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Study-Unit Description
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CODE MDS4015

 
TITLE Geriatric Medicine, Oncology and Palliative Care

 
LEVEL 04 - Years 4, 5 in Modular UG or PG Cert Course

 
ECTS CREDITS 5

 
DEPARTMENT Faculty of Medicine and Surgery

 
DESCRIPTION The programme builds upon teaching programmes MED1 and MED2 and MED4013 and MED4014.

It is of necessity that one assumes, as background, a platform-knowledge of clinical medicine, basic clinical methods and at least 18 months’ clinical experience with regard to both in-patient and out-patient care.

In addition to clinical medicine the programme also addresses topics in social medicine, clinical ethics, clinical pharmacology, rehabilitation medicine and care of the terminally ill.

Structure of the programme: A. teaching methods, B. assessment.

A. Teaching methods.

1. Classroom-based integrated teaching sessions aimed at imparting basic principles of geriatrics, clinical oncology and palliative care. All of the sessions in geriatrics are in the form of seminars and address clinical problems that cut across several medical specialties.
2. The programme of lectures in oncology/palliative care is symptom-specific, and not system-specific, in order to reflect actual medical practice. The lectures are designed to address common clinical problems, disease processes, ancillary investigations and priorities in management/rehabilitation.
3. Tutorials: interactive small-group teaching sessions aimed to focus on problems related to geriatrics, gerontology and care of patients with cancer: in terms of clinical methods, communication skills and interpretation of investigative data. Whenever possible real patients are involved in teaching.
4. Clinical attachments: specific consultant physicians.
5. Log-book. The Department of Medicine has a proforma electronic logbook that spans the last three years of the course of studies. The logbook, driven by learning objectives and expected competences, gives precise details for the acquisition of clinical skills.

B. Assessment

General aim: test both presence of knowledge and its practical application.

One three-hour paper divided into two sections: 1. geriatrics and 2. oncology/palliative care.

Objectives of the written examination are twofold: to assess the ability to think critically about diagnosis and management and to ensure that the candidate has a satisfactory base of factual knowledge.

The examiners shall determine and document the correct answers to both sections at the time that the papers are set. Any multiple-choice paper shall be marked on the ‘negative-marking’ principle, awarding one mark for every correct answer and deducting one mark for every incorrect answer. The weighting of each section is subdivided proportionately.

Study-unit Aims

1. To introduce geriatrics/gerontology and oncology/palliative care to students who have already acquired c proficiency in general internal medicine, general pathology and basic clinical methods.
2. To present an integrated approach involving the clinical disciplines, pathology and clinical pharmacology as a reflection of actual day-to-day clinical practice.
3. To provide guidance for the acquisition of knowledge as basis to health and medical care of the elderly and of patients with cancer.
4. To provide an order of priority and a theoretical complement to the acquisition of clinical skills.
5. To provide details on the mode of action and clinical use of various classes of drugs used in the specific medical conditions: neurology: epilepsy, Parkinson’s, Alzheimer's and other movement disorders; forensic medicine: drugs of abuse; paediatrics.
6. Use formal lectures and tutorials to enhance case based learning and provide an understanding of drug safety.
7. To provide details on the mode of action and clinical use of various classes of drugs used in relation to Geriatric, Oncology and Palliative Care conditions.
8. Use formal lectures and tutorials to enhance case based learning and provide an understanding of drug safety in relation to Geriatric, Oncology and Palliative Care conditions

Learning Outcomes

1. Knowledge & Understanding:

By the end of the study-unit the student will be able to:
1. apply the knowledge gained through the study of geriatrics and oncology /palliative care to clinical practice.
2. access information sources and carry out an appropriate literature search.
3. critically appraise published medical literature.
4. use information technology including hospital based electronic sources such as iSoft, PACS and census databases.

CPH

5. show an understanding of basic principles involved in clinical pharmacology and therapeutics specific classes of drugs specifically antimicrobial drugs and drugs used in relation to Geriatric, Oncology and Palliative Care conditions.
6. describe the various scientific principles underlying the actions and uses of these specific classes of drugs in the clinical setting in relation to Geriatric, Oncology and Palliative Care conditions.
7. recognise the importance of understanding the mode of action and clinical use of these classes of drugs in relation to Geriatric, Oncology and Palliative Care conditions.
8. list the clinical principles involved in the selection of these classes of drugs to the individual patient in relation to Geriatric, Oncology and Palliative Care conditions.
9. predict the effects of these classes of drugs in specific patients in relation to Geriatric, Oncology and Palliative Care conditions.
10. outline the concept of individualised drug therapy in use of these classes of drugs in relation to Geriatric, Oncology and Palliative Care conditions.

