Formação Geral de um Médico Autónomo

The general training intern doctor should be able to:

1. know the general principles of approaching an urgent patient, including Triage;
2. Adequately assess the severity of the clinical condition of an adult or paediatric patient, thus being able to identify the critical patient;
3. Manage the patient in a standardised way according to the ABCDE approach;
4. Systematically approach the patient with the most frequent pathologies in the emergency room;
5. Be able to differentiate situations of simple resolution from others that require referencing, more or less urgent;
6. Improve the skills to manage the patients and the communication with them and their families, approached apropos of the various taught subjects.

The general training intern doctor should be able to apply the adult and paediatric Basic Life Support algorithm, including the following competences:

1. Recognise the importance of the Basic Life Support by identifying each of the links in the chain of survival (early recognition, reanimation, defibrillation and stabilisation)
2. Adequately assess the conditions of safety for the rescuer, victim and third parties
3. Assess the victim's state of consciousness
4. Permeabilise the airway if it is clinically appropriate
5. Assess breathing
6. Identify the situations in which the victim should be put in a lateral recovery position and be able to do it
7. Request help from the emergency medical service
8. Do effective chest compressions
9. Do insufflations properly
10. Identify a situation of airway obstruction and classify it according to its clinical severity
11. Apply the airway clearance algorithm
12. Know how to use properly an automated external defibrillator (AED)

This module is intended to make known the Portuguese Health System and the organisation of the National Health Service, as well as the concepts of (including: evolution of the health level over time; measurement of health level, disease and health problems; health determinants; Primary Health Care; levels of prevention; health promotion) public health and Health Planning (including: the definition of health planning; population-based versus institutional-based planning; strategic, tactical and operational planning; concept of health program and project; planning articulation at the three geographical levels: national, regional and local), among others.

The general training intern doctor should be able to:

1. Recognise the threat of antibiotic resistance and health care associated infections;
2. Understand the general principles of microbiology and antibiotic resistance;
3. Know the good practices of diagnosis and prescription concerning the main infections and the importance of the support programmes to the prescription of antimicrobials;
4. Identify early and approach the patient with sepsis;
5. Know the general principles on infections associated with health care and infection prevention, and control and epidemiological surveillance;
6. Do a proper hand hygiene, by identifying the moments in which it should be done;
7. Implement personal protection measures, by knowing the available equipment and the contexts in which their use is recommended;
8. Know the indications for the different types of isolation (contact, droplet and airway) and measures to be instituted;
9. Know in which circumstances it is indicated and how to act in order to do the screening for the major infections;
10. Know the good practices in invasive procedures and prevention of the main infections associated with health care.

The general training intern doctor should be able to:

1. Know the basic ethical and deontological aspects inherent in the medical practice, including the most relevant principles, values, codes and laws that govern it.
2. Be familiar with the CDOM, namely in what concerns:

• the doctor-patient relationship, respect for autonomy, free choice and refusal of treatment, as well as the right to conscientious objection or refusal of assistance;
• the patient's consent, the duty of information and professional secrecy, including the management of the clinical file and information and its transmissibility;
• the issues related to the beginning and end of life, transplantation, medically assisted procreation and sexuality and gender;
• the scientific research and human experimentation, the conduct of clinical trials and the relationship with industry;
• the relationship with peers and third parties, in particular with regard to the duty of solidarity, aid and cooperation, and the social and legal responsibility of the doctor.

3. Understand the implications of the legislation currently in force concerning data protection.
4. Master techniques that enable a proper communication with the patients, their relatives and other health professionals.

The general training intern doctor should be able to:
1. Know the 4 questions of blood use:
A) Who?
- Know the most frequent genetic and oncological pathologies with transfusion requirements in the different age groups.
B) When?
- Know the most frequent urgent and chronic clinical situations
C) Which ones?
- Know the criteria for choice and prescription
- Know the expected benefits
D) How many?
- know the calculation criteria for prescription and administration;
- know its impact on the analytical results of monitoring the clinical situation.

2. Know the 4 R’s of blood use:

A) References:
- know legal norms
- know the DGS norms
- know the referral network of Immunohemotherapy

B) Risks:
- Know the risks associated with administration
- Know the appropriate management of risk / benefit

C) Response Speed:
- Recognise and treat speedily acute haemorrhages and adverse effects.

The general training intern doctor should be able to:
A - Know the main Complementary Diagnostic Tests and their application in different areas:
1. Laboratory area
a) Know the laboratory tests within the scope of prevention, screening, prognosis, diagnosis, treatment and monitoring of human diseases and the physiological balance state.
b) Rational prescription.
c) Know how to interpret the analytical results.

2. Imaging Area
a) Know the different methods of imaging assessment.
b) Rational prescription and most frequent clinical indications.
c) Recognise risks and contraindications.
d) Interpret conventional radiology exams in an emergency context.

3. Electrocardiogram
Know the fundamentals and basic principles of ECG interpretation.