Curriculum standards
Curriculum standards
Advanced Training in Clinical Pharmacology
Knowledge guides
LG13: Clinical pharmacology by system
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
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.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.
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.
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.
Presentations
- Patients referred for care
Conditions - cardiovascular
- Arrhythmia
- Heart failure
- Hyperlipidemia
- Hypertension
Conditions – dermatological
- Cellulitis
Conditions – endocrine
- Diabetes:
- type 1
- type 2
- Thyroid disorders:
- hyperthyroidism
- hypothyroidism
- thyroid nodules
- thyroiditis
Conditions – gastrointestinal
- Acid peptic disease:
- gastritis
- gastroesophageal reflux disease (GERD)
- peptic ulcer disease
- Motility disorders:
- gastroparesis
- irritable bowel syndrome (IBS)
Conditions – haematologic
- Anaemia
Conditions – kidney and urinary system
- Kidney failure:
- acute injury (AKI)
- chronic (CKD)
Conditions – musculoskeletal
- Arthritis:
- osteoarthritis
- rheumatoid arthritis
- Gout
- Musculoskeletal disorders:
- fibromyalgia
- osteoporosis
- soft tissue injury
Conditions – nervous system
- Epilepsy
- Neuropathies
- Stroke
Conditions – respiratory
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Pneumonia
- Pulmonary embolism
AIM
- Multimorbidity
- Psychiatric comorbidities
Geriatric syndromes
- Cognitive impairment
- Delirium
- Dementia
- Falls
- Fractures
- Incontinence
- Vertigo
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
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
Presentations
- Patients referred for care
Conditions - dermatological
- Cancer – skin
- Infection
- Psoriasis
Conditions – haematologic
- Cancer
- Clotting disorders
- Leukaemia
- Lymphoma
Conditions – immune
- Autoimmune disorders
- Deficiencies
- Systemic lupus erythematosus (SLE)
Conditions – kidney
- Glomerulonephritis
- Nephrotic syndrome
Conditions – neurological
- Multiple sclerosis
Conditions – reproductive system
- Infertility
- Menstrual disorders
- Prostate conditions
- Sexually transmitted infections
Less common conditions
- Genetic disorders, rare
PCH
- Neonatal abstinence syndromes
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
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
- Anatomy and physiology of organ systems
- Clinical sciences, epidemiology, and pathophysiology of the conditions listed above in ‘Key presentations and conditions’
- Clinical sciences of therapies used to treat cancer, such as:
- chemotherapy
- radiotherapy
- Impact of drugs on organ systems, such as:
- bone health, such as:
- bisphosphonates
- kidney function
- bone health, such as:
- Pharmacology and toxicology of medications to treat or manage the conditions listed above in ‘Key presentations and conditions’, such as:
- cardiovascular conditions:
- angiotensin II receptor blockers (ARBs)
- angiotensin-converting enzyme (ACE) inhibitors
- anticoagulants
- antiplatelets
- calcium channel blockers
- HMG CoA reductase
- loop diuretics
- thiazide and thiazide-like diuretics
- endocrine conditions:
- antiresorptive
- biguanides
- carbimazole
- dipeptidyl peptidase-4 (DPP4)
- glucagon-like peptide 1 receptor agonist (GLP1RA)
- insulin
- sodium-glucose cotransporter 2 inhibitors (SGLT2i)
- sulfonylureas
- thyroxine
- gastrointestinal conditions:
- aperients
- proton pump inhibitors
- haematologic conditions:
- antiplatelets
- direct oral anticoagulants (DOACs)
- heparins
- low molecular weight heparin (LWMH)
- warfarin
- immune conditions:
- steroids
- nervous system conditions:
