21

9. CHILD HEALTH, DEVELOPMENT AND AGEING BLOCK (CHDA)

9.1 An Overview of the Block 23
9.2 Course Organisers and Contact Details 24
9.3 Block Aims and Objectives 26
9.4 Orientation 33
Guys/St Thomas Campus 33
Kings College Hospital Campus 34
Princess Royal University Hospital Campus 35
University Hospital Lewisham Campus 36
9.5 Outside and Overseas Attachments 37
9.6 Symposia Information 38
9.7 Aims and Objectives for Symposia 38
9.8 Seminar Titles 41
9.9 Aims and Objectives for Seminars (Medicine and Psychiatry of Old Age) 42
(For Paediatrics & Child Health Seminar Aims and Objectives please refer to Paediatrics
Seminar Guide)
9.10 Recommended Reading and Computer-Aided Learning 46
22
9.1 An Overview of the Block
Introduction
The Child Health Development and Ageing (CHDA) course arose from a shared vision of the similarities in a number
of respects between the clinically disparate specialties of geriatric medicine and paediatrics. The course incorporates
dermatology - a clinical specialty highly relevant across the age spectrum - and palliative medicine. At Kings College
Hospital, Guys and St. Thomass and Princess Royal University Hospital there are two introductory
seminar/symposia weeks and one final seminar/symposia and revision week. The remaining 9 weeks of the block
consists of 3 weeks of paediatrics (including hospital paediatrics, community child health and the care of the
newborn) and child psychiatry based at GST or KCH; for those students based at KCH and GST, a 3-week
placement in paediatrics at a local DGH, or at a hospital in the Overseas Exchange Programme, or at a hospital
arranged independently; and 3 weeks of Medicine and Psychiatry of Old Age. Students at University Hospital
Lewisham & Princess Royal Hospital (Orpington) have a fully integrated block, with seminars throughout the 12
weeks, and equivalent paediatric experience obtained during 8 weeks on campus, as well as 4 weeks of Medicine
and Psychiatry of Old Age.
The Block has a series of seminars covering Medicine and Psychiatry of Old Age, Paediatrics, Dermatology, Child
Psychiatry and Palliative Medicine. The symposium programme is integrated across the CHDA block as a whole.
Thus the changes in drug handling (pharmacokinetics) across the age spectrum from neonate to extreme age are
considered in the Therapeutics Across the Ages symposium jointly run by a geriatrician and a paediatrician.
Similarly, communication problems and abuse, violence and neglect are all considered from a multidisciplinary stand-
point.
It is expected that students will not only acquire the attitudes, knowledge and skills appropriate to the clinical
disciplines but also the attitudes and knowledge relevant to the consideration of ageing and its implications.

The Medicine & Psychiatry of Old Age
The Medicine and Psychiatry of Old Age module brings the medicine and psychiatry of old age together. It includes a
small but crucial component of palliative medicine. The strength of this joint approach between medicine and
psychiatry is that it not only enables overlap areas to be taught jointly (e.g. seminars on delirium, and the law) but
also ensures that the two subjects are taught in an integrated manner. The core curriculum includes a variety of
conditions that students should be familiar with. This familiarity can be achieved by self-directed learning, clerking
patients and presenting cases to teachers as well as by attending bedside teaching sessions. The sub-block aims to
strike a balance between clinical teaching and self-directed activities. In addition to the skills logbook, where formal
assessment of clinical skills will be documented, students will be given guidance as to the range of cases they should
see. Medicine and Psychiatry of Old Age is taught in the seminars symposia and, importantly, in the clinical setting
including the ward, outpatient clinics, Day Hospitals and community teams.

