SCOPE OF PRACTICE GUIDELINES

FOR LICENSED HEALTHCARE

PROFESSIONALS (FAMILY MEDICINE)

JULY 2022

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Contents

1. Introduction ............................................................................................................................. 3
2. Purpose .................................................................................................................................... 3
3. Definition ................................................................................................................................. 4
4. Basic Core Competencies ........................................................................................................ 4
5. Core Practice ............................................................................................................................ 7
6. Clinical Practice Areas.............................................................................................................. 7
7. References ............................................................................................................................. 19

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 Scope of Practice Guidelines for Licensed Healthcare Professionals
Document Title
(Family Medicine)
DOH/GDL/FAMILY
Document Ref. Number Version 1
MEDICINE/SOP/
Effective Date 14 July 2022
Previous Versions n/a
Document Owner Healthcare Workforce Planning Division
All Healthcare Professionals mentioned in this document who are
Applies to licensed by DOH and are working in different healthcare settings in the
Emirate of Abu Dhabi.

1. Introduction
The Department of Health (DOH) is responsible for regulating the practice of Healthcare
Professionals in the Emirate of Abu Dhabi. A system of licensing and examination has been
established to ensure that licensed healthcare professional is fit and safe to practice within the
guidelines set by the DOH

2. Purpose
The purpose of this document is to outline the roles & responsibilities that Family Medicine
physicians, once licensed, are permitted to perform, as shown in their respective licensures
issued by the DOH as well as the privileges granted to them based on their competencies with
the healthcare facility they practicing in.

Note: Healthcare Professional may be privileged by individual health care facilities to perform
certain procedures beyond this scope after showing evidence of competency by training and
a system to ensure maintenance of this competency. Healthcare Professionals are required
to maintain and enhance their professional knowledge and skills within their scope of practice,
through self-assessment, continuous learning and professional engagement.

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3. Definition
3.1 Family medicine is the medical specialty, which provides continuing, comprehensive
healthcare for the individuals and their families. It is a specialty in breadth that integrates
the biological, clinical and behavioral sciences.
3.2 The scope of practice of family medicine physicians encompass all ages, both genders,
each organ system and every disease entity. They focus on meeting the entire family needs
and providing care for the whole person throughout his/her life, from birth to old age
through a holistic approach.
3.3 Family Medicine physicians are trained in several subspecialties to provide comprehensive
health care for people of all ages. A Family Medicine physician diagnose and treat acute
and chronic illnesses as well as provide routine preventive health screenings and counsel
patients on lifestyle changes. They focus on the health of the whole person combining
physical, psychological and social aspects of care.
3.4 The mood of care delivery includes face to face encounters, community out-reach
services, tele-medicine, and other utilizations of artificial intelligence

4. Basic Core Competencies

4.1 Medical Knowledge and Expertise
4.2 Patient Centered Care
4.3 Interpersonal and Communication Skill
4.4 Professionalism
4.5 Continue Medical Education and Research
4.6 System-Based Practice
4.7 Leadership and Health Advocate
4.8 Maintaining Trust

4.1 Medical Knowledge and Expertise

4.1.1 Demonstrate knowledge of the basic sciences and medical conditions.
4.1.2 Perform and interpret diagnostic tests and procedures.
4.1.3 Apply management plans for patients.
4.1.4 Recognize critical medical conditions, initiate management, and escalate as appropriate.
4.1.5 Develop management plans in collaboration with the health care team and patient’s family
members.
4.1.6 Demonstrate awareness of personal limitations regarding knowledge, procedures and
experience in the care of patients and escalates appropriately.
4.1.7 Demonstrate an understanding of medico-legal issues.

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4.2 Patient Centered Care:
4.2.1 Provide high-quality and safe patient-centered care.
4.2.2 Perform patient-centered clinical assessment and establish management plans.
4.2.3 Counsel patients and family members.
4.2.4 Make informed diagnostic and therapeutic decisions, prescribe and perform essential
medical procedures.
4.2.5 Order and perform management and clinical procedures for the purpose of assessment.
4.2.6 Treat patients politely and considerately and respect patients’ right to confidentiality.
4.2.7 Serve as patient advocates in all health-related matters, including the appropriate use of
specialists, health services, and community resources.
4.2.8 Serve as a counsellor and advocate to effectively improve the health of patients, families
and communities.

