Subject: pediatrics
Learning goals
Upon completion of this module the student should have acquired basic theoretical knowledge and practical skills in pediatrics.
Learning outcomes
Knowledge
Upon completion of module 6, the student should be able to describe and explain
- normal growth and development in children and adolescents
- presentation of common diseases from the history and clinical examination, symptoms and signs
- pathogenesis and pathophysiology of common and important diseases in infants, children and adolescents
- the most important physical, psychological, and social risk factors for disease in childhood, adolescence and in the family
- investigations/examinations which are used to support diagnoses and assess relevant differential diagnoses
- basic management of common and important diseases in infants, children and adolescents, in particular the therapeutic principles pertinent to diseases in this age group
- when to refer to specialist care
- warning symptoms and signs that warrant urgent response and action
- the long-term consequences of diseases in childhood
- regulations, practices, and procedures in preventive health care for the paediatric and adolescent age group. The Norwegian immunization program, contraindications and side effects of vaccines, and how to respond to reluctance and mistrust to the use of vaccines
- recommended nutrition in infancy, childhood, and adolescence
- legal framework that governs children’s rights to health care, and regulations involving patient autonomy in children and adolescents
- signs and symptoms of child neglect and abuse and the legislation for reporting cases
- challenges to child health in a global perspective
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have in-depth knowledge of the most important tasks and areas of responsibility in pediatrics
Skills
Upon completion of this module the student should be able to:
- obtain a relevant, detailed and appropriate pediatric history
- communicate with the caregivers and the child adapted to their age and developmental stage
- document a pediatric patient record including history, clinical findings, summary, interpretation and conclusion with diagnosis, treatment and further investigation/follow up
- recognize symptoms and signs and cope adequately with severe illness and life-threatening situations in children to stabilize vital functions and immediately refer to specialist care
- evaluate the physical growth of newborns, children, and adolescents and development according to milestones
- interpret findings of basic investigations, initiate targeted and relevant investigations
- avoid unnecessary testing and treatment
- conduct a general and age-appropriate targeted medical examination of newborns, infants, children and adolescents. This includes all examinations normally performed in adults, but with the adaptations and approach necessary for children
- measure length/weight/head circumference, and plot growth curves
- perform cardiopulmonary resuscitation including bag-and-mask ventilation on mannequins using the infant and child algorithms
- instruct patients in the application of age-appropriate administration of medications, adrenalin autoinjector and inhalation techniques
- obtain a capillary blood sample
The student should under supervision be able to perform on patient/model:
- venous cannulation
- insertion of nasogastric tube
The student should have observed, live or on video at pediatrics.no and be able to explain the performance of:
- lumbar puncture/tap
General competence
Upon completion of this module, the student should have acquired and developed:
- respect for the children and families as active collaborators
- ability to seek guidance from more experienced physicians when necessary
- ability to collaborate with other professions involved in social and health care of children
- competence to seek further necessary knowledge required for professional tasks in the future. This includes critical understanding of scientific evidence for clinical work and research.
Subject: Obstetrics/Gynecology
Learning goals
Upon completion of this module the student should have basic theoretical knowledge and practical skills in obstetrics and gynecology.
Learning outcomes:
Knowledge
At the end of the module, it is expected that the student must be able to describe and explain:
- normal physiology of pregnancy and puerperium including breast feeding
- the principles for antenatal controls and risk estimation of pregnancy and delivery
- pregnancy complications including multiples, fetal growth abnormalities and infections
- medical disorders in pregnancy including hypertensive disorders, diabetes and epilepsy
- complications in early pregnancy including spontaneous abortion , ectopic pregnancy and molar pregnancy.