Dr Thomas Ernst, Consultant acute physician and geriatrician

Paediatrics, Child Health & Child Psychiatry
Whether you choose to become a GP, work in an A&E, as a surgeon or even a Paediatrician - at some point in your
career you will have to look after children. This block offers you the only real focused opportunity to develop the skills
you need to do this before you qualify. Children differ from adults in many ways. It is not just the difference in
physiology, pharmacokinetics and spectrum of pathology that you need to be aware of. Children need their doctors to
understand them in the context of their families and society and to consider their developmental, social and
educational needs. You also need to develop skills to communicate with both children and their often anxious
parents.
During your attachment in Paediatrics you will spend time in Neonatology, Community Paediatrics, Child Psychiatry,
and Dermatology. Learning about children's medicine starts with an in-depth knowledge of basic child sciences and
a clear understanding of how and why children, especially babies, differ from adults. Once the first two years of life
are past most children in developed countries live healthy lives but they can easily be blighted by conditions that are
readily preventable through accident control, immunisation, wholesome food, parental education and clean water.
The way we teach paediatrics and child health is changing. The emphasis is on knowing where to look rather than
keeping vast stores of knowledge in one's head. We will try to point the way through formal teaching. We hope you
will appreciate that child health is best promoted through teamwork and that you learn much from therapists and
nurses. Your real teachers are children and their parents. Learn how to listen to them.
Dr Simon Waller Consultant Paediatric Nephrologist & Lead for undergraduate Paediatric teaching
Dr Simon Hannam, Department of Neonatal Paediatrics, KCH and head of phase 4
23
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9.2 Course Organisers and Contact Details
Paediatrics and Child Health
GST
020 7188 7188
KCH
020 7737 4000
PRUH
01689 863000
UHL
020 8333 3000
Dr Simon Waller
Simon.Waller@gstt.nhs.
uk

0207 188 4586 (Sec)
Dr Simon Hannam
020 7737 4000
ext 4644
simon.hannam@
kcl.ac.uk

Adm: Ms Emma Jones
e.jones1@nhs.net
020 7848 5224
Dr Riaz Ahmed
riaz.ahmed@nhs.net
Dr Dorothy Garvie
020 8333 3030 ext 3127
dorothy.garvie@uhl.nhs.uk
Sec: Ms Sue Crome
020 8697 3450
sue.crome@uhl.nhs.uk
Child Psychiatry
GST
020 7188 7188
KCH
020 7737 4000
PRUH
01689 863000
UHL
020 8333 3000
Iris Rathwell
Iris.Rathwell@slam.nhs.
uk.
Dr Teresa Lax-Pericall
020 7346 3219
teresa.lax-pericall@
slam.nhs.uk
Dr B Kessel
01689 865851
Belinda.Kessel@nhs.net
Malcolm Wiseman
malcolm.wiseman@slam.nh
s.uk
Community Paediatrics
GST
020 7188 7188
KCH
020 7737 4000
PRUH
01689 863000
UHL
020 8333 3000
Dr Ros Healy
0203 049 8143
ros.healy@
southwarkpct.nhs.uk
Dr Ann Lorek
020 7414 1400
ann.lorek@
southwarkpct.nhs.uk
Dr Sujata Sharma
020 8466 9988
Sujata.Sharma@
bromleypct.nhs.uk
Dr G Siggers
Sec Sharon Nelson
Georgie.siggers@lewishamp
ct.nhs.uk
Sec. Sharon Nelson
sharon.nelson@lewishampct
.nhs.uk
Dermatology
GST
020 7188 7188
KCH
020 7737 4000
PRUH
01689 863000
UHL
020 8333 3000
Dr Rachael Morris-Jones
rachael.morris-jones@
nhs.net
Dr Rachael Morris-Jones
rachael.morris-jones@
nhs.net
Dr Karen Watson
01689 865070
karen.watson7@nhs.net
Dr Pui Banerjee
Pbanerjee@nhs.net
Sec: Ms Sandra Burlington
020 8333 3030 ext 6181
Medicine of Old Age
GST
020 7188 7188
KCH
0203 299 6071
PRUH
01689 863000
UHL
020 8333 3000
Dr Tom Ernst
Tel: 020 71882516
Email:
Thomas.ernst@gstt.nhs.
uk
Dr Rohan Pathansali
pathansalir@aol.com


Dr Belinda Kessel
01689 865851
Belinda.Kessel@nhs.net
Dr Ian Starke
020 8333 3379
ian.starke@uhl.nhs.uk or Dr
Mehool Patel
mehool.patel@uhl.nhs.uk
ext 6609
Neonatology
GST
020 7188 7188
KCH
020 7737 4000
PRUH
01689 863000
UHL
020 8333 3000
Dr Morag Campbell
020 7188 4031
morag.campbell@
gstt.nhs.uk
Dr Simon Hannam
020 7737 4000 ext 4644
simon.hannam@kcl.ac.uk
Dr Riaz Ahmed
riaz.ahmed@nhs.net
Dr Dorothy Garvie
020 8333 3000 ext 3127
dorothy.garvie@
uhl.nhs.uk