4.3 Interpersonal and Communication Skill:

4.3.1 Communicate professionally and work effectively with the other caregivers and staff
members, to provide best care for the patient and ensure patient safety, confidentiality
and privacy.
4.3.2 Engage patients and their families in developing plans that reflect the patients’ healthcare
needs and expected outcomes.
4.3.3 Establish professional relationships with patients and their families, and communicate
care effectively with them in a way they can understand with professional manners with
sympathy and compassion.
4.3.4 Elicit and synthesize accurate and relevant information, incorporating the perspectives of
patients and their families.
4.3.5 Use shared decision making to align patient/family values, goals, and preferences with
treatment options to make personalized care plans.
4.3.6 Listen to and respond to patients concerns and preferences.
4.3.7 Give information in a way that they can understand.
4.3.8 Respect the right of patient to reach decisions about their care and management.

4.4 Professionalism:
4.4.1 Show commitment to the health and well-being of individual patients and community
through ethical practice, high personal standards of behavior, as promised and as
expected by public, institutes and other caregivers.
4.4.2 Practice within their own limits and within ethical and professional frameworks, and seek
help when needed.
4.4.3 Conduct themselves honestly, including reporting accurately and acknowledging own
errors.
4.4.4 Prioritize patients ' welfare and community benefit above self - interest.

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 4.4.5 Recognize and respect the personal and professional integrity, roles, and contribution of
peers.
4.4.6 Protect patients ' rights to privacy and confidentiality.
4.4.7 Understand and practice according to current community and professional ethical
standards and legal requirements.
4.4.8 Deliver highest quality care with integrity, honesty and compassion.

4.5 Continue Medical Education and Research:

4.5.1 Engage in continuous improvement and professional development through on going
learning through CME “continuous medical educations”.
4.5.2 Facilitate the learning of students, trainees, other healthcare professionals, and the
public.
4.5.3 Keep up to date with the new guidelines and evaluate new research that might benefit
their patients and the community.
4.5.4 Refer to evidence - based clinical guidelines and critically analyze medical literature.
4.5.5 Use appropriate educational techniques to promote understanding of health and disease
amongst patients as well as to facilitate the learning of peers, junior colleagues, and other
health professionals.
4.5.6 Use personal performance data to analyze, reflects on, and institute behavioral change
to narrow the gap between expectations and actual performance.
4.5.7 Provide supervision for junior colleagues.
4.5.8 Understand research methodology and the process for designing a research project.

4.6 System Based Practice:

4.6.1 Work effectively in various health care delivery settings and systems relevant to family
practice.
4.6.2 Coordinate patient care within the health care system.
4.6.3 Incorporate considerations of risk benefit analysis in patient care.
4.6.4 Advocate for quality patient care and optimal patient care systems.
4.6.5 Identify system errors and implement solutions.

4.7 Leadership and Health Advocate:

4.7.1 Demonstrate leadership in professional practice.
4.7.2 Work effectively in multidisciplinary teams.
4.7.3 Contribute to the improvement of healthcare delivery in teams, organizations and systems
using appropriate channels.
4.7.4 Maintain personal health and wellbeing and consider health and safety of juniors, peers,
senior colleagues, and other health professionals.
4.7.5 Participate and engage in health promotion.

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4.8 Maintaining Trust:
4.8.1 Never discriminate unfairly against a patient or a colleague.
4.8.2 Never abuse patient’s trust in you or public trust in profession.
4.8.3 Ensure maintaining confidentiality of patient information and data based on policies and
regulations.

5. Core Practice
The core practice outlines the types of clinical procedures that a Family Medicine Physician is
permitted to perform using evidence based medical practices and based on his/her training,
competency, and facility practice set up:
5.1 Evaluation, diagnosis, treatment of common medical conditions of all ages.
5.2 Provide the necessary medical patient and family education and counselling.
5.3 Provide preventative services periodically based on the DOH regulations and guidelines.
5.4 Assessment and determine the disposition of patients with emergent conditions.
5.5 Follow up with patients.
5.6 Refer patients to more specialize services when needed in collaboration with other
Healthcare Professional.

6. Clinical Practice Areas

6.1 Adolescent Health:
6.1.1 Communicate effectively with the adolescent patient and his or her family to establish
and maintain therapeutic relationships.
6.1.2 Demonstrate sensitivity and responsiveness to the adolescent patient’s needs.
6.1.3 Monitor the development and growth during the adolescent years to include physical,
mental, emotional, and sexual milestones.
6.1.4 Use appropriate assessment tools to ensure acquisition of comprehensive information
in adolescent patients.
6.1.5 Identify, evaluate, and counsel the core conditions that may affect the health of an
adolescent, such as family problems, mental health, depression, school failure,
obesity, eating disorders, violence, drug abuse, and sexually transmitted diseases
(STDs).
6.1.6 Emphasize the importance of exercising on weight, mood, and overall health.
6.1.7 Screen patients for eating disorders, interpret body mass index (BMI), provide
counseling regarding obesity risk factors, make recommendations for nutrition and
activity, and referrals for specialty care when needed
6.1.8 Provide preventive services, immunizations, health promotion, and guidance to
adolescent patients during wellness visits, routine care visits, and acute care visits.
6.1.9 Perform and interpret screening tests including cholesterol, diabetes, thyroid, cardiac,
hormonal test, etc.
6.1.10 Assess blood pressure in the context of normal ranges for age and height.
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 6.1.11 Use appropriate and effective approaches to assess and support smoking cessation