- bleeding in late pregnancy including placental abruption and placenta praevia
- the normal and complicated/pathological birth with indications for operative delivery and pain relief
- the complicated puerperium including infections
- mental health and psychiatric disorders related to pregnancy and the puerperium
- the menstrual cycle and the diagnosis and treatment of vaginal bleeding disorders
- adolescent gynecology including primary amenorrhea and genital malformations
- benign tumors of the genital tract and their treatment
- menopausal physiology, symptoms and treatment
- urinary incontinence
- infections in gynecology and obstetrics, including sepsis
- malignant diseases in gynecology
- acute abdomen related to gynecology including extra-uterine pregnancy
- efficacy, use and side effects of contraceptive methods
- methods of sterilization and related legislation
- etiology, diagnosis and treatment of pelvic pain including endometriosis
- methods and complications of induced abortion; different attitudes, ethical and legal issues (the Norwegian abortion act)
- prenatal testing including indications and methods; ethical and legal issues (selective abortion and the Norwegian Biotechnology act)
- etiology, diagnosis and treatment of the infertile couple (female and male); ethical and legal issues in modern reproductive technology (the Norwegian Biotechnology act)
- global maternal reproductive health
- reproductive epidemiology
- the theory of the developmental origins of health and disease
- diagnose and treat pelvic organ prolapse
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have in-depth knowledge of the most important tasks and areas of responsibility in obstetrics and gynecology
Skills
Upon completion of this module, the student must be able to:
- obtain a medical history from and obstetrical and gynecological patient and summarize
- explain and use antenatal cards/records ("Helsekort for gravide")
- judge the size of the pregnant uterus and measure the symphysis-fundal height
- calculate estimated date of delivery from last menstrual period
- palpate fetal lie, presentation, position and engagement (Leopold’s / Pawlik’s maneuvers)
- count the fetal heart rate
- examine and estimate the dilatation of the cervix in labour
- assist at normal deliveries
- inform patients on birth control and sterilization
- inform women who apply for induced abortion
- perform gynecological examination (inspection and exploration)
- take a cytological / HPV cervix sample
- insert and remove an IUD (on model or patient)
- assess the use of peccary for pelvic organ prolapse (model or patient)
- identify signs of genital infections and perform relevant tests including examination of wet preparation
- establish and maintain good contact with patients
- give preconceptional counseling and risk estimation for future pregnancies
- prescribe medication in pregnancy and during breast feeding
- diagnose and treat gynecological infections
- diagnose and treat urinary incontinence and pelvic organ prolapse
- recognize and treat symptoms related to menopause
General competence
Upon completion of this module the student should be aware of and be able to reflect on ethical issues in obstetrics and gynecology and develop an attitude that:
- respect a womans's choice in difficult ethical situations
- treats every woman with empathy and respect
- ensures respect towards women with regard to gynecological examination
- actively seeks help from more experienced doctors whenever needed in clinical work
- implies ability to collaborate with other professions involved in gynecologic and obstetric patients
- ensures that the patient understands relevant clinical information
Subject: General practice/family medicine
Learning goals
Upon completion of this module the student should have basic theoretical knowledge and practical skills in obstetrics/gynaecology and paediatrics.
Learning outcomes
Knowledge
Upon completion of this module the student should be able to:
- describe normal pregnancy and birth topics
- explain risks and benefits of treatment of menopausal symptoms
- describe common gynaecological disorders like infections, incontinence, menstruation disorders and endocrinological disorders
- describe normal health and development of children, including nutritional issues and the benefit of breastfeeding
- describe common paediatric disorders and their prevalence at different ages
Skills
Upon completion of this module the student should be able to:
- recognize severe disease in children and adolescents and know when to refer
- recognize severe obstetrical/gynaecological conditions and know when to refer
- perform routine gynaecological examinations including Pap smear tests and tests for gynaecological infections
- insert and remove IUDs
- perform the first and subsequent pregnancy consultations, including the 6-week postnatal follow up according to national guidelines
- measure symphysis-fundus height, and assess the foetal heart rate and foetal presentation
- provide information on contraception and family planning
- provide abortion counselling
- diagnose and treat common obstetric and gynaecological disorders, including point-of- care testing
- communicate on sensitive topics like abortion, sexual problems and prenatal diagnostics
- perform examination and decide differences between normality and abnormality in newborns and children and adolescents at different ages
- plot and interpret growth charts, and know major milestones in psychomotor and language development
- diagnose and treat common paediatric disorders, using point-of-care testing where relevant
- discuss contraceptive alternatives
- discuss sexological issues
- inform patients about the management packages for gynaecological cancers
- convey the legal requirements for women seeking abortion, sterilization or prenatal testing
- convey the national vaccination programme
- discuss consequences of illegal drug use and medical assisted rehabilitation (MAR) during pregnancy
General competence
Upon completion of this module, the student should have acquired and developed:
- empathy in meeting patients and families
- understanding of the reciprocity of child health and health caretakers
- ability to approach children and parents for optimal communication and work-up
- ability to collaborate with other health professions like midwifes, social workers and public health nurses, especially in women with comorbidities or substance abuse, or their children
- ability to reflect on ethical issues and concerns
Subject: Pathology
Learning goals
Upon completion of this module, the student should have theoretical knowledge about the most common pathological processes in obstetrics, gynecology and pediatrics, and have acquired an understanding for the diagnostic processes of these conditions.