Psychiatry of Old Age
GST KCH PRUH UHL
24
020 7188 7188 020 7737 4000 01689 863000 020 8333 3000
Dr Vivenne Mak
020 7411 6201
vivienne.mak@
slam.nhs.uk
Dr Nicola Funnell
Nicola.Funnell@slam.nhs.uk
Sec: Jean Anderson
020 32281620
Dr Cherian Sebastian
0208 462 3183
Cherian.Sebastian@Oxleas.
nhs.uk
Dr Cait Goddard

Cait.Goddard@slam.n
hs.uk

Palliative Medicine
GST
020 7188 7188
KCH
020 7737 4000
PRUH
01689 863000
UHL
020 8333 3000
Dr Rob George
020 7188 4721
rob.george@gstt.nhs.
uk

Dr Polly Edmonds
020 3299 4060
polly.edmonds@kcl.ac.uk
Dr Louise Exton
01689 865667
louise.exton@harrishospiscar
e.org.uk
Dr Katie Emmitt
katie.emmitt@
uhl.nhs.uk
PRUH Student Coordinator
Shayron Beesley
01689 864347
Shayron.Beesley@nhs.netuk
UHL Student
Coordinator
Samantha Newman
020 8333 3030 ext
8734
samantha.newman@
uhl.nhs.uk

25
9.3 Block aims and objectives
Paediatrics & Child Health
1. Attitudes
You should develop appropriate attitudes during the
course, which will include:

a child-centred approach
respecting the developing rights through
childhood




sharing with the patients an advocacy role
2. By the end of the paediatric course you should be
able to:
recognise when a child is ill
explain the importance of prevention in child
health
demonstrate the skills of obtaining a history
from parent and child
adapt clinical examination skills to the needs
of the child
describe the difference between the child and
adult patient



recognise the importance of the stages of child
development
connect the clinical situation with basic
sciences (especially genetics and embryology)
analyse the role of the family, society and
environment
plan a management strategy for the individual
child patient
3. Emergencies
You should read about the initial management of the following paediatric emergencies during your paediatric
firms. You should have a chance to see some of these during your time on take.
cardio-respiratory arrest
acute asthma
upper respiratory tract obstruction (croup)
septicaemia (including meningococcal)
meningitis
status epilepticus
coma

dehydration (secondary to gastroenteritis,
diabetic ketoacidosis)
burns
the severely injured child (accident, child
abuse)
accidental poisoning
cardiac failure
4. Skills and procedures
You should be competent in the following skills:
take a history from a parent and child
examine a baby
examine a child
explain a common complaint to a child
make a developmental assessment of an
infant/child
demonstrate basic life support for a child
examine a childs ear
perform a screening examination on a newborn
baby

You should observe the following
Try to follow your patient through the
investigations or treatment so you can
appreciate the impact that these have on the
child and the family as well as familiarising
yourself with techniques
setting up of an IV infusion
insertion of a nasogastric tube
accurate measurement of height and weight
administration of nebulised bronchodilators
lumbar puncture ultrasound examination of
abdomen and head
CT, MRI scan
renal isotope scan
tracheal intubation
insertion of a chest drain
5. Preventive Paediatrics
It is important for you to understand the principles and methods in child surveillance and prevention such as
immunisation and screening. You should have the opportunity to participate in a developmental assessment
session, immunisation clinic and to discuss the importance and difficulties involved in child protection.
26
6. Core curriculum presentations
You should try to see examples of the following conditions. Using your contact with the child as the centre
of your learning, expand your knowledge of the epidemiology, pathology, clinical features and management by
reading around the subject. Try to clerk as many patients as possible, preferably one of each of the following
although some of the neonatal cases may not be directly accessible to you. There will be children with other
conditions and by clerking these also it will help you in your skills of history taking, clinical examination and creating
organised notes.
respiratory distress syndrome
oesophageal atresia +/- tracheo-oesophageal
fistula diaphragmatic hernia
chronic lung disease of prematurity bronchiolitis
asthma (3, 4)
cystic fibrosis (3,4)
innocent murmur
heart failure
patent ductus arteriosus ventricular
septal defect coarctation of aorta
Fallot's tetralogy arrhythmias
feeding difficulties (134)
failure to thrive: starvation (124)
vomiting (18)
diarrhoea (23)
coeliac disease constipation (24) faecal
incontinence (27) recurrent abdominal
pain (10, 11)
urinary tract infections (31, 32,33,36)
enuresis (32) vesico-ureteric reflux
nephrotic syndrome (10B) acute renal
failure chronic renal failure
hypertension (2B) rickets (91, 95)
sickle cell disease (5B) iron deficiency
(5B)
idiopathic thrombocytopenic purpura
leukaemia
haemophilia
tonsillitis (82)
febrile child (121)
chickenpox (102)
herpes simplex stomatitis (102)
febrile convulsions (69)
infectious mononucleosis (60, 82)
AIDS
epilepsy (69)
cerebral palsy (95) spina bifida
(95) developmental delay
(126) learning difficulties (126)
brain tumours
diabetes mellitus (1B)
short stature (125)
hypothyroidism delayed puberty
(125) acute otitis media (75, 76)
recurrent otitis media (75,76)
deafness (78) delayed speech
(126) Squint (87)
arthritis (92, 93)
eczema (104)
impetigo (105)
infestations (lice, scabies) (100)
osteomyelitis
child abuse (120, 94, 109, 124)
neglect
congenital dislocation of hip (95)
behavioural difficulties
anorexia nervosa
psychological response to illness
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Child Psychiatry
1. Attitudes:
Throughout the course, you should aim to be non -judgmental in understanding how a childs emotional and
behavioural status can result from abnormalities of the inter-relationship within the childs family, educational and
social life


