Domain 1

Professional Values & Behaviour

HK Doctors Core Competences mapped to this domain:

Integration of basic, social and clinical sciences into the clinical context - Medical graduates should be competent in integrating the current knowledge in basic, social and clinical sciences and applying the knowledge to recognize, explain and manage health problems of patients.

Attitude and Professionalism - Medical graduates should be able to demonstrate an appropriate professional attitude and uphold important tenets of professionalism. These include altruism, accountability and responsibility, commitment to excellence and service, honour and integrity, respect for others, and adherence to standards of professional behaviour including appropriate attire and use of professional language.

Ethical understanding and legal responsibilities - Medical graduates should be able to grasp the ethical principles and to understand the legal responsibilities in the practice of medicine.

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Basic Training

Learning Outcomes
  1. Be committed to excellence, service, honour, integrity and respect of others.
  2. Take the interest and welfare of children as the first and most important consideration.
  3. Apply the knowledge of growth and development in the holistic care of Children and Young Persons (CYP).
  4. Demonstrate insight and recognize the limits of their capabilities in common emergency and non-emergency paediatric conditions.
Key Capabilities
  1. Act with altruism, accountability and responsibility.
  2. Respect the autonomy of CYP and their families in making informed decisions about medical care and assess their competence in doing so
  3. Foster constructive working relationships with healthcare professionals, CYP and their families taking into account of the effect of different cultural and religious backgrounds on patient care
  4. Reflect on one's own work
Illustrations
  1. Recognize and manage common pediatric emergency and non-emergency conditions,
  2. Explain management plans to CYP and families, involving them in decision making
  3. Obtain consent for common procedures by explaining the procedure, benefits, risks and potential complications
  4. Demonstrate the understanding of how the developing physiology, anatomy and psychology affect the care of CYP.
  5. Assess psychological and mental issues of CYP and refer to appropriate health professionals
  6. Seek help and advice from seniors and colleagues when encountering difficulty in patient management
  7. Make appropriate referrals to healthcare professionals for assessment and treatment
  8. Understand the importance of confidentiality in patient care.

 

Higher Training

Learning Outcomes
  1. Act in a way that is safe, appropriate and does no harm to the patients when handling a broad range of common paediatric conditions and emergencies as an independent clinician.
  2. Act as an example to junior colleagues in upholding professional and personal integrity.
Key Capabilities
  1. Apply knowledge of the principle of medical ethics and current local legislation related to the care of children and families.
  2. Manage more difficult clinical conditions and complex situations, seeking help when appropriate.
Illustrations
  1. Apply management guidelines in daily work when appropriate.
  2. Research for legal and ethical guidelines to support their work.
  3. Understand the local legislation regarding the welfare of CYP.
  4. Understand medical ethics pertaining to palliative care, end-of-life care and resolve situations where the beliefs of the CYP or the family may affect patient care.
  5. Advise junior colleagues when making difficult decisions and handling patient complaints.

 

Opinion Recieved by the Working Group for Curriculum Review

Opinions
To include Point -of-care Ultrasound skills in key capabilities, e.g. Basic echocardiogram for assessing left ventricular function (M mode), appreciating poor contractility, diagnosing pneumothorax, ultrasound guided blood vessel catheter insertion. (Dr Lawrence Chan, 27 Jan 2022)
  • Working Group Replies (16 Feb 2022): Thanks, Lawrence! The Group agrees that ultrasound usage is becoming an essential skill for paediatricians. In the backbone of a curriculum statement, we think it is appropriate to state a generic requirement of POCUS but without specifying the region and the usage. We think the specific skills e.g. detecting pericardial effusion can be listed in the syllabus of the relevant subspecialty. A trainee may acquire these skills according to their scope of training.
To change the following key capabilities to a new "Optional" category and to be listed in the illustration section (Dr Eric Lee, Dr Sabrina Tsao, Dr NC Fong and Dr SP Wu, 5 March 2022):​
  • Basic Training - Peripheral arterial catheterization (reason: it is considered a skill that is nice to have, but not absolutely mandatory for all paediatricians.)​
  • Higher training - Exchange transfusion. (reason: this procedure is increasingly rare)

To accept simulation training as an alternative to real patient training in the following key capabilities (Dr Eric Lee, Dr Sabrina Tsao, Dr NC Fong and Dr SP Wu, 5 March 2022):

  • Basic Training - Advanced airway management, including tracheal intubation​
  • Basic Training - Intraosseous need insertion
  • Basic Training - Use of epinephrine auto-injector
  • Basic Training - Chest drain and chest tube insertion, including needle thoracocentesis
  • Basic Training - Use of Automated External Defibrillators

To specify performing blood culture instead of "Microbiological specimen collection" to be more specific (Dr Eric Lee, Dr Sabrina Tsao, Dr NC Fong and Dr SP Wu, 5 March 2022)

Inclusion of reduction of pulled elbow and removal of foreign body from oropharynx with Magill forceps under Domain 3 (Dr Philip Sham)

Upon the drafting of syllabus, the Working Group agreed that red reflex examination is a mandatory skill during basic training. This applies to the newborns and young children for the detection of cataract and intraocular mass. (WGCR 29 Sept 2022)

Adding the word "holistic" in the Learning outcome of Domain 1 to emphasize the importance of whole person care (WGCR 29 November 2022)

Adding 'Physical and mental health" in key capability of Domain 4 to emphasize that emergency and serious conditions does not only refer to physical body, but also the mind (WGCR 29 November 2022)

Refine the scope of advocacy in the domains. Focus on injury prevention. The difference between "Illness Prevention" and "Disease Prevention"of domain 5 (Dr CB Chow, 7 March 2023)

Responses
 Reply from Dr SP Wu (7 March 2023)​
(1) The eleven domains are the same as the ones of the Progress Curriculum of RCPCH. The wordings originated from the GMC. We tried to map the domains to the "HK Doctors" document issued by the MCHK. In the latter document, the wording was "disease prevention" and not "illness prevention". The meaning of the word was taken loosely and we do not intend for a stringent literal distinction between illness and disease. I suppose illness is broader in a sense, although this is only my take on the word.
(2) I agree that injury prevention was only tangentially alluded to in the Safeguarding domain. I will bring this to the attention of the Working Group.
(3) "Taking the interest and welfare of children as the first and most important consideration" is a learning outcome in Professional values and behavior, although the word "advocacy" appears only in the syllabuses of "Adolescent Health" and "Community Paediatrics". I will discuss with the Working group if the advocacy should be included as a learning outcome.

 

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