- anaesthetics
- analgesics
- anti-epileptics
- antipsychotics
- respiratory conditions:
- bronchodilators
- inhaled corticosteroids (ICS)
- long-acting beta-agonists (LABA)
- long-acting muscarinic antagonists (LAMA)
- short-acting beta agonists (SABA)
- cardiovascular conditions:
- Cardiovascular disease (CVD) risk assessment tool
- New York Heart Association (NYHA) classification for heart failure
- Angiogram – coronary
- Apolipoprotein B and lipoprotein (a)
- Blood pressure monitoring
- Blood tests
- CT / MRI – cardiac
- ECG
- Echocardiogram
- Electrophysiology study (EPS)
- Holter monitor
- Lipid profile
- Natriuretic peptides – NT-proBNP, PMN
- Troponin test
- Ultrasound – kidney, such as hypertension investigation
- Urine albumin-creatinine ratio (ACR)
- Coronary artery bypass grafting (CABG)
- Percutaneous coronary intervention (PCI)
- Valve replacement or repair
- Body mass index (BMI)
- Biopsy – fine needle aspiration
- Catecholamines and metanephrines
- Dexamethasone suppression test
- Diabetes autoantibodies
-
Glucose:
- continuous monitoring
- fasting plasma
- oral tolerance test
- Haemoglobin A1C (HbA1c)
- Hormonal investigation
- Renin-aldosterone ratio
-
Thyroid function tests, such as:
- free T3
- free T4
- thyroid stimulating hormone (TSH)
- Ultrasound – thyroid
- Urine ACR
- Hormone replacement therapy
- Insulin therapy
- Thyroidectomy
- Bristol Stool Scale
- Gastrointestinal Symptom Rating Scale (GSRS)
- Colonoscopy
- CT
- Endoscopy – upper
- Gastric emptying study
- Helicobacter pylori testing
- Oesophageal manometry
- pH monitoring
- Ultrasound – abdominal
- Biopsy – liver
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Polypectomy
- Biomarkers test
-
Radioimaging, such as:
- CT
- x-ray
- Ferritin levels
- Haemoglobin levels
- International normalised ratio (INR)
- Biopsy – bone marrow
- Coagulation profile
- Complete blood count (CBC)
- Flow cytometry
- Blood transfusion
- Stem cell transplantation
- Therapeutic phlebotomy
- Allergy symptom score
- Clinical activity score (CAS) for autoimmune diseases
- Allergy testing
- Autoantibody tests
- Human immunodeficiency virus (HIV) and immunodeficiency tests
- Immunoglobulin levels
- Administration of biologic agents
- Immunotherapy
- Plasmapheresis
- Chronic kidney disease epidemiology collaboration (CKD-EPI) equation
- Urine ACR
- Biopsy – kidney
- CT – urogram
- Glomerular filtration test
- Serum creatinine and estimated glomerular filtration rate (eGFR)
- Ultrasound – kidney
- Urinalysis
-
Dialysis:
- haemodialysis
- peritoneal
- Transplantation – kidney
- Disease activity score in 28 joints (DAS28) for rheumatoid arthritis
- Range of motion (ROM) measurements
- Visual analogue scale (VAS) for pain
- Arthroscopy
- Biopsy
- Bone density scan (DEXA)
- MRI
- X-ray
- Fracture repair
-
Surgery:
- arthroscopic
- joint replacement
- Glasgow Coma Scale (GCS)
- Mini-Mental State Examination (MMSE)
- Montreal Cognitive Assessment (MoCA)
- CT – brain
- EEG
- Lumbar puncture
- MRI – brain
- Carotid endarterectomy
- Deep brain stimulation (DBS)
- Neurosurgical interventions for tumours
- Asthma control test (ACT)
- Chronic obstructive pulmonary disease (COPD) assessment test (CAT)
- Pulmonary function tests
- Bronchoscopy
-
Chest tests:
- CT
- x-ray
- Spirometry
- Biopsy – lung
- Mechanical ventilation for critical care
- Thoracentesis
-
Importance of informatics within health care, such as:
- electronic health records
- health roundtables
- hospital-acquired complications
- Management of oncological conditions with therapies, such as chemotherapy and radiotherapy
- National and local guidelines for the quality use of medicines