Genitourinary Medicine (GUM) with General Internal Medicine (GIM) CESR Portfolio Guide

• Aware of, and adheres to, the GMC professional requirements
• Aware of public health issues including population health, social determinants of health and global health perspectives
• Demonstrates effective clinical leadership
• Demonstrates promotion of an open and transparent culture
• Keeps up to date through learning and teaching
• Demonstrates engagement in career planning
• Demonstrates capabilities in dealing with complexity and uncertainty
• Aware of the role and processes for commissioning
• Aware of the need to use resources wisely

• Aware of national legislation and legal responsibilities, including safeguarding vulnerable groups
• Behaves in accordance with ethical and legal requirements
• Demonstrates ability to offer apology or explanation when appropriate
• Demonstrate ability to lead the clinical team in ensuring that ethical and legal factors are considered openly and consistently

• Communicates clearly with patients and carers in a variety of settings
• Communicates effectively with clinical and other professional colleagues
• Identifies and manages barriers to communication (e.g. cognitive impairment, speech and hearing problems, capacity issues)
• Demonstrates effective consultation skills including effective verbal and non-verbal interpersonal skills
• Shares decision making by informing the patient, prioritising the patient’s goals and wishes, and respecting the patient’s beliefs, concerns and expectations
• Shares decision making with children and young people
• Applies management and team working skills appropriately, including influencing, negotiating, re-assessing priorities and effectively managing complex, dynamic situations

• Makes patient safety a priority in clinical practice
• Raises and escalates concerns where there is an issue with patient safety or quality of care
• Demonstrates commitment to learning from patient safety investigations and complaints
• Shares good practice appropriately
• Contributes to and delivers quality improvement
• Understands basic Human Factors principles and practice at individual, team, organisational and system levels
• Understands the importance of non-technical skills and crisis resource management
• Recognises and works within limit of personal competence
• Avoids organising unnecessary investigations or prescribing poorly evidenced treatments

• Manages clinical information / data appropriately
• Understands principles of research and academic writing
• Demonstrates ability to carry out critical appraisal of the literature
• Understands the role of evidence in clinical practice and demonstrates shared decision making with patients
• Understands public health epidemiology and global health patterns
• Demonstrates appropriate knowledge of research methods, including qualitative and quantitative approaches in scientific enquiry
• Demonstrates appropriate knowledge of research principles and concepts and the translation of research into practice
• Follows guidelines on ethical conduct in research and consent for research
• Recognises potential of applied informatics, genomics, stratified risk and personalised medicine and seeks advice for patient benefit when appropriate

• Delivers effective teaching and training to medical students, junior doctors and other healthcare professionals
• Delivers effective feedback with action plan
• Able to supervise less experienced trainees in their clinical assessment and management of patients
• Able to supervise less experienced trainees in carrying out appropriate practical procedures
• Able to act as a clinical supervisor to doctors in earlier stages of training

• Demonstrates professional behaviour with regard to patients, carers, colleagues and others
• Delivers patient centred care including shared decision making
• Takes a relevant patient history including patient symptoms, concerns, priorities and preferences
• Performs accurate clinical examinations
• Shows appropriate clinical reasoning by analysing physical and psychological findings
• Formulates an appropriate differential diagnosis
• Formulates an appropriate diagnostic and management plan, taking into account patient preferences, and the urgency required
• Explains clinical reasoning behind diagnostic and clinical management decisions to patients/carers/guardians and other colleagues
• Appropriately selects, manages and interprets investigations
• Recognises need to liaise with specialty services and refers where appropriate

• Able to manage patients who have been referred acutely to a specialised medical service as opposed to the acute unselected take (e.g. cardiology and respiratory medicine acute admissions)
• Demonstrates professional behaviour with regard to patients, carers, colleagues and others
• Delivers patient centred care including shared decision making
• Takes a relevant patient history including patient symptoms, concerns, priorities and preferences
• Performs accurate clinical examinations
• Shows appropriate clinical reasoning by analysing physical and psychological findings
• Formulates an appropriate differential diagnosis
• Formulates an appropriate diagnostic and management plan, taking into account patient preferences, and the urgency required
• Explains clinical reasoning behind diagnostic and clinical management decisions to patients/carers/guardians and other colleagues
• Appropriately selects, manages and interprets investigations
• Demonstrates appropriate continuing management of acute medical illness in a medical specialty setting
• Refers patients appropriately to other specialties as required

