasound and fine needle aspiration, specialised endocrine tests.

Emergency care:
 

Acute management of diabetic emergencies – hypoglycaemia, hyperglycaemic ketoacidosis and hyperglycaemic hyperosmolar non-ketotic coma
 

Acute management of thyroid emergencies – myxoedema coma and hyperthyroid crisis

 

Recognition and primary care management of Addisonian crisis

Treatment:
 

Understand principles of treatment for common conditions managed largely in primary care – obesity, diabetes mellitus, hypothyroidism, hyperlipidaemia, hyperuricaemia

Prevention:
 

Health promotion activities include dietary modification and exercise advice
 

Understand when prevention of hyperuricaemia is appropriate, e.g. patients treated for myelo/proliferative disorders

 

Obesity and diabetes mellitus are risk factors for other conditions, so optimal management is preventative