6.2 Allergy and Immunology:

6.2.1 Perform a comprehensive history and physical examination with special emphasis on
the diagnosis of allergic and immunological conditions.
6.2.2 Identify, evaluate, diagnosis, and manage allergic and immunologic conditions
including but not limited to rhinitis, dermatitis, asthma, urticaria, immunodeficiency,
hypersensitivity reactions and anaphylaxis.
6.2.3 Counsel the patients and their families about the proper techniques to avoid
environmental triggers for allergic conditions.
6.2.4 Consult with other healthcare professionals in the management of critical care
situations and refer when needed.

6.3 Cardiology:
6.3.1 Perform history and physical examination and develop an appropriate differential
diagnosis, as well as plan for further evaluation and management.
6.3.2 Apply evidence-based knowledge regarding primary, secondary, and tertiary
prevention of cardiovascular disease
6.3.3 Make an initial diagnosis to the symptoms that might be cardiac in origin such as:
Chest pain, breathlessness, ankle swelling, symptoms/signs thought to be caused by
peripheral vascular disease (arterial and venous), palpitations and silent arrhythmias,
symptoms/signs of cerebrovascular disease as strokes and transient ischemic
attacks, dizziness and collapse.
6.3.4 Use clinical tools and laboratory tests to assess and calculate cardiovascular risk such
as: Blood pressure (BP) measurement, electrocardiogram (ECG), 24-hour ambulatory
BP, measurement, venous dopplers and ankle brachial pressure index (ABPI)
measurement, able to interpret and perform 24 hr ECG Holter or event recorder and
refer patients who have an abnormal holter reading for further investigations such as
Stress ECG, Echo, etc.
6.3.5 Develop management plans to improve the care of patients with cardiovascular
disease according to evidence-based practice.
6.3.6 Provide patient education that clarifies disease processes, promotes prevention, self-
care, and evidence-based management
6.3.7 Demonstrate an ability to perform cardiac resuscitation and procedures necessary to
stabilize a patient experiencing a cardiac emergency

6.4 Care of the Surgical Patient:

6.4.1 Demonstrate the knowledge, skills and ability to deal with surgical emergencies or
appropriately refer the patient as needed.

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 6.4.2 Maintain and show evidence of the skills required to independently and safely perform
minor surgical procedures including but not limited to local anesthesia, incision and
drainage of cysts and abscesses, needle aspiration, foreign body removal, minor burns
management, wound debridement and closure, nail surgery, cryosurgery (liquid
nitrogen), repairing lacerations, etc.

6.5 Chronic Disease Management & Chronic Illness Care:

6.5.1 Perform comprehensive history taking and physical examination to help in the
diagnosis of the chronic disease and risks related.
6.5.2 Assess and monitor the impact of the chronic disease to the quality of patient life, level
of function, and mental health.
6.5.3 Identify, diagnose and manage, chronic diseases including but not limited to
hypertension, diabetes, asthma, chronic obstructive pulmonary disease, chronic
kidney disease and others.
6.5.4 Assess and monitor chronic pain, level of function, and quality of life parameters.
6.5.5 Identify physiologic changes in the various body systems such as: diminished
homeostatic abilities, altered metabolism, effects of drugs, and other changes relating
to the chronically ill patients.
6.5.6 Understand and identify the disease related physiologic changes in the various body
systems through active screening, assessment and investigations on a regular basis
based on the disease and patient specific risks.
6.5.7 Aware and follow up on asthma management plan.
6.5.8 Evaluate opioid abuse risk using a validated screening tool and review patients’
medications list as well as adjust treatment plans based on diagnosis and risk for
opioid abuse.
6.5.9 Interpret urine toxicology screening tests.
6.5.10 Able to monitor patients on warfarin.
6.5.11 Maintain a patient centric, holistic, coordinated, multidisciplinary approach toward
patient care and treatment.
6.5.12 Refer patients to more specialize services when needed.
6.5.13 Promote for health through patient education that includes encouraging a healthier
lifestyle, involving the patient and family in care decisions, and promoting self-
management.
6.5.14 Coordinate admissions and inpatient care within the hospital system.