• Demonstrates professional behaviour with regard to patients, carers, colleagues and others
• Delivers patient centred care including shared decision making
• Demonstrates effective consultation skills
• Formulates an appropriate diagnostic and management plan, taking into account patient preferences, and the urgency required
• Explains clinical reasoning behind diagnostic and clinical management decisions to patients/carers/guardians and other colleagues
• Demonstrates appropriate continuing management of acute medical illness inpatients admitted to hospital on an acute unselected take or selected take
• Recognises need to liaise with specialty services and refers where appropriate
• Appropriately manages comorbidities in medial inpatients (unselected take, selected acute take or specialty admissions)
• Demonstrates awareness of the quality of patient experience

• Demonstrates professional behaviour with regard to patients, carers, colleagues and others
• Delivers patient centred care including shared decision making
• Demonstrates effective consultation skills
• Formulates an appropriate diagnostic and management plan, taking into account patient preferences
• Explains clinical reasoning behind diagnostic and clinical management decisions to patients/carers/guardians and other colleagues
• Appropriately manages comorbidities in outpatient clinic, ambulatory or community setting
• Demonstrates awareness of the quality of patient experience

• Demonstrates effective consultation skills (including when in challenging circumstances)
• Demonstrates management of medical problems in inpatients under the care of other specialties
• Demonstrates appropriate and timely liaison with other medical specialty services when required

• Applies management and team working skills appropriately, including influencing, negotiating, continuously re-assessing priorities and effectively managing complex, dynamic situations
• Identifies appropriate discharge plan
• Ensures continuity and coordination of patient care through the appropriate transfer of information demonstrating safe and effective handover
• Effectively estimates length of stay
• Delivers patient centred care including shared decision making
• Recognises the importance of prompt and accurate information sharing with primary care team following hospital discharge

• Demonstrates prompt assessment of the acutely deteriorating patient, including those who are shocked or unconscious
• Demonstrates the professional requirements and knowledge of legal processes associated with consent for resuscitation
• Participates effectively in decision making with regard to resuscitation decisions, including decisions not to attempt CPR, and involves patients and their families
• Demonstrates competence in carrying out resuscitation

• Identifies patients with limited reversibility of their medical condition and determines palliative and end of life care needs
• Identifies the dying patient and develops an individualised care plan, including anticipatory prescribing at end of life
• Demonstrates effective consultation skills in challenging circumstances
• Demonstrates safe and effective use of syringe pumps in the palliative care population
• Able to manage non complex symptom control including pain
• Facilitates referrals to specialist palliative care across all settings
• Demonstrates compassionate professional behaviour and clinical judgement

• Takes a comprehensive sexual and reproductive health history from cis and trans men and women, including non-binary individuals, and performs a risk assessment in all with empathy and sensitivity, respecting the patients’ confidentiality
• Performs HIV pre-test discussion
• Demonstrates medical examination of the genitals, anus and rectum with valid consent and use of chaperones
• Demonstrates appropriate sample taking and interpretation of laboratory tests for HIV, STIs, blood borne viruses, cervical cytology, pregnancy and pre-immunisation
• Medically leads an integrated sexual health clinic providing care for asymptomatic patients and patients with uncomplicated STIs, genital lumps, vaginal discharge, urethral discharge, vulvovaginitis, balanitis and genital infestations
• Facilitates partner notification with clinical team, with understanding of available range notification methodologies, issues around need of disclosure and respecting confidentiality
• Prescribes emergency contraception if indicated
• Assesses patients’ contraception needs meeting those initially wherever possible and referring into specialist services where indicated
• Able to adopt the utilisation of technology of remote management in sexual health eg telephone clinics, video consults, online image viewing/testing/platforms for meetings and teaching, postal testing, digital partner notification. Understands advantages and limitations of these tools in the context of sexual health

• Medically leads a clinic seeing symptomatic patients including those with complicated sexual health conditions, STIs, genital ulcers, systemic and extra-genital manifestations
• Clinically manages and uses tools to identify individuals who may need safeguarding or are vulnerable eg those who have experienced sexual assault, sexual exploitation, sexual abuse gender-based violence, victims of modern slavery, female genital mutilation (FGM) or who are engaging in chemsex. Manages psychosocial aspects of care for these patients and/or is able to refer appropriately
• Supports HIV and viral hepatitis testing and prevention for individuals at highest risk, including vaccination and pre- or post-exposure prophylaxis if provided locally, and appropriate onward referral of positive cases. Demonstrates awareness of indications, available options, interactions and complications of treatment for patients with viral hepatitis
• Demonstrates assessment and referral of pregnancy, gynaecological and obstetric problems
• Identification, initial assessment, management and appropriate referral of psychosexual dysfunction and genital pain syndromes
• Able to manage STIs in pregnancy, including working collaboratively with antenatal team to reduce mother to child transmission
• Demonstrates knowledge of investigation and management of genital infections in newborn, infants and children
• Assesses and clinically manages sexual & reproductive health needs and child sexual exploitation in <18s. Shows understanding of issues relating to valid consent and Fraser competency assessment and to importance of discussions regarding confidentiality. Awareness of legal considerations eg Sexual Offences Act
• Facilitates partner notification with clinical team, with understanding of available range of notification methodologies, issues around need to disclose vs respecting confidentiality, consideration of safeguarding for <18s, vulnerable and complex cases
• Assesses suitability for and administers or refers on for long-acting reversible contraception methods including sub-dermal implants, intrauterine devices and systems
• Clinically manages patients with genital dermatological conditions and awareness of when to refer to specialist services

