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Curriculum standards

Knowledge guides

LG19: Adolescent and young adult medicine

Key presentations and conditions

Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.

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Less common or more complex presentations and conditions

Advanced Trainees will understand these presentations and conditions.

Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.

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Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.

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Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

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Presentations
  • Academic and learning difficulties
  • Acute-on-chronic neurodevelopmental disability
  • Anxiety / Depression
  • Attention and concentration difficulties
  • Body image concerns
  • Bullying and other forms of victimisation and social exclusion
  • Chronic pain
  • Constipation
  • Diarrhoea
  • Dysmenorrhoea or heavy menstrual bleeding
  • Eating issues:
    • food refusal
    • picky eating
  • Family dysfunction
  • Fatigue / Tiredness
  • Gender identity concerns
  • Headaches
  • Loss of consciousness / Fainting
  • Medication / Treatment non-adherence
  • Physical violence
  • School refusal and excessive absenteeism
  • Self-harm
  • Skin concerns
  • Sleep disorders
  • Social media use concerns
  • Suicidal ideation
  • Transition from paediatric to adult care
  • Underweight / overweight
Conditions
  • Acne
  • Attention deficit hyperactivity disorder (ADHD)
  • Autism spectrum disorder (ASD)
  • Avoidant restrictive food intake disorder
  • Chronic fatigue syndrome
  • Chronic health conditions
  • Complex neurodevelopmental disorders
  • Contraception
  • Depression and anxiety
  • Diabetes
  • Disabilities and associated conditions
  • Disorders of pubertal development
  • Eating disorders
  • Epilepsy
  • Functional neurological disorders
  • Gender incongruence / dysphoria
  • Headaches
  • Menstrual conditions
  • Sexually transmitted infections
  • Substance use disorders

For each presentation and condition, Advanced Trainees will know how to:

Synthesise
  • recognise the clinical presentation
  • identify relevant epidemiology, prevalence, pathophysiology, and clinical science
  • take a developmentally comprehensive clinical history
  • conduct an appropriate examination
  • establish a differential diagnosis
  • plan and arrange appropriate investigations
  • consider the impact of illness and disease on patients and their quality of life when developing a management plan
  • consider the impact of illness and disease on growth and the bidirectional impact on education, peers, and family relationships
Manage
  • provide evidence-based management
  • prescribe therapies tailored to patients’ needs and conditions
  • recognise potential complications of disease and its management, and initiate preventative strategies
  • involve multidisciplinary teams
Consider other factors
  • identify individual and social factors and the impact of these on diagnosis and management
  • identify educational / vocational pathways
Presentations
  • Amenorrhoea
  • Electronic device addiction
  • Genital dermatology
  • Sexual abuse
  • Sexual dysfunction
  • Suicide attempt
  • Unexplained physical symptoms
Conditions
  • Complex post-traumatic stress disorder
  • Hypermobile Elhers–Danlos syndrome
  • Postural orthostatic tachycardia syndrome
  • Pregnancy

For each presentation and condition, Advanced Trainees will know how to:

