Medicine I and Medical Specialities

Code:

M4_BM03

Acronym:

M1EM

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2020/2021 - 2S

Active?	Yes
Responsible unit:	Medical Teaching
Course/CS Responsible:	Integrated Masters Degree in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIM	79	Official Study Plan	4	-	15	144	405

Teaching language

Portuguese

Objectives

The student will have to fully integrate the knowledge acquired in the basic sciences with the knowledge acquired in the clinical disciplines. He will have to approach the patient with full integration of pathophysiology, semiology and clinic. He will have to recognize different clinical syndromes and different pathologies, integrating the anamnesis and physical examination; to acquire attitudes and competences in the recognition of the different clinical problems presented by the patient, to recommend a diagnostic strategy and to establish differential diagnoses in a reasoned manner. He will acquire and train his clinical reasoning. The student is expected to know how to elaborate a clinical research plan, namely which complementary diagnostic means (MCDT) should be requested, including its rigorous justification and correct interpretation and integration with clinical findings. Also, the student must know the indications, advantages and limitations of the different MCDT and must present a therapeutic plan and establish a prognosis. The student is expected to develop communication skills with peers and realize the need for multidisciplinary health work particularly in the patient's clinical approach. Finally, the student will have to establish an adequate physician-patient relationship and demonstrate total respect for the confidentiality and privacy of the patient.

Learning outcomes and competences

We intend that, at the end of the school period, the student, in front of a patient, should be able to fully evaluate him in its objective and subjective components and also that such step is carried out based on a proper physician-patient relationship and taking into account socio-cultural factors.

The student will have to possess the necessary theoretical knowledge and skills to be able, through a coherent clinical reasoning, to elaborate a complete clinical history, including a diagnostic and therapeutic strategy.

Students will have to demonstrate communication skills with their peers in the discussion of clinical cases, in practical and theoretical-practical classes. The student should be aware of the need for group work in the clinical approach of a patient.

In the clinical practice, the physician needs to acquire a set of nuclear competences, without which a rapid recognition of pathologies and/or clinical situations requiring timely therapy may be compromised.

In this sense, in each module of the Curricular Unit there will be a set of knowledge and skills considered essential to the practice of medicine. This set is called the competence grid (see documents).

Working method

Presencial

Pre-requirements (prior knowledge) and co-requirements (common knowledge)

Adequate knowledge of anatomy, physiology, physiopathology and medical semiology.

Ability to elaborate a full clinical report.

Ability to communicate with patients, teachers, other health professionals and their peers.

Program

Cardiology

Ischemic heart disease

Arrhythmias

Congenital heart disease

Aortic syndromes

Pericardial diseases

Lead electrocardiogram

Heart failure

Cardiomyopathies

Syncope

Valvular heart disease

Dermatology

Acne vulgaris

Non-necrotizing bacterial acute dermo-hypodermitis (erysipelas, infectious cellulitis)

Eczema

Photocarcinogenesis and introduction to cutaneous oncology

Superficial bacterial infections (folliculitis, furuncle, contagious impetigo, ecthyma)

Parasitic infections of the skin

Viral infections of the skin

Sexually transmitted infections (STIs)

Dermatologic semiology

Superficial mycoses

Psoriasis

Topic therapy

Gastroenterology

Hepatic cirrhosis

Gastroesophageal reflux disease

Inflammatoy bowel disease (Chron’s disease and ulcerative colitis)

Chronic diarrhea

Proctological examination and semiology

Helicobacter pylori

Gastrointestinal bleeding

Viral hepatitis (HBV and HCV)

Chronic constipation

Eosinophilic esophagitis

Esophageal motility disorders (achalasia and diffuse esophageal spasm)

Peptic ulcer disease

Hematology

Acquired and congenital anemia

Hemostasis and thrombosis diseases

Acute leukemia

Lymphomas and chronic lymphocytic leukemia

Transfusion medicine

Multiple myeloma

Philadelphia-negative myeloproliferative neoplasms. Chronic myeloid leucemia

Myelodisplasic syndromes

Nephrology

Approach to the patient with urinary alterations

Acute renal lesion

Chronic renal disease

Hydroelectrolytic and acid-base disorders

Glomerular diseases and nephritic and nephrotic syndromes

Renal vascular lesions

Hereditary polycystic kidney disease

Tubulointerstitial renal disease

Pneumology

Bronchial asthma

Bronchiectasis

Basic concepts of interstitial pathology

Type I and II acute respiratory failure

Chronic obstructive pulmonar disease

Cystic fibrosis, allergies, eosinophilia, anaphylaxis, systemic mastocytosis and ARDS

Pleural physiology and pathology

Community-acquired pneumonia

Obstructive sleep apnea syndrome

Non-invasive ventilation

Mandatory literature

20th Edition; Harrison's principles of internal medicine
BOLOGNIA, Jean L., et al.; BOLOGNIA, Jean L., et al. Dermatology essentials. Elsevier Health Sciences, 2014. ISBN 9781455708413
8th Ed. 2017; Fitzpatrick’s Color Atlas, , McGraw-Hill Education, 2017

Comments from the literature

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Teaching methods and learning activities

Theoretical classes

 

The main programmatic contents are those to which the student must devote a substantial part of his study schedule. These classes are not meant to address in a complete and exhaustive manner the different pathologies and clinical syndromes. They are an important study guide and a place where professors will awaken the need for students to study and what they need to know in order to address their patients with the most varied pathologies they will be confronted with.

