Curriculum standards: LG11: Foundations of adolescent and young adult medicine

Knowledge guides

LG11: Foundations of adolescent and young adult medicine

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have in-depth knowledge of the topics listed under each clinical sciences heading.

For the statistical and epidemiological concepts listed, trainees should be able to describe the underlying rationale, the indications for using one test or method over another, and the calculations required to generate descriptive statistics.

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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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Brain development across adolescence
Characteristics of adolescence and young adulthood (10–24 years old) as a developmental stage, including changes across this period, and patterns of engagement with family and peers
Cognitive development and capacity to consent
Epidemiology and patterns of abuse, such as:
- emotional abuse
- exposure to domestic and/or family violence
- neglect
- physical abuse
- sexual abuse
- short- and long-term effects of abuse
Epidemiology of the common health conditions affecting adolescents, including:
- gender
- reproductive
- sexual
Injuries
Intellectual disabilities across adolescence, and how adolescent development might affect these, such as:
- Down syndrome
- fetal alcohol spectrum disorder (FAS-D)
- fragile X syndrome
Mental health
Normal and abnormal patterns of growth and pubertal development
Nutritional requirements
Physical disabilities, and how adolescent development might affect these, such as:
- cerebral palsy
- muscular dystrophy
- spina bifida
Principles of pharmacology, such as:
- chronic pain medications
- commonly used psychotropic medications
- gender-affirming hormones
- impact of growth and development on drug dosing and metabolism
- indications, contraindications, and side effects of:
  - medications for attention deficit hyperactivity disorder (ADHD)
  - medications to improve sleep
  - puberty blockers
Psychosocial screening, including rationale and different approaches
Public health significance of:
- health risk behaviours
- immunisations
- notifiable diseases
- sexually transmitted infections
Sexual and reproductive health issues, including menstruation and contraception
Substance use disorders

Common interventions

Allied health support
Cognitive behavioural therapy (CBT)
Family therapy
Family-based treatment (FBT)
Motivational interviewing
Psychopharmacology
Trauma-informed care

Common interventions

Body mass index (BMI)
Bone age tests
Bone mineral density tests
Comprehensive adolescent health assessment, including Home, Education / employment, Eating / exercise, Activities, Drugs and alcohol, Sexuality, Suicide and depression, Safety (HEEADSSS)
Genetic investigations, such as microarray and fragile X testing
Growth charts
Nutritional screening blood tests, such as ferritin, vitamin D, and other micronutrient screening
Physical examination, including Tanner staging (when appropriate and with consent)
Screening examinations and investigations, and their indications, such as:
- audiology
- blood pressure, including orthostatic measurement, heart rate (including orthostatic)
- cholesterol / lipids
- haemoglobin A1C (HbA1C) test
- hormone levels for pubertal assessment
- standardised questionnaires
- vision

Adolescent development and stages, such as:
- cognitive development
- gender identity exploration and consolidation
- physical change, including linear growth and puberty
- psychosocial
- sexual health and sexuality
Concepts of, and factors that support, resilience throughout the life course
Conceptual frameworks, such as:
- biopsychosocial model of health
- child protection frameworks and legislation
- harm reduction model
- life course perspectives, such as the triple dividend
- positive youth development
- resilience
- risk and protective factors
- social and commercial determinants of health
- transtheoretical model of change
- trauma-informed care
Confidentiality considerations, such as:
- balancing adolescent and parent perspectives
- limitations
- medicolegal frameworks
- principles of clinical ethics and autonomy
Developmental theories, and how these can be framed within contemporary knowledge of adolescent brain development, including:
- developmental tasks of adolescence
- emerging independence and cognitive, physical, and sociocultural development
- impact of trauma
- self-identity
Distinction between gender identity and sexual orientation
Education system considerations, such as:
- impact of disrupted education
- school access and educational support, especially for students with neurodiversity
- school and education processes for young people with cognitive, physical, and psychiatric / psychological disabilities
- school and post-secondary education structures
- school health, including health promotion and clinical services
Exploratory and risk-taking behaviours
Health policies, resources, and services:
- access to 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
- disability support accessibility, policies, services, and resources
- education resources and support for young people with neurobehavioural and developmental conditions
- managing young people with cognitive disabilities, neurobehavioural conditions, and neurodiversity
- public health policy and legislation affecting the health and wellbeing of young people
- role of government and non-government agencies
- role of primary health, local, and community-based services
- role of school health services for adolescents
Impact of family life, including:
- protective factors, such as:
  - improving communication within families
  - parenting strategies for young people with cognitive disabilities
  - range of parenting styles appropriate for adolescents and young adults (AYA)
  - supporting neurodivergent youth within the family
- risk factors, such as:
  - caregiver burnout
  - family and/or domestic violence awareness and screening
  - family separation and blended families
  - impact of psychosocial issues on families and young people
Impacts of bullying, including:
- face-to-face
- in schools
- online
- the role of bystander
Interaction between health and other services, such as mental health and substance use, and other sectors, such as education, housing, legal, welfare, and youth justice
Legal environment of the care of AYA, such as:
- capacity, consent, and refusal of treatment, including assessing capacity to consent and the mature minor concept
- child maltreatment, including recognition and reporting requirements
- confidentiality, including laws, concepts, and processes for safe-guarding privacy
- gender-affirming medical care
- guardianship issues
- indications for involuntary treatment
- mandatory reporting requirements
Medical implications in adolescence and adulthood of common procedures that occurred earlier in childhood, such as caecostomies, management of spasticity, and percutaneous endoscopic gastrostomy (PEG)
Prevalence and risk factors for physical violence, including intimate partner violence, in the local community
Principles of health promotion and harm minimisation
Principles of protective behaviours
Sleep hygiene
Specific health contexts, such as:
- Aboriginal and Torres Strait Islander peoples and Māori adolescents
- adolescents in custodial contexts, including on youth justice orders
- adolescents in out-of-home care
- adolescents whose parents have an addiction, mental illness, or a disability
- LGBTQIA+ adolescents
- neurodiverse adolescents
- pregnant and parenting adolescents
- refugee and asylum seeker families
- socioeconomically disadvantaged young people
- victims of physical and/or sexual abuse
- young people who are homeless or living in precarious housing
Supporting AYA transitioning to adult care settings
Techniques for engaging and communicating with AYA