2. Skills:

By the end of the study-unit the student will be able to:
1. communicate with elderly patients by taking a structured history while being aware of any sensory and/or intellectual impairment.
2. communicate with empathy and understanding with a patient diagnosed to be suffering from cancer and its complications.
3. carry out a comprehensive clinical examination appropriate to the medical condition.
4. assess a patient’s mental status.
5. plan and interpret appropriate investigations.
6. match appropriate drugs to a specific clinical context.
7. assess psychological and social factors and the impact of illness.
8. devise and discuss the rationale and practicalities of a basic management plan, including rehabilitation.
9. discuss the theoretical aspects of diagnosis, possible complications and management options.

CPH

10. show an understanding of the knowledge of the mode of action of drugs to specific clinical scenarios in the use of specific classes of drugs specifically antimicrobial drugs and drugs used in relation to Geriatric, Oncology and Palliative Care conditions.
11. show an understanding of the basic pharmacological principles in prescribing decisions for these classes of drugs in relation to Geriatric, Oncology and Palliative Care conditions.
12. predict inter-patient variability with respect to drug response in these classes of drugs in relation to Geriatric, Oncology and Palliative Care conditions.
13. explain the selection of differing drug therapies in these drug classes for the individual patient in relation to Geriatric, Oncology and Palliative Care conditions.

Main Text/s and any supplementary readings

Textbooks as suggested for the whole three-year teaching programme in medicine. No specific books on geriatrics or oncology/palliative care are suggested:

1. Clinical Medicine. Parveen Kumar & Michael Clark, Saunders, 8th Edition, 2012. Chap 10. Palliative medicine and symptom control. M J Johnson, G Eva and S Booth Eds.
2. Macleod's Clinical Examination. Graham Douglas, Fiona Nicol, Colin Robertson. Churchill Livingstone. 12th Edition, 2009.
3. Oxford Handbook of Clinical Medicine. Murray Longmore, Ian Wilkinson, Edward Davidson, Alexander Foulkes, OUP. 8th Edition, 2010.

Online resources:
http://emedicine.medscape.com/
http://www.medicalstudent.com/

Recommended Clinical Pharmacology text books:

1. Humphrey P. Rang HP, Dale MM, Ritter JM, Flower R. Rang & Dale's Pharmacology. Churchill Livingstone. 6th Ed.
2. Grahame-Smith D, Aronson J. Oxford Textbook of Clinical Pharmacology and Drug Therapy. Oxford University Press. 3rd Ed.
3. Bennett PN, Brown MJ. Clinical Pharmacology. Churchill Livingstone. 10th Ed.
4. British National Formulary. Pharmaceutical Press.

Reference/Additional:

1. Brunton L, Lazo J, Parker K. Goodman & Gilman's The Pharmacological Basis of Therapeutics. McGraw-Hill Medical. 11th Ed.
2. Waller DG, Renwick AG, Hillier K. Medical Pharmacology and Therapeutics. Saunders. 3rd Ed.

Lecture notes:

1. Reid JL, Rubin PC, Walters MW. Clinical Pharmacology and Therapeutics (Lecture Notes). Blackwell. 7th Ed.
2. Neal MJ. Medical Pharmacology at a Glance. Wiley-Blackwell. 6th Ed.

 
STUDY-UNIT TYPE Lecture, Independent Study & Placement

 
METHOD OF ASSESSMENT
Assessment Component/s Resit Availability Weighting
MCQ & Examination (2 Hours) Yes 100%

 
LECTURER/S Stephen Abela
Stephen Brincat
George Bugeja
Joseph Cordina
Brian Farrugia
Peter Ferry
Anthony Fiorini
Marise Gauci
Pierre Mallia
Rachel Antonia Micallef
Doreen Pace
Nicholas Refalo
Mario Vassallo
Antoine Vella

 
The University makes every effort to ensure that the published Courses Plans, Programmes of Study and Study-Unit information are complete and up-to-date at the time of publication. The University reserves the right to make changes in case errors are detected after publication.
The availability of optional units may be subject to timetabling constraints.
Units not attracting a sufficient number of registrations may be withdrawn without notice.
It should be noted that all the information in the study-unit description above applies to the academic year 2017/8, if study-unit is available during this academic year, and may be subject to change in subsequent years.
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