6.6 Dermatology:
6.6.1 Diagnose and manage common skin diseases such as: Acne, Actinic Keratosis,
alopecia and hair disorders, bacterial infections, bites and stings, contact dermatitis,
cutaneous viral infections and exanthems, dermatologic manifestations of sexually
transmitted infections, Eczema and atopic dermatitis, fungal skin infections,
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 hyperpigmentation and hypopigmentation, Infestations (lice, scabies, bedbugs,
schistosome cercarial dermatitis, myiasis), Lichen planus and bullous/vesicular
diseases, nail disorders, nevi, Psoriasis, Rosacea, Seborrheic dermatitis, skin ulcers
and pressure sores, Urticaria and drug eruptions
6.6.2 Perform common dermatologic procedures as scraping skin for fungus determination,
inserting sutures and repairing lacerations, cryotherapy and incising and draining
abscesses and other procedures based on physician training and privilege.
6.6.3 Identify life threatening dermatological emergencies.
6.6.4 Promote for skin wellbeing through health education, promotion and disease
prevention strategies appropriately.

6.7 Emergency and Urgent care:

6.7.1 Identify and respond to emergencies and perform initial urgent care management to
stabilize the patient.
6.7.2 Understand the principles of care through range of medical management to include:
6.7.3 Consultation, disposition, mass casualty and disaster planning as cascaded by the
incident commander and coordination of care with appropriate healthcare
professionals and caregiver, prioritization and triage, reassessment and monitoring,
resuscitation and stabilization.
6.7.4 Assess and perform initial management for the following areas:
6.7.4.1 Trauma:
6.7.4.1.1 Blunt trauma (e.g. heart, lung, intra-abdominal organ rupture).
6.7.4.1.2 Penetrating trauma (e.g. gunshot, stab wounds).
6.7.4.1.3 Wounds of head and neck, spine and spinal cord, facial, soft tissue, chest,
abdomen, extremities, genital and urinary.
6.7.4.2 Psychiatric emergencies: such as acute alcohol withdrawal, acute anxiety and
panic disorders, acute mania, addictive disorders, overdose syndromes, delirium
and altered mental status, homicidal ideation, suicidal ideation plans and attempts,
hysterical conversion, management of the combative patient, mood disorders, risk
assessment and involuntary commitment of a mentally disordered person,
utilization of mental health services in the emergent setting.
6.7.4.3 Environmental disorders: such as bites and stings, burns, electrocution and
lightening injuries, heat and cold injuries, hypersensitivity reactions and
anaphylaxis, poisonous plants.
6.7.5 Obstetric and gynecological emergencies such as acute pelvic pain, ectopic
pregnancy, emergency contraception, precipitous delivery, pre-eclampsia and
eclampsia, sexual assault and rape, threatened or spontaneous abortion, vaginal
bleeding.

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 6.7.6 Recognize, stabilize, perform initial management and refer patient with common
primary care conditions acute life-threatening conditions in the emergency and urgent
care setting such as:
6.7.7 Acute cardiovascular disorders, acute endocrine disorders, acute gastrointestinal
disorders, acute genitourinary system disorders, acute musculoskeletal disorders,
acute neurologic disorders, acute respiratory disorders

6.8 End of Life Care/Palliative Care:

6.8.1 Follow up the plan of care for terminally ill patients based upon a comprehensive
interdisciplinary assessment.
6.8.2 Define the level of treatment intervention according to the individual patient.
6.8.3 Identify and manage different types of pain and understand the commonly used drugs
in palliative care.
6.8.4 Prescribe opioids drugs effectively as needed.
6.8.5 Identify and manage the side effects of opioids such as nausea/vomiting, constipation,
opioid toxicity and pruritus.
6.8.6 Identify, assess, and manage potential problems such as acute pain crises, bowel
obstructions (gastric outlet, small bowel, and large bowel), constipation, delirium,
dyspnea, nausea/vomiting
6.8.7 Identify and manage potential emergencies such as neutropenic sepsis,
hypercalcemia, seizure, spinal cord compression and hemorrhage.
6.8.8 Deliver bad news compassionately and empathetically to both individuals and families

6.9 Genetics:
6.9.1 Identify the risk of a genetically linked disorder and provide appropriate counseling.
6.9.2 Use family medical history tools and/or genetics pedigree charts including a three
generational family history.
6.9.3 Understand the role of genetic tests in the assessment of people with developmental
delay, developmental disability and/or dysmorphic features and refer the patients
appropriately.
6.9.4 Recognition of the need for sensitivity to the patient's and family's concerns relating
to referral for genetic evaluation and diagnosis of a genetic disorder.
6.9.5 Recognition of the importance of confidentiality, ethical and legal issues involved in
medical genetics.