 

Theoretical/Practical classes

 

Excellent space for active, participatory and joint discussion of clinical cases. In each of the eleven classes there will be the possibility to prepare and present, at least, one clinical case. All students will participate in its study and discussion. The clinical case will be disclosed to the course, by the regent, with a week in advance. Each of these cases will also lead to the set of key issues to be addressed and objectives to be achieved with its discussion. These classes are open and held throughout the course. We want this discussion to be active, participatory, where students feel completely comfortable in order to participate, either by giving their opinion about the patient's clinical orientation or by presenting their doubts and questions.

 

Practical classes

 

Most of them will take place in the sick-wards, near the patients. If possible, a couple of classes will take place at the Biomedical Simulation Center. In this facility it is possible to repeat gestures and attitudes without "disturbing" the patient and to achieve an adequate level of proficiency. After this "first" part with the patient, teachers and students will build a full clinical history. We want an active role of all students.

Evaluation Type

Distributed evaluation with final exam

Assessment Components

Designation	Weight (%)
Prova oral	30,00
Teste	60,00
Participação presencial	10,00
Total:	100,00

Amount of time allocated to each course unit

Designation	Time (hours)
Estudo autónomo	261,00
Frequência das aulas	144,00
Total:	405,00

Eligibility for exams

Face-to-face teaching activities

To be approved, the student must:

1. Have an evaluation ≥ 10 values in each of the 3 evaluation components;
2. Be present in 3/4 of the practical classes (for each module), as well as in 3/4 of the theoretical-practical classes;
3. Have a competency grid, per module, filled in ≥ 75%;
4. Elaborate and deliver the clinical history to the professor, in the practical test, in a maximum period of 4h (this time already encompasses 30 minutes of tolerance);

Calculation formula of final grade

The final classification in the Curricular Unit will be the result of the weighted average of continuous evaluation, practice test and multiple-choice testing. The weightings will be 10%, 30% and 60% respectively.

To this result can be added 1 bonus value according to the performance and attendance of the student in the theoretical-practical classes.

Thus, to receive this bonus, the student, besides belonging to one of the 3 classes best classified in the presentation and discussion of clinical cases, must have participated in the respective class and missed only 1 theoretical-practical lesson. This bonus is only assigned if the student's overall final score is ≥ 10 values.

Special assessment (TE, DA, ...)

At the special time for the conclusion of the MIM, the final test will be performed through an oral examination, which includes practical proof and theoretical proof. Multiple-choice test will not be performed.

Classification improvement

Through the multiple-choice test. Maintains ratings obtained from other valuation components.

Observations

As previously stated, the way in which the classes will be taught will be dependent on the epidemiological situation (Covid-19). So:
Presential or face-to-face teaching activities:

Theoretical classes (Primer), theoretical/practical classes and practical classes: the whole course, together, attends classes face-to-face, according to the defined schedule.

Semi-presential teaching activities for the contact hours:

• Theoretical classes (Primer): the course is divided into two groups. One group has classes in the morning and the other in the afternoon.
• Theoretical/practical classes: Half of the course has a face-to-face class and the other half through a digital platform, alternately. The group responsible for the class, the professor(s) and the regent will always be in the classroom. During classes half the class will be in the sick-ward, with the patient, while the other half will be doing another task. The discussion of the clinical case takes place outside the sick-ward, with the group assembled.
• practical classes: all classes have face-to-face lessons.

Distance education for every classes (Theoretical, theoretical/practical and practical classes):

• Every teaching activities will be via digital platforms. The theoretical and theoretical/practical classes will be held together, with the entire course, in videoconference. The practical classes will be held in smaller groups.

Erasmus Students

The evaluation will be carried out according to the request by the faculty of origin. So:

• If a quantitative score is requested, students will take a multiple choice test, in Portuguese. They can benefit from the bonus.
• If a quantitative assessment is not requested, students will be classified as approved or not approved, depending on their performance in practical classes.
• In addition to points a) and b), in order to be approved, students must be present in 3/4 of the practical classes, as well as 3/4 of the theoretical / practical classes.

 

1. Semi-presential teaching activities

To be approved, the student must:

• Have an evaluation ≥ 10 values in each of the 3 evaluation components;
• Be present in 3/4 of the practical classes (for each module), as well as in 3/4 of the theoretical-practical face-to-face classes;
• Have a competency grid, per module, filled in ≥ 75%;
• Elaborate and deliver the clinical history to the professor, in the practical test, in a maximum period of 4h (this time already encompasses 30 minutes of tolerance);

Erasmus Students

The evaluation will be carried out according to the request by the faculty of origin. So:

• If a quantitative score is requested, students will take a multiple choice test, in Portuguese. They can benefit from the bonus.
• If a quantitative assessment is not requested, students will be classified as approved or not approved, depending on their performance in practical classes.
• In addition to points a) and b), in order to be approved, students must be present in 3/4 of the practical classes.

 

1. Distance education for every classes (Theoretical, theoretical/practical and practical classes):

To be approved, the student must:

1) Have an evaluation ≥ 10 values in each of the 2 evaluation components;

• Be present in 3/4 of the videoconference practical classes (for each module).