Learning outcomes
Knowledge
Upon completion of this module, it is expected that the student should be able to:
- describe the most common malformations of the uterus and explain the embryology behind its development
- describe the most common skin diseases of the vulva
- describe the different types of human papillomavirus (HPV), understand its life cycle and the molecular mechanism by which HPV causes premalignant and malignant disease in the female genitalia
- describe the premalignant and malignant lesions of the uterine cervix, and their risk factors
- describe the most common conditions of the myometrium
- describe endometriosis and the different etiologic theories
- describe endometrial hyperplasia and carcinoma, and recognize the predisposing factors and pathogenesis of the different histological types of carcinoma
- describe the aetiology of the different ovarian cysts, including polycystic ovarian syndrome
- describe the classification of ovarian tumors, both according to cells/tissue of origin and grade (benign, borderline, malignant), and recognize the most common types within each group
- describe the pathogenesis of pathological pregnancies, including spontaneous abortions, ectopic pregnancies and molar pregnancies
- describe the pathology behind placental dysfunction, including maternal vascular pathology, placental inflammations and foetal vascular pathology
- describe the placental implantation disorders
- describe the placenta in multiple pregnancies
- describe the most common placental neoplasms
- describe cryptorchidism, its aetiology and associated diseases
- describe the major types of testicular germ cell tumors and the malignancy risks according to age
- describe the pathology in lungs of premature born children
- describe the most common paediatric malignancies and explain their major differences compared to malignancies in adults
Skills
Upon completion of this module, it is expected that the student should be able to:
- recognize a pathological process from normal anatomy in the female and male genitals, and in children
- describe and diagnose microscopically specified obstetric, gynaecologic and paediatric disorders
- read and interpret a pathology report
General competence
Upon completion of this module, it is expected that the student should:
- acknowledge the role of pathologists in the diagnostic process of benign and malignant diseases
- acknowledge the importance of correct handling and fixation of tissues and cells for the quality of the diagnosis
Subject: Pharmacology
Learning goals
Upon completion of this module, the student should have acquired knowledge and skills in basic pediatric pharmacology and principles of drug treatment in the clinical situations in gynecology and obstetrics.
Learning outcomes
Knowledge
Upon completion of this module the student should be able to:
- describe principles of pharmacokinetics and pharmacodynamics in children with emphasis on developmental changes and the consequences for drug treatment
- explain principles of drug treatment for common diseases in childhood
- explain special precautions for drug treatment and effects of drug of abuse in pregnancy and around birth (including drugs affecting uterine motility)
- explain the possibilities of teratogenicity for medicines that cross the placenta
- explain basic principles of hypertension drug treatment in pregnancy, preeclampsia and eclampsia
- describe principles of hormonal contraceptives and hormonal replacement therapy
- describe drug treatment principles of cancer treatment in gynecology
- explain therapeutic principles for common diseases such as infections and urinary incontinence
Skills
Upon completion of this module the student should be able to:
- prescribe and treat patients with efficient and safe drugs
- avoid concomitant use of drugs causing serious interactions
- interpret drug serum concentrations
- interpret pharmacogenetic analyses for therapeutic drug monitoring
- discuss drug abuse and drug intoxication
- discuss the risk of drug transfer from mother to child during breast feeding
Subject: Child psychiatry
Learning goals
Upon completion of this module, the student should have acquired skills and knowledge needed to understand and evaluate child psychiatric conditions.
Learning outcomes
Knowledge
Upon completion of this module the student should be able to describe and explain:
- the biopsychosocial approach to children, adolescense and families
- the psychological and social aspects of chronic or severe illness in childhood
- age specific challenges and psychiatric disorders
- definitions of child maltreatment and child neglect
- best practice for medical assessment of child maltreatment and neglect
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have in-depth knowledge of the most important tasks and areas of responsibility in child psychiatry
Skills
Upon completion of this module the student should be able to:
- evaluate child psychiatric conditions often presented in primary or pediatric units and initiate referrals to child psychiatric units
- evaluate signs and clinical features of child maltreatment and neglect
- plan necessary evaluations and know how to report to child protection services
- plan and implement cooperation with the child and family
- communicate with children, adolescence and families with chronic diseases
- discuss short- and long term consequences of child maltreatment to mental health and social development in children
- discuss psychosocial challenges related to migration
General competence
Upon completion of this module the student should have acquired and developed an attitude that:
- ensures empathy with sick children, their families including siblings and life situation
- shows respect for the child and family regardless of the type of disease, problem, or background
- considers the child and family as active collaborators in the treatment and problem- solving process
- makes the student able to communicate medical information in an open-minded and reflective way
- includes sensitivity to signs of child neglect and abuse and ensures the safety of children
Subject: Behavioural Sciences
Learning goals
Understand diseases/illnesses among children and adolescents in light of the biopsychosocial model and know the importance of good communication skills in meeting with these patients and their parents.