6.10 Geriatrics:
6.10.1 Perform comprehensive medical evaluation and assessment of the elderly including
the normal psychological, mental, physical, social, and environmental changes of
aging.
6.10.2 Develop treatment plans based on the medical and mental evaluation.
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 6.10.3 Identify the atypical presentation of common medical illnesses in the elderly.
6.10.4 Incorporate a systematic functional assessment in patient evaluations such as: Basic
activities of daily living (ADLs), instrumental activities of daily living (IADLs), mental
status and depression, mobility, including risk of falls, cognitive assessment using the
folstein and montreal cognitive assessment (MoCA), sensory assessment (vision and
hearing), bladder function, caregiver and social supports, use of sleep aids,
polypharmacy
6.10.5 Educate patients and their families on the safety issues related to physical changes
with age as well as patients’ functional needs to maintain independence, as
appropriate
6.10.6 Identify support services for older patients, as podiatry, visual and hearing aids,
immobility and walking aids, meals on wheels, home care services.
6.10.7 Ensure conducting the required health screening.
6.11 Men’s Health:
6.11.1 Perform a comprehensive men’s health history, including occupational, behavioral,
mental, psychosocial, and sexual history.
6.11.2 Perform comprehensive male physical examination, including a urogenital, rectal, and
prostate examination and perform related diagnostic procedures as uroflow
meter..etc.
6.11.3 Assess and refer presentation of male genitourinary problems.
6.11.4 Use appropriate and effective approaches to assess and support smoking cessation
and alcohol use.
6.11.5 Aware of genitourinary emergencies such as testicular torsion and penile injuries.
6.11.6 Implement health promotion and disease prevention through education about the
diseases affecting men of different age groups, their impact on health and life and the
preventive services that prevail in the male population.

6.12 Mental Health:

6.12.1 Evaluate patients for mental health disorders using appropriate techniques and skills.
6.12.2 Identify common signs and symptoms of common mental health disorders such as
mood disorders, anxiety disorders, psychotic disorders, substance abuse, and
personality disorders and refer when needed.
6.12.3 Identify psychiatric emergencies and refer when needed.
6.12.4 Identify physical child abuse and refer when needed.
6.12.5 Perform behavioral modification techniques such as stress management, smoking
cessation, obesity management and other lifestyle changes.
6.12.6 Work with behavioral and mental health professionals whenever possible to ensure the
best care for their patients.

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 6.13 Musculoskeletal:
6.13.1 Perform musculoskeletal history and physical examination.
6.13.2 Formulate differential diagnosis and recommend treatment, including appropriate
subspecialty referrals when needed.
6.13.3 Perform simple diagnostic procedures based on physician training and privilege as:
6.13.3.1 Aspiration and injection of joints, tendons, or bursae
6.13.3.2 Dislocations: simple/closed reduction
6.13.3.3 Preliminary Plain Radiograph interpretation
6.13.3.4 Fracture care: non-operative / non-displaced
6.13.3.5 Fracture care: closed reduction
6.13.3.6 Ganglion: aspiration / drainage
6.13.3.7 Casting, splinting, and bracing
6.13.4 Diagnose, identify red flags, and refer when needed the following:
6.13.4.1 Infection (septic arthritis or osteomyelitis)
6.13.4.2 Cancer (bony metastases and osteogenic sarcoma)
6.13.4.3 Fracture (fragility fracture in osteoporosis)
6.13.4.4 Inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis)
6.13.5 Formulate appropriate exercise recommendations and/or physiotherapy for diseases
such as diabetes and hypertension.
6.13.6 Screen and identify those patients at risk of systemic bone disorders, such as
osteoporosis and vitamin D deficiencies and provide the required support to ensure
their understanding of risks and prevention of fragility fractures as indicated.
6.13.7 Assess the clinical presentation, diagnostic criteria, and initial treatment for various
rheumatologic conditions such as: osteoarthritis, gout, rheumatoid arthritis, lupus
erythematosus, and polymyalgia rheumatic.
6.13.8 Assess the levels of disability relating to musculoskeletal conditions and refer when
needed.
6.13.9 Evaluate drugs dependency to treat long-term chronic pain and refer when needed.
6.13.10 Implement health promotion and disease prevention through appropriate education
about screening and prevention strategies related to musculoskeletal system.