• Recognises and assesses individuals with previously undiagnosed HIV infection in primary, secondary and tertiary settings
• Medically leads a clinic treating people living with HIV-1 and HIV-2 (PLWH), including specific populations such as adolescents, pregnant women, men who have sex with men (MSM), sex workers, injecting drug users, haemophiliacs, transgender people, migrants, asylum seekers, health care workers, prisoners and older people pharmacokinetics, modes of action, interactions, mechanisms and relevance of resistance and cross-resistance
• Demonstrates ability to monitor treatment response including laboratory tests, drug adherence and drug tolerance.
• Able to tailor therapy to individual patients, taking into account medical co-morbidities, concurrent medications, social circumstances, lifestyle, patient preference and cost efficacy considerations
• Demonstrates detailed awareness of current treatment guidelines including therapy for the prevention of mother-to-child transmission and treatment as prevention
• Able to tailor advise of risk of onward transmission of HIV through sexual route, non-sexual route and occupational implications based on virological outcome; with considerations over the need for partner notification,
• preventative measures and potential medico-legal implication of non-disclosure
• Demonstrates provision of relevant counselling to patients, partner(s), carers and family when appropriate; with careful considerations over confidentiality and disclosure.
• Manages HIV-related medical conditions, prescribing and monitoring of antiretroviral therapies (ART) and chemo-prophylaxis and demonstrates knowledge of appropriate vaccination strategies, including contraindications
• Ability to explain the function of the intact immune system, pathophysiology of HIV.
• Demonstrates an extensive knowledge of the data supporting the uses of anti-retroviral therapy in HIV infection including: indications, contraindications and relative merits of the different antiviral medications,
• Demonstrates awareness of indications, available options, interactions and complications of treatment for patients with viral hepatitis co-infection
• Demonstrates awareness of monitoring for medical complications in patients with viral hepatitis co-infection
• Clinically addresses the psychosocial care needs affecting PLWH, including mental health issues, mood disorders and issues arising from participation in chemsex, within a multidisciplinary team and/or refers on to specialist services
• Clinically manages the sexual and reproductive health care needs of PLWH
• Clinically manages transitional care of adolescents/young people with HIV, including those who were vertically infected
• Understands the differences in epidemiology, morbidity and management of HIV infection in prison populations
• Understands the differences in epidemiology, clinical presentation, investigation, management and prevention of systems complications
• Uses knowledge of the epidemiology and natural history of HIV to prevent late diagnosis
• Recognises and assesses individuals with known and previously undiagnosed viral hepatitis co-infection in primary, secondary and tertiary settings
• Supports and promotes active engagement by patients in follow up in HIV positive individuals compared with HIV-negative individuals, including the role of immunosuppression
• Understands the epidemiology, clinical presentation, investigation, management and prevention of complications of HIV disease relating to different organ systems including AIDS and non AIDS defining malignancies

• Clinically manages unwell or immunosuppressed patients with medical complications of HIV and/or co-morbidities as part of a multi-professional team
• Demonstrates awareness of drug interactions between antiretrovirals and/or medication to manage coexisting medical conditions or those related to HIV infection
• Demonstrates ability to lead the decision making and co-ordination of care for PLWH with complex multi-system conditions including elderly patients with frailty.
• Demonstrates considerations over confidentiality, legal and ethical aspects relating to HIV infection including mental capacity, Do-Not-Resuscitate (DNR) order, end of life and palliative care
• Clinically manages the full range of opportunistic infections in PLWH and is able to describe and explain the correlation between the epidemiology, immunosuppression, clinical presentation, investigation and management of a full range of infections including:
• Viral: Cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV), Epstein-Barr virus (EBV), Human herpes virus-8 (HHV8), parvovirus, JC virus
• Bacterial: including specific HIV susceptibility to pneumococcus, haemophilus, norcardia and syphilis
• Tuberculosis (TB) and atypical mycobacterial infection
• Fungi: including candida, pneumocystis, cryptococcus and aspergillus
• Protozoa: toxoplasmosis and gut-related protozoa including cryptosporidium
• Helminths: including strongyloidiasis
• Describes the use of primary and secondary prophylaxis against opportunistic infection
• Describes the epidemiology, diagnosis, investigation and management of immune reconstitution inflammatory syndrome (IRIS)