2. Knowledge:
By the end of the course, you should be able to
describe:
major social and development phases in
children, social relationships (126)
family functioning and healthy child
development, socialisation
malparenting and family dysfunctional features
behavioural problems: pre-school
tantrum,aggression and defiance in older
children, the overactive child; eating disorders
(29, 58)

severe psychiatric disorders in children:
common features (59)
neuropsychiatric issues e.g. epilepsy, head
injury (63, 69)
child abuse (120)
assessment and treatment procedures in
Child and Adolescent Psychiatry
professionals and Agencies to contact for
helping child with emotional and/or
behavioural problems
substance abuse in children (52)
attempted suicide in children (51)
3. Skills:
You should observe:
Important features in taking a history from
parents, children, adolescents and a family
interview


Communication with children/adolescents of
different ages

Dermatology
1. Knowledge
By the end of the course you should be able to
describe the:
normal skin anatomy and physiology

scientific basis and pathogenesis of core skin
conditions
principles of treatment of the skin disease
the management of a patient with skin
disease
2. Skills
By the end of the course you should be able to:
take a dermatological history
take a drug history in relation to a skin
disorder
make a full skin examination for a common
condition

explain to a patient how to apply a skin
preparation
give health advice on the risks of excess sun
exposure
3. Core curriculum presentations
Nail disorders (97)
Hair loss (98)
Hairiness (99)
Pruritus (100)
Pigmented skin leisions (pigmentary disorders,
moles and melanomas) (101)

Acute rashes (102)
Chronic rashes (103)
Eczema and dermatitis (104)
Skin infections (105)
Bruising and purpura (106)
Lumps in the skin (107)

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Medicine & Psychiatry of Old Age
1. Attitudes
During the course, you should:
develop a positive attitude to ageing and older
people
recognise the value of older peoples
experience
appreciate the importance of equal right of
access to health and local authority services
be aware of the potential for health
improvement in older people

be aware of societal ageism and paternalism
be aware of patients' and relatives' reactions
to loss of function and bereavement
recognise the importance of physical and
psychological care for patients with advanced
incurable diseases and their carers
2. Knowledge
By the end of the course, you should be able to:
(a) Service Provision
list the health care professionals who comprise
the multidisciplinary team
describe the roles of these individuals with
reference to common clinical/situational
problems e.g. patients with stroke or fractured
neck of femur
describe the objectives and components of an
effective service for meeting the health care
needs of elderly patients
describe the interfaces between primary and
secondary health care services for elderly
patients

(b) Gerontology
describe the present and future population
structure with regard to age and predict the
implications of these changes for health care
delivery
outline the epidemiology of prevalent age
related disorders
discuss the main theories of ageing and the
physiological and biochemical changes in cell
biology associated with ageing
list the physiological changes seen in organs
with ageing and differentiate where possible
from pathology
outline (a) the concepts of functional reserve
and increased variability as applied to ageing;
(b) the causes, presentation and management
of elder and carer abuse