6.14 Neurology:
6.14.1 Perform comprehensive neurological and neurodevelopmental assessments
6.14.2 Perform initial diagnosis, initial investigation and perform diagnostic procedures based
on physician training and privilege as nerve conductive study, neuro imaging...etc , and
primary care management of the following: Dementia, delirium, headache, peripheral
neuropathy, light headedness/vertigo, motor disorders, neurological complications
and comorbidities of developmental delay/mental retardation/learning disability,
tremor, neuralgia, concussion/traumatic brain injury, paresthesia, nerve palsies.

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 6.14.3 Identify potential drug interactions and adverse drug effects, especially in elderly
patients.
6.14.4 Treat acute neurological emergencies, such as status epilepticus.
6.14.5 Identify the neurological complications of systematic illnesses.
6.14.6 Identify the impact of chronic neurological conditions on a patient’s relationships,
occupations, social status and everyday function and refer when needed.

6.15 Nutrition:
6.15.1 Perform a comprehensive nutritional assessment including:
6.15.1.1 Medical, social, and diet histories
6.15.1.2 Physical examination
6.15.1.3 Anthropometrics (i.e., height, weight, BMI, and body-fat distribution
waist circumference and waist-to-hip ratios)
6.15.1.4 Laboratory tests and other diagnostic interventions as oligo-scan..etc
6.15.2 Understand and Identify:
6.15.2.1 Secondary malnutrition caused by systemic diseases
6.15.2.2 Weight loss strategies and counseling
6.15.2.3 Eating disorders
6.15.2.4 Use of dietary supplements
6.15.2.5 Prevention, recognition, and treatment of food-borne illness
6.15.2.6 Allergies and food intolerances
6.15.2.7 Enteral and parenteral nutrition
6.15.3 Counsel/refer patients regarding the nutritional recommendations.
6.15.4 Appropriate management plan for weight disorders including medication, health
education and referrals.
6.15.5 Identify patients who are at high risk for nutrition-related complications and refer them
to nutrition consultants who can provide counseling and education.
6.15.6 Use an evidence-based approach to assess the patient’s nutritional status and
determine the effectiveness of interventions.

6.16 Obstetrics and Gynecology:

6.16.1 Perform, evaluate, recognize, and differentially diagnose acute and chronic pelvic
pain, including recognition of emergencies.
6.16.2 Develop treatment plans for common conditions affecting female patients such as
reproductive tract diseases, genital tract infections, urinary tract infections, infectious
diseases, menstruation disorders, gynecology in older women, breast health and
screening, family planning and early pregnancy evaluation, post-partum health and
conditions.
6.16.3 Provide health promotion, disease prevention and periodic health evaluation such as:

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 6.16.3.1 Normal growth and development of females from puberty to
adulthood.
6.16.3.2 Normal physiology of reproduction in healthy women from puberty to
menopause
6.16.3.3 Diagnosis sexual responses and the diagnosis of sexual dysfunction
6.16.3.4 Recommendations on breastfeeding
6.16.3.5 Intrauterine device removal

6.16.4 Evaluate and counsel using evidence-based practice for:

6.16.4.1 Female nutritional needs
6.16.4.2 Cancer screening guidelines, including Human papillomavirus (HPV)
6.16.4.3 Immunization
6.16.4.4 Osteoporosis prevention
6.16.4.5 Smoking cessation
6.16.4.6 Oral health in pregnant and non-pregnant women
6.16.4.7 Cardiovascular disease in women

6.16.5 Perform pre-conceptual counseling in the areas of nutrition, contraception,

prevention of birth defects, optimizing health prior to conception, assessment of
immunization status, screening for preconception, exercise, and occupational
hazards assessment.

6.16.6 Antenatal Care:

6.16.6.1 Perform initial prenatal history and evaluation including clinical
assessment of gestational age.
6.16.6.2 Perform initial diagnosis and referral of abnormal gestations (e.g.
gestational trophoblastic disease, ectopic pregnancy).
6.16.6.3 Assess and manage symptoms of the first trimester.
6.16.6.4 Identify risk and perform screening for gestational diabetes, urinary
tract infection and complications, iron deficiency anemia, bacterial or yeast
vaginitis, asymptomatic bacteriuria, group B beta-hemolytic strep
screening, sexually transmitted diseases.
6.16.6.5 Identify and refer patients with the following medical conditions in
pregnancy: gestational diabetes, maternal hypothyroidism, hypertension,
maternal infections, intrauterine growth restriction (IUGR), placental
previa, and premature rupture of membranes.
6.16.6.6 Deal with psychosocial stressors of pregnancy associated with normal
and complicated pregnancies as well as first trimester pregnancy loss.
6.16.6.7 Knowledge of the medication’s pregnancy categories and their safety
of their use during pregnancy.
NOTE: NOTHING IN THIS DOCUMENT IS INTENDED TO REPLACE CLINICAL JUDGMENT. CLINICAL
JUDGMENT REMAINS WITH THE TREATING PHYSICIAN (S).