• Demonstrates knowledge of STI transmission networks, partner notification, time frames for tests of cure and effective interaction with sexual health advisers and/or other healthcare professionals engaged with prevention activity
• Utilises local and national data sources to influence specialist service delivery
• Demonstrates use of social determinants of health on STI, BBV and HIV epidemiology to influence specialist service provision
• Delivers interventions to prevent HIV, other blood borne viruses (BBVs) and STI transmission including delivery of pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), knowledge of treatment as prevention, preventing mother to child transmission of HIV, encouraging participation in vaccination programmes and awareness of consequences of engagement in chemsex and support with safer sexual practice
• Demonstrates knowledge of viral hepatistis, including in PLWH; persons living with HIV infection, the tests required to establish stage of infection, treatment strategies and when to refer, how to report notifiable viral hepatitis infections to public health, encourage screening and vaccination of contact

• Interacts with colleagues in public health, acute and community settings, including primary care, to promote testing for STIs and HIV
• Facilitates pathways for positive STI and HIV diagnoses from primary, secondary care, online/postal testing, community settings including risk group venues and voluntary premises, into specialist services results. Explains which sites to sample, storage of specimens and transfer time to lab. Describes time frame to positive result from infection and to negative result post treatment
• Explains and delivers tests to enable early detection of STIs and HIV including online/postal testing, point of care HIV tests and light and dark-field microscopy
• Demonstrates working with HIV and sexual health third sector and voluntary sector groups to promote public and patient engagement
• Understands test sensitivity and specificity, need for confirmation by same or different tests and timescale for
• Demonstrates ability to give a negative, positive or indeterminate STI and BBV (including HIV) test results in a sensitive manner and discusses relevant issues including confidentiality, partner notification and disclosure

• Demonstrates understanding of the epidemiology of common STIs and HIV including incidence, prevalence and measures of risk
• Demonstrates an understanding of the key determinants of transmission and maintenance of STIs and HIV at a population level, including at risk groups
• Practices safeguarding of individuals and the wider public from the negative consequences of sexual ill-health and BBV infection, including HIV
• Demonstrates use of information technology to maintain and improve public health, including understanding of data collection through local, regional and national coding systems e.g. Genitourinary Medicine Clinical Activity Dataset, HIV and AIDS Reporting System, Sexual and Reproductive Health Activity Dataset.
• Demonstrates an awareness of notifying outbreaks of STIs and HIV to Public Health in addition to their role in the control of notifiable disease. Facilitates referral of these patients across all care settings.
• Demonstrates engagement with colleagues in all sectors (including the media and voluntary sector) to promote behaviours to reduce HIV infection and sexual ill health
• Demonstrates level 3 training in safeguarding of children and young people <18 years and the delivery of information in a format which is accessible by this age group. Demonstrates awareness of the mental capacity act and how to recognise and safeguard vulnerable adults including those who have experienced sexual assault, sexual exploitation, sexual abuse or gender-based violence, victims of modern slavery, female genital mutilation (FGM) or who are engaging in chemsex
• Able to engage with other organisations involved in safeguarding eg Social Services, the Police, SARCs, voluntary agencies, and awareness of how to refer appropriately
• Understanding of how to engage with marginalised groups including those who have a hearing or visual impairment, a physical disability, whose first language is not English and who have challenges with reading and/or writing in English

• Understands working with bodies responsible for the organisation and commissioning of services to deliver cost-sensitive specialist services that meet local population demographics
• Recognises the tendering/commissioning process is different in the four Nations and across NHS/HSC and non-NHS providers. Demonstrate contribution/participation within local process.
• Demonstrates evidence-based approach using scientific method and critical analysis for specialist service development and quality improvement
• Develops and works as part of wider professional network in sexual health and HIV care
• Participation in multi-professional meetings to agree a consensus view to progress delivery of specialist services.
• Participating in research, audit and quality improvement projects.
• Participating/leading on service innovation to improve clinical effectiveness

Currency Window

Evidence of your recent practice will be given more weight to reflect current capabilities and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).

Evidence Volume

around 100 electronically uploaded documents