(c) Clinical medicine
recognise the non-specific presentation of
disease and the, often different, specific
presentations of disease in later life

recognise the presence of multiple pathology
and co-existence of chronic diseases
be aware of the effect of environment on
presentation and management
recognise common syndromes with which
patients present rather than restricting the
approach to the diagnoses that are made after
full assessment

(d) Primary/secondary care interface
describe the main community based agencies
in both public and voluntary sectors which
provide services for older people, what
services they provide and how these services
can be accessed
describe the roles of the GP and primary
health care team members in co-ordinating
hospital discharge
describe the indications for referral to hospital
based services: acute admission, outpatient
consultation, Day Hospital and domiciliary
visiting
clerk a new referral to the Day Hospital or
Community Mental Health Team and
contribute towards the formulation of a
problem list and plan of management. This
patient should be reviewed with a member of
the multidisciplinary team after at least two
visits
visit a community based facility for elderly
patients
describe the principles of management of
dying patients
describe the presentations and management
of carer fatigue
describe the meaning of the terms disability,
impairment and handicap and how disease
processes lead to disability, impairment and
handicap
3. Core curriculum presentations
You should try to see examples of the following
conditions:
Delirium (64)
Dementia (70)
Anxiety and depression (56, 57)
Falls, blackouts, syncope and their sequelae

Weight loss (19)
Common infective presentations (6,7)
Mobility problems (68)
Functional problems
Ankle swelling (9, 50)
Chronic skin ulceration (48, 49)
Weakness, tiredness and fatigue (60)
29
(63, 65, 69)
Bowel and bladder problems (31,32, 33,34)
Breathlessness (3,4)
4. Skills
By the end of the course you should be able to:
take a history and examine an older patient
and include an assessment of function
take a history from a third party on behalf of
an elderly patient
formulate a problem list and management plan
from presentation to discharge
perform a full examination & systematic
assessment of a patient with depression
perform a full examination & systematic
assessment of a patient with dementia

In addition, you should:
observe members of the core multidisciplinary
team consider the discharge arrangements for
patients needing an occupational therapy
home visit before discharge and home care
services after discharge.
have contributed towards a multidisciplinary
needs assessment of a patient prior to long
term placement including discussion with the
patient concerning the patient's wishes and
alternative strategies

Vertical Strand disciplines: an all age perspective

Communication Skills

You should be able to:
communicate with the young, their parents, elderly people and their relatives
develop good listening skills and empathic responses
explore the implications of different courses of treatment and check for understanding.
use appropriate verbal and non-verbal communication skills i.e.: effective listening, questions styles
and empathic responses
develop flexibility of every day use of language to match the child and parents and use or suggest
aids to help with explanation and follow up support
break news of serious illness and treatment to patients communicate effectively in clinical teams

Knowledge

1. Clinical Genetics
You should be aware of genetic conditions that affect children and adults, including late onset genetic
disorders and the genetic basis of common diseases. Areas to be covered include:
Assessment of children with developmental delay.
Unusual modes of inheritance and their clinical significance in paediatric disease, including chromosome
microdeletions, mosaicism and imprinting.
The use and limitations of genetic testing for diagnosis.
Counselling and ethical issues surrounding testing for genetic disease in children.
Issues surrounding pre-symptomatic testing for genetic disease - e.g. Huntingtons disease.
The Genetic basis of common diseases e.g. breast cancer.
New approaches to treatment for disease stem cells and cloning.

2. Clinical Pharmacology & Therapeutics
You should be able to describe the following:
changes in pharmacokinetics and pharmacodynamics across the ages
the application of these changes to prescribing
the factors leading to the excess prevalence of adverse reactions in older patients
the completion of a Yellow Card report to the Committee on Safety of Medicines
a prescribing checklist
the role of non pharmacological treatments in physical and mental illnesses, giving examples

3. Clinical Sciences
the embryology of kidneys, heart and enteric system in relation to paediatric nephrology, heart
murmurs and paediatric surgery
forensic pathology: sudden infant death syndrome (SIDS) and infanticide
nutrition and aspects of care
gerontology: socio-demographic issues of ageing
30

