Rheumatology with General Internal Medicine (GIM) CESR Portfolio Guide

Generic Capabilities in Practice

• 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

Generic Capabilities in Practice

• 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

Generic Capabilities in Practice

• 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

Generic Capabilities in Practice

• 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

Generic Capabilities in Practice

• 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

Generic Capabilities in Practice

• 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

Clinical Capabilities in Practice

• 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

Clinical Capabilities in Practice

• Able to manage patients who have been referred acutely to a specialised medical service as opposed to the acute unselected take
• 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

Clinical Capabilities in Practice

• 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
• Demonstrates awareness of the quality of patient experience

Clinical Capabilities in Practice

• 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

Clinical Capabilities in Practice

• 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

Clinical Capabilities in Practice

• 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

Clinical Capabilities in Practice

• 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

Clinical Capabilities in Practice

• 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

Specialty Specific Capabilities in Practice

• Demonstrates behaviour appropriately with regard to patients
• Demonstrates behaviour appropriately with regard to clinical and other professional colleagues
• Demonstrates effective consultation skills including challenging circumstances
• Accurate diagnosis and appropriate comprehensive management of patients referred to an outpatient clinic or ambulatory setting including appropriate use of investigations
• Appropriate management of comorbidities in an outpatient clinic or ambulatory setting including appropriate use of investigations and evidence-based prescribing
• Demonstrates effective communication working across boundaries in multiple care settings
• Demonstrates ability to negotiate shared decision making
• Supports health promotion and patient self-management

Specialty Specific Capabilities in Practice

• Demonstrates behaviour appropriately with regard to patients
• Demonstrates effective consultation skills including challenging circumstances
• Demonstrates ability to negotiate shared decision making
• Demonstrates effective clinical leadership and prioritisation
• Demonstrates behaviour appropriately with regard to clinical and other professional colleagues
• Accurate diagnosis and appropriate continuing management of rheumatologic emergencies in patients admitted to hospital in the emergency department or intensive care or in an ambulatory setting including appropriate use of investigations and evidence-based prescribing
• Demonstrates ability to liaise with the rheumatology multidisciplinary team and other specialty teams as appropriate

Specialty Specific Capabilities in Practice

• Demonstrates behaviour appropriately with regard to patients
• Demonstrates effective consultation skills including challenging circumstances
• Demonstrates ability to negotiate shared decision making
• Demonstrates effective clinical leadership
• Accurate diagnosis of complex /rare rheumatologic problems in patients presenting in an outpatient or ambulatory setting
• Demonstrates behaviour appropriately with regard to clinical and other professional colleagues
• Appropriate management of complex/rare rheumatologic problems in patients presenting in an outpatient or ambulatory setting including appropriate use of investigations and evidence-based prescribing
• Demonstrates effective communication working across boundaries in multiple care settings

Specialty Specific Capabilities in Practice

• Demonstrates behaviour appropriately with regard to patients
• Demonstrates behaviour appropriately with regard to clinical and other professional colleagues
• Demonstrates effective consultation skills including challenging circumstances
• Demonstrates ability to negotiate shared decision making
• Demonstrates effective clinical leadership
• Accurate diagnosis of adolescent rheumatologic/chronic pain/metabolic bone and rarer rheumatologic problems in patients presenting in an outpatient setting
• Appropriate management of adolescent rheumatologic/chronic pain/metabolic bone and rarer rheumatologic problems in patients presenting in an outpatient or ambulatory setting including appropriate use of investigations and evidence-based prescribing
• Demonstrates effective communication working across boundaries

Specialty Specific Capabilities in Practice

• Able to outline the indications and contraindications for the procedures and take consent
• Evidence of aseptic technique and safe use of steroids and local anaesthetic drugs
• Evidence of safe learning in a joint injection course or simulation or supervised procedures clinically
• Aspirate and inject joints competently using appropriate techniques
• Recognise macroscopic appearance of normal and abnormal synovial fluid

Specialty Specific Capabilities in Practice

• demonstrates behaviour appropriately with regard to clinical and other professional colleagues
• demonstrates effective consultation skills including challenging circumstances
• demonstrated effective communication skills with all members of the multidisciplinary team
• demonstrates effective clinical leadership
• demonstrates ability to work well in a multidisciplinary team, in all relevant roles
• demonstrates appropriate liaison with specialty teams when required
• recognises when to refer patients to members of the multidisciplinary team and other specialists
• participation in MDT/multidisciplinary meetings/X-ray meetings
• effective handover of patients
• provides appropriate supervision and support to colleagues

Specialty Specific Capabilities in Practice

• recognizes the importance of prompt and accurate information sharing with primary care team about patient care
• demonstrate understanding of diagnosis and management of rheumatologic conditions in the community
• understanding local referral pathways for different rheumatologic conditions
• demonstrates effective communication working across boundaries in multiple care settings
• demonstrates awareness of patient beliefs influencing care and patient autonomy in making decisions
• demonstrates the ability to support self-management in patients
• demonstrates the ability to communicate effectively with patients and family members or carers
• provides effective patient education with support of the multidisciplinary team
• encourages patient participation in appropriate disease prevention and self-management programmes
• promotes patient involvement in appropriate support networks

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