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 6.16.7 Peri-partum Care (Labor and Delivery)
6.16.7.1 Assess and refer emergency normal labor cases appropriately.
6.16.7.2 Understand the normal course of the third stage of labor, and the
steps involved to prevent excessive bleeding and reduce risk of
postpartum hemorrhage using the active management techniques as
described in Advanced Life Support in Obstetrics (ALSO).
6.16.7.3 Counsel patients regarding breastfeeding in the immediate post-
partum period.
6.16.7.4 Perform diagnostic procedures: as ultrasound, fetoscope…etc
6.16.8 Post-partum and neonatal care:
6.16.8.1 Provide comprehensive postpartum care by evaluating delayed
hemorrhage, postpartum fever and endometritis, pain, depression, thyroid
status, uterine infections, breastfeeding.
6.16.8.2 Identify normal neonatal growth and identify congenital anomalies.
6.16.8.3 Identify and refer Hepatitis B positive mother, neonatal respiratory
distress, jaundice, hypoglycemia, and neonatal fever.
6.16.8.4 Provide support for breastfeeding and guidance to new mothers.

6.17 Otolaryngology:
6.17.1 Assess and treat common acute and chronic conditions and recognize the red flags.
6.17.2 Investigate, diagnose and manage otolaryngology medical conditions.
6.17.3 Manage sore throats and reducing the incidence of progression to rheumatic heart
disease.
6.17.4 Manage acute emergency and chronic conditions such as: sleep apnea, sinusitis,
epistaxis and otitis media.
6.17.5 Detect and safely remove foreign bodies
6.17.6 Request and interpret test results.
6.17.7 Apply and utilize the screening and diagnostic tools for hearing disorders.

6.18 Ophthalmology:
6.18.1 Diagnose, manage, and refer common eye problems such as: Cataracts, conjunctival
disorders, corneal diseases, external muscular disorders, refractive errors, glaucoma,
iritis, optic nerve disorder, retinal disease, skin and adnexal disorders, trauma.
6.18.2 Identify red flags.
6.18.3 Identify common causes and treatment of acute and chronic visual loss and recognize
indications for screening examinations.
6.18.4 Identify the following:
6.18.4.1 Psychological and adaptive needs of patients with chronic ocular
deterioration
NOTE: NOTHING IN THIS DOCUMENT IS INTENDED TO REPLACE CLINICAL JUDGMENT. CLINICAL
JUDGMENT REMAINS WITH THE TREATING PHYSICIAN (S).

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 6.18.4.2 Effects of drugs and toxins on ocular function and disease
6.18.4.3 Effects of ocular drugs on systemic function
6.18.4.4 Ocular manifestations and complications of systemic disease
6.18.4.5 Ocular disability in elderly patients and the importance of regular
assessment and maintenance of functional capacity.
6.18.4.6 Ways of prevention of eye injury and vision loss.

6.19 Occupational Medicine:

6.19.1 Perform comprehensive occupational assessments and the appropriate physical
examination.
6.19.2 Assess fitness to work, perform pre-employment medicals and onsite assessments
when relevant.
6.19.3 Develop comprehensive treatment plans and identify possible long-term rehabilitation
symptoms.
6.19.4 Identify the effects of over-the-counter and prescribed medications on job
performance.
6.19.5 Provide preventive treatment in the form of vaccinations/ongoing surveillance
programs.
6.19.6 Manage health care worker exposure to blood/body fluid.
6.19.7 Apply and utilize the screening skills and tools for any health risks related to the
occupation.
6.19.8 Implement health promotion and disease prevention through appropriate occupation
hazards and exposures focused education.

6.20 Oncology:
6.20.1 Identify, assess and manage risk factors that contribute to cancer, such as lifestyle,
environmental, familial and dietary.
6.20.2 Utilize the screening programs and early detection tools to identify malignancies.
6.20.3 Identify common malignancies.
6.20.4 Identify and investigate significant symptoms, including those of metastatic disease,
and refer when needed.
6.20.5 Identify and manage common symptoms and side effects during or after treatment in
conjunction with the treating oncology team.
6.20.6 Perform relevant screening tests based on guidelines.
6.20.7 Discuss the benefits and risks of treatment options to patients and their families and
refer more specialized knowledge and advice.