Learning outcomes
Knowledge
Upon completion of this module the student should be able to explain:
- the biopsychososial model in relation to diseased/illnesses among children and adolescents
- understand the families’ challenges when severe diseases affect children and adolescents
Skills
Upon completion of this module the student should be able to:
- collect and give relevant information and support to pediatric patients of different ages
- collect and give relevant information and support to the parents of pediatric patients
- identify and relate to psychosocial needs among pediatric patients and their families
General competence
Upon completion of this module, the student should have acquired attitudes and skills that:
- ensures empathy with sick children and their families including the children’s siblings
- views the children and their families as active collaborators
Subject: Medical ethics
Learning goals
Upon completion of this module, the student should have gained insight in ethical issues in paediatrics, gynaecology, obstetrics, perinatal medicine, and global health.
Learning outcomes
Knowledge
Upon completion of module 6, the student should be able to:
- explain important arguments in the ethical debates on biotechnology, prenatal diagnosis and abortion
- explain important ethical arguments in debates about global health
- describe the rights and roles of the child, next of kin and the doctor, respectively,
Skills
Upon completion of module 6, the student should be able to:
- outline a systematic ethical analysis of treatment decisions in neonatal medicin
General competence
Upon completion of module 6, the student should be able to:
- reflect critically on how decision-making authority in paediatrics ought to be distributed between doctors and parents
Subject: Medical genetics
Learning goals
At the end of the module the student should be able to make use of medical genetic knowledge in the clinical situations, counseling for family planning, pregnancy, perinatal period, infancy, and childhood.
Learning outcomes
Knowledge
Upon completion of this module the student should be able to describe and explain:
- different sampling methods for prenatal diagnosis (amniocentesis, chorionic villus sampling, first trimester screening, NIPD), including advantages and disadvantages
- process and procedure of genetic preimplantation diagnosis (PGD)
- genetic conditions requiring medical treatment which come to attention in pregnancy or in newborns and in childhood
- incidence and prevalence of genetic disorders in newborns and infants
- the most prevalent congenital malformations (isolated malformations) and their causes
- approaches to diagnostics and management of complex developmental defects (genetic syndromes)
- indications for referral to genetic counseling and to clinical genetic investigations in newborns, infants and children.
- strategies and particular challenges associated with diagnosis and management of rare genetic disorders
Skills
Upon completion of this module the student should be able to:
- recognize and describe dysmorphic features in a child
- take a relevant family history and communicate with the parents in an empathic manner
- recognize when to refer to clinical genetic investigations, genetic counseling, and national reference centers for rare diagnoses
General competence
Upon completion of this module the student should be able to reflect on:
- possible indications for and ethical aspects of genetic prenatal diagnosis and induced abortion
- ethical issues regarding treatment of children with severe congenital genetic disorders
Subject: Public Health (global health)
Learning goals
The student should know leading explanations for inequity in health globally, and be able to identify dominant policies and suggest solutions. The student should through the course see the relevance of global health knowledge for a future health practitioner working in an increasingly interconnected world.
Learning outcomes
Knowledge
Upon completion of this module the student should be able to describe and explain:
- major global health challenges including reproductive and child health, communicable diseases, pandemics, immunization and antibiotic resistance, non-communicable diseases and injuries, and public health approaches to treat and prevent them
- central actors involved in global health work on the global arena
- national health systems including different organizational models and financing
Skills
Upon completion of this module the student should be able to:
- discuss strengths, weaknesses and differences between horizontal and vertical initiatives to improve health
- discuss the impact of historical, social, economical and political determinants of health globally including urbanisation, migration, conflicts and climate change, and identify efforts to influence these
- discuss different health and disease measures to understand global health inequalities
General competence
Upon completion of this module the student should be able to:
- avoid stereotyping people, nations and continents
- promote equity in health care
- reflect on the role of doctors as global health advocates
Subject: Clinical biochemistry
Learning goals
To learn necessary concepts in basic clinical biochemistry and principles of quality aspects of laboratory results for a correct application and interpretation in pediatrics, gynecology and obstetrics.
Learning outcomes
Knowledge
Upon completion of module 6 the student should be able to:
- describe deviations in endocrine markers in: adrenal cortex disturbancies, pubertas precox, infertility, abnormal pregnancy and menopause
- describe diagnostic tests for anemias, nutrition deficiencies, and the diagnostic tests applied in the newborn screening program
- explain the most important biochemical changes in acute newborn conditions
- explain important biochemical changes relevant for diagnostic purposes in patho-physiological states in pediatrics, obstetrics and gynecology
Skills
Upon completion of module 6 the student should be able to:
- prepare the patients adequately to obtain a correct specimen collection
- handle the specimen correctly to preserve high pre-analytic quality
- interpret the laboratory results with respect to the biological reference ranges and assess the results critically in light of the clinical picture
- interpret patterns of deviations from a combination of analytes
General competence
- reflect on biochemical markers used in diagnostics and monitoring, -and the clinical utility and limitations