4. Ethics, the law & older people
confidentiality and patient autonomy
informed consent, capacity and competence
advance directives/living wills
medical intervention in advanced physical and mental illness
euthanasia
Power of Attorney
Court of Protection
Mental Health Act (relevant sections)

5. Palliative Medicine
symptom control
care of the dying patient, focussing on elderly patients
ethical issues at the beginning and end of life
communication skills - checking understanding and giving information sensitively

6. Pathology & Laboratory Sciences
nutrition: bone chemistry, bacteriology of gut, iron deficiency anaemia
abuse, violence and neglect: forensic pathology
dermatology: simple histopathology of core presentations
bacteriology and virology of common infections; common immunisations
basic haematological knowledge of sickle cell disease and childhood leukaemia
the correlation of autopsy with pre-mortem findings in the elderly

7. Primary Care and the Community Study
The community study offers students an opportunity to study the following topics from the perspectives
of the childs family and primary care:
Impact of new baby on mother and family social, cultural and psychological factors.
Infant feeding including breast feeding and weaning.
Child growth and developmental progress the 6 week check and use of parent held record
Immunisation
Parental stress presentation of children in A+E ; emergency care - lay and professional
perspectives
Non-accidental injury in primary care
Links to core curriculum
Professional attitudes (6)
Communication skills (7)
Knowledge: infant feeding problems (134); non-accidental injury (120); failure to thrive (124);
developmental delay (126); acute rashes (102) (immunisation)

8. Public Health
1. Epidemiology of common diseases
describe the basic epidemiological features of the following conditions; Paediatrics: infectious
disease, neural tube defects, asthma, sudden infant death; Medicine & Psychiatry of Old Age: stroke,
dementia, osteoporosis; Dermatology: skin cancer
demonstrate a clear understanding of the following epidemiological terms when applied to the above
diseases incidence, prevalence, crude mortality, age-sex specific death rates, standardised
mortality ratios, standardised death rates, population attributable risk, population attributable risk
fraction,
identify modifiable social and environmental risk factors for these diseases (eg. poverty, occupation,
housing, indoor air quality, outdoor air quality, smoking, obesity, diet, exercise)
interpret Standardised Mortality Ratios, odds ratios, relative risks, population attributable risks,
population attributable risk fractions and other epidemiological data as they relate to these diseases
And in addition for Paediatrics
interpret data on perinatal mortality, neonatal mortality and infant mortality to identify what measures
can be taken to improve outcome




31
2. Screening
apply the WHO (Wilson and Junger) criteria for screening to the following programmes and discuss,
using their knowledge from their clinical teaching whether these programmes are likely or unlikely to
fulfil the criteria: Paediatrics: neonatal screening; Medicine & Psychiatry of Old Age: osteoporosis
identify social and health service factors associated with low uptake of screening and strategies that
can be adopted to improve uptake
outline how screening programmes can be audited and evaluated
interpret data concerning the sensitivity, specificity and positive predictive value of tests used for the
above screening programmes and demonstrate an understanding of how they influence what
information should be given to patients if they undergo screening tests

3. Health promotion
describe primary, secondary and tertiary prevention of the following conditions, demonstrating an
understanding of measures that can be taken at an individual and population level to reduce the
incidence and/or prevalence of: Paediatrics: accidents, infectious disease, sudden infant death
syndrome, exposure to environmental tobacco smoke; Medicine & Psychiatry of Old Age: accidents
(including falls); Dermatology: skin cancer
and in addition for Paediatrics
describe the health benefits of breast feeding and discuss what measures can be taken at an
individual and population level to increase breast feeding rates

4. Infectious diseases
Paediatrics:
describe the rationale behind the current immunisation programme in children.
explain the importance of herd immunity
describe how diseases are notified and how this information can be used to monitor the epidemiology
of notifiable diseases
identify the major steps required in controlling an outbreak of meningitis in children
describe the epidemiology and public health measures required to prevent spread of threadworm,
head lice, scalp ringworm, scabies

5. Health Services
describe current important demographic changes in the UK and internationally
discuss how demographic changes in the UK could impact on the prioritisation of health services in
the UK
list factors that should be considered when deciding whether to invest resources in a new drug
treatment or health service

Students are reminded that the public health sciences does not wish to overburden students with factual
knowledge. However students are expected to be able to apply basic epidemiological, public health,
sociological and economic principles to the conditions above using their medical knowledge to identify
the issues that might be of relevance for that condition.