6.21 Pediatrics:
6.21.1 Perform comprehensive age appropriate history.

NOTE: NOTHING IN THIS DOCUMENT IS INTENDED TO REPLACE CLINICAL JUDGMENT. CLINICAL

JUDGMENT REMAINS WITH THE TREATING PHYSICIAN (S).

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 6.21.2 Perform physical examination including use of growth charts and milestone
development.
6.21.3 Perform age appropriate screening services.
6.21.4 Perform a comprehensive physical exam of the newborn to screen for congenital
abnormalities
6.21.5 Diagnosis and treatment plan for common pediatric conditions.
6.21.6 Identify developmental delays.
6.21.7 Assess parent-child interaction (all ages and stages), family dynamics and family
functioning.
6.21.8 Identify, manage and appropriately refer infants and children with medical problems.
6.21.9 Provide appropriate anticipatory guidance and education for parents during the well-
child visits in specific areas including nutrition, dental care, sleep, safety, and
cognitive stimulation.
6.21.10 Understand children vaccination according to the childhood vaccination schedule
and manage the defaulters.
6.21.11 Knowledgeable about age-appropriate pediatric dosage, of age- and weight-specific
fluid, electrolyte, acid base, and nutritional needs for well child and common
illnesses.

6.22 Respiratory:
6.22.1 Identify, diagnosis, manage, and refer (when needed) common respiratory
diseases as asthma, chronic obstructive pulmonary disease, and interstitial
diseases.
6.22.2 Use an evidence-based approach to antibiotic prescribing for respiratory
infections.
6.22.3 Able to interpret spirometry results.
6.22.4 Implement health promotion and disease prevention through appropriate
education about the diseases, risk factors, preventive measures such as flu
vaccination for asthmatic patients.

6.23 Substance Use Disorders:

6.23.1 Perform comprehensive history regarding the patient’s substance use.
6.23.2 Identify the below commonly abused drugs, their physiologic effects and
metabolism, related withdrawal syndromes and to refer when needed: Tobacco,
alcohol, cannabis, sedative/hypnotics medication, opioids, buprenorphine,
methadone and other prescription medications, amphetamines, “Club” or
designer drugs, cocaine, hallucinogens, anabolic steroids, inhalants,
phencyclidine (PCP).
6.23.3 Assess the motivational stage of an addicted patient and refer when needed.

NOTE: NOTHING IN THIS DOCUMENT IS INTENDED TO REPLACE CLINICAL JUDGMENT. CLINICAL

JUDGMENT REMAINS WITH THE TREATING PHYSICIAN (S).

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 6.23.4 Educate patients and their family about the nature of addictions and that they
are chronic and relapsing disorders.
6.23.5 Use evidence-based resources for the diagnosis and management of substance
abuse.
6.23.6 Provide the required guidance and referral to the appropriate institutes to ensure
the safety of the addict and support the treatment and recovery as needed.
6.23.7 Comply with the medico legal regulations.

6.24 Travel Medicine:

6.24.1 Identify and be up to date through the appropriate channels and organizations
on the immunization requirements and specific preventive measures relating to
travel.
6.24.2 Prescribe immunization for the traveler going overseas.
6.24.3 Implement health promotion and disease prevention through appropriate
education about the location specific diseases, risk factors, and preventive
measures.

7. References

1. Curriculum Objectives by Clinical Domains. Department of Family Medicine - McGill

University. Last accessed: 22 December, 2020.
https://www.mcgill.ca/familymed/education/postgrad/curriculum-overview/clinical-
curriculum/objectives
2. Family Medicine Residency Curriculum Guidelines. The American Academy of Family
Physicians (AAFP). Last accessed: 22 December, 2020. http://www.aafp.org/medical-
school-residency/program-directors/curriculum.html
3. Privileging dictionaries. British Colombia (BC) Medical Quality Initiative. Last accessed:
22 December, 2020. http://bcmqi.ca/credentialing privileging/dictionaries/view-
dictionaries
4. https://www.acgme.org/Specialties/Overview/pfcatid/8
5. https://www.aafp.org/dam/AAFP/documents/medical_education_residency/progra
m_directors/Reprint278_Adolescent.pdf
6. https://www.aafp.org/afp/1999/0701/p305.html
7. https://cdn.mdedge.com/files/s3fs-public/jfp-archived-issues/1982-volume_14-
15/JFP_1982-12_v15_i6_pediatric-training-in-family-practice-a.pdf

NOTE: NOTHING IN THIS DOCUMENT IS INTENDED TO REPLACE CLINICAL JUDGMENT. CLINICAL

JUDGMENT REMAINS WITH THE TREATING PHYSICIAN (S).

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