Synthesise
  • recognise the clinical presentation
  • identify relevant epidemiology, prevalence, pathophysiology, and clinical science
  • take a developmentally comprehensive clinical history
  • conduct an appropriate examination
  • establish a differential diagnosis
  • plan and arrange appropriate investigations
  • consider the impact of illness and disease on patients and their quality of life when developing a management plan
  • consider the impact of illness and disease on growth and the bidirectional impact on education, peers, and family relationships
Manage
  • provide evidence-based management
  • prescribe therapies tailored to patients’ needs and conditions
  • recognise potential complications of disease and its management, and initiate preventative strategies
  • involve multidisciplinary teams
Consider other factors
  • identify individual and social factors and the impact of these on diagnosis and management
  • identify educational / vocational pathways
  • Brain development
  • Cognitive development and capacity to consent
  • Common causes of mortality and morbidity
  • Early developmental trauma and its impact on adolescent development
  • Epidemiology of alcohol and other drug use
  • Epidemiology of mental health and risk-taking behaviours
  • Normal and abnormal adolescent development, including normal and abnormal patterns of growth and pubertal development
  • Social determinants of health
Clinical assessment tools
  • ADHD assessment tools
  • Broad psychosocial assessment, including HEEADSS assessment
  • Mental health questionnaires
  • Mental state examination
Investigations
  • Blood tests
  • Electrocardiography (ECG)
  • Electroencephalography (EEG) / Neuroimaging
  • Medical imaging
  • Sexually transmitted infection investigations
  • ADHD:
    • management of sleep and other complications
    • non-pharmacological and pharmacological management of ADHD and comorbidities
    • regulations for prescribing stimulant medications
  • Adolescent development and stages:
    • cognitive development and psychosocial development
    • gender development and identity
    • normal and abnormal physical development
    • sexual development and identity
  • ASD:
    • awareness of behavioural modification techniques in adolescents and young adults with neurodevelopmental disorders
    • complications of ASD
    • medications used in management of ASD, including atypical antidepressants and antipsychotics
    • neurodiversity and need for supports to change during adolescence
    • role of allied health professionals when managing young people with developmental disabilities
  • Chronic pain:
    • non-pharmacological and pharmacological management of chronic pain and comorbidities
    • understanding the role of allied health and patient education
  • Eating disorders:
    • acute medical complications
    • liaising with allied health / mental health services
    • medical and nutritional stabilisation of malnutrition in eating disorders / management of in-patient eating disorders
    • refeeding syndrome
    • understanding psychological treatment approaches, including FBT and CBT-E
  • Education system:
    • impact of disrupted education
    • school access and educational support
    • school and education processes for young people with developmental delays / disabilities
    • school and post-secondary education structures
  • Engage and build rapport with adolescents and young adults:
    • HEEADSS assessment
    • interviewing young people by themselves
    • motivational interviewing
  • Families:
    • family domestic violence awareness and screening
    • impact of psychosocial issues on families and young people
    • improving communication within families
    • parenting strategies for young people with developmental difficulties and neurodiversity
    • range of parenting styles appropriate for adolescents and young adults
  • Gender dysphoria:
    • non-pharmacological and pharmacological management of gender dysphoria and comorbidities
    • understand the role of allied health and capacity assessment
  • Health policies, resources, and services:
    • availability of services in regional and remote communities
    • common barriers to health care
    • communication processes and relationships between acute care services, community centres, primary health, and private sector
    • delivery of health services within individual communities
    • education resources and support for young people with neurobehavioural and developmental conditions
    • local, regional, and national disability support accessibility, policies, services, and resources
    • local, regional and national public health policy and legislation affecting health and wellbeing of young people
    • managing young people with developmental disabilities and neurodiversity
    • role of government and non-government agencies
    • role of primary health, local, and community-based services
    • role of school health services for adolescents
  • Health status of priority populations:
    • Aboriginal and Torres Strait Islander peoples
    • culturally and linguistically diverse backgrounds, including young people in refugee and asylum seeker families
    • Māori and Pasifika peoples
    • neurodiverse young people
    • regional and remote communities
    • socioeconomically disadvantaged young people
    • unhoused young people
    • young people in out-of-home care / juvenile justice settings
    • young people with disability
  • Integrating mental health within medical settings
  • Manage chronic health conditions, including promoting adherence to treatment
  • Management:
    • biopsychosocial model and its application to patient care
    • importance and role of case conferences
    • role of allied health professionals when managing young people
    • use of motivational interviewing for behavioural change
    • use of patient-centred care with shared goal setting with young people
  • Mental health:
    • counselling and supporting distressed young people
    • management of common mental health conditions, both non-pharmacological and pharmacological
    • management of risk-taking behaviours, violence, and harm minimisation
  • Peers:
    • intimate partner violence and safe relationships
    • personal safety with social media
    • psychosocial impacts of bullying
    • psychosocial impacts of social media
  • Principles of effective health services for adolescents and young adults
  • Principles of trauma-informed care
  • Provision of health care:
    • assessing capacity and consent
    • legal aspects and limits to providing confidential health care
    • mental health risk assessment
  • Strengths-based care:
    • capability-based – build skills and promote participation
    • holistic – understand the context of young peoples’ lives
    • relational – partnership-, patient-, and family-centred
  • Substance use:
    • complications of substance use disorders
    • non-pharmacological and pharmacological management of substance use disorders
    • withdrawal management
  • Support adolescents and young adults transitioning to adult health care settings