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Medical expertise

 

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Definition of competency

To acquire, integrate and apply medical knowledge, clinical skills and professional attitudes in the provision of patient care through:

  • demonstrating medical skills and expertise
  • monitoring and evaluating care
  • managing safety and risk.

Key clinical tasks and the workplace

The related key clinical tasks (KCT) have been designed to help you apply the Framework to your job. You can use these to obtain feedback on, and/or assessment of, your level of performance.

Select the PGY (1–3) tabs below to view the progression of the expected skills, knowledge and behaviours across the early postgraduate years

 
  • PGY1
  • PGY 2
  • PGY 3
  • Practise hand hygiene, noting standard precautions, transmission-based precautions, personal protective equipment and aseptic technique
    • hand hygiene
    • handover
    • venous thromboembolism prophylaxis
    • Follow stages of a verification process and comply with the organisation’s procedures to ensure correct identification of a patient.
  • Undertake a comprehensive and focussed history, eliciting symptoms and signs relevant to the presenting problem or condition. Note medication history, including medicine allergies and previous adverse drug reactions.
  • Identify and provide relevant and succinct information when ordering investigations. Ensure tests and results are documented.
  • Know and work within hospital, state and government policies and legislation relating to prescribing. Make use of guidelines and standard documents, e.g. National Inpatient Medication Chart
    • Accurately and safely prescribe (common) medications and recognise (potential) administration errors
    • Know the types, causes and risks of medication errors and adverse drug reactions
    • Use standard reporting mechanisms to report medication errors and adverse drug reactions.
  • Understand the key features of antibiotic prophylaxis and appropriate therapeutic use, noting local protocols and the Therapeutic Guidelines (Antibiotics).
  • Recognise and effectively assess acutely ill, deteriorating and dying patients.
  • Perform basic emergency and life support procedures while continuing full assessment of the patient to include:
    • Apply principles of triage and medical prioritisation
    • Identify patients requiring immediate resuscitation and when to call for help, e.g. Code Blue, MET calls
    • Implement basic airway management, ventilatory and circulatory support
    • Identify indications for advanced airway management
    • Participate in decision making, and debriefing, about cessation of resuscitation.
  • Recognise common symptoms and signs
  • Manage common conditions
  • Seek help when unsure.

  • Present common cases effectively to senior medical staff and other health professionals.
  • Perform a comprehensive examination of all systems.
  • Identify common risks in older and complex patients, e.g. falls risk and cognitive decline. Take appropriate actions to prevent or minimise harm.
  • Follow-up and interpret investigation results appropriately to guide patient management.
  • Work within unit-based protocols with regard to pre-operative assessment and care, operative procedures and post-operative care:
    • apply medical knowledge to clinical practice
    • implement and evaluate a management plan relevant to the patient following discussion with a senior clinician
    • identify when patient transfer is required, and manage risks prior to and during patient transfer
    • recognise indications for, and risks of, fluid and electrolyte therapy and blood products
    • provide appropriate aftercare and arrange follow up for common procedures 
    • safely manage anti-coagulant therapy and manage diabetes
    • recognise acute cardiac events and use relevant resuscitation/drug protocols
    • initiate resuscitation of the unwell patient. Recognise indicators for sepsis and implement clinically relevant plan
    • maintain a clinically relevant patient management plan of fluid, electrolyte and blood product use
    • recognise and manage fluid and electrolyte imbalances in a patient
    • effectively use semi-automatic and automatic defibrillators
    • provide appropriate aftercare and arrange follow up for more complex procedures
    • recognise when patients are ready for discharge and arrange referral to relevant members of the healthcare team to promote planning for safe discharge.
  • Safely prescribe use of antimicrobials and be aware of the influence of the pharmaceutical industry. Clearly understand proper surgical prophylaxis and distinguish this from therapeutic use of antibiotics for bacterial infections.
  • Specify peri-operative management of anticoagulants and antiplatelet agents and recognise prescription and/or administration errors.
  • Identify common risks in older and complex patients, e.g. falls risk and cognitive decline.
  • Recognise when a patient is dying and implement an appropriate care plan.
  • Follow-up and interpret investigation results appropriately to guide patient management.
  • Prescribe pain therapies to match the patient’s analgesia requirements. Be empathic when managing pain and review outcomes when prescribing.
  • Identify medical errors or adverse events and implement the appropriate clinical protocols to manage them.
  • Understand recommendations for user-applied labelling of injectable medicines, fluids and lines.
  • Deal with common (presenting) symptoms and signs and common conditions. See extracts from:
  • Present complex cases effectively to senior medical staff and other health professionals.
  • Can supervise/advise and understands medicines with high risk of adverse events. Double check and document dose calculations.
  • Understand the actions and interactions, indications, monitoring requirements, contraindications and potential adverse effects of each medication used.
  • Evaluate outcomes of medication therapy. Monitor and review the patient’s response to treatment
    • aligned to NPS MedicineWise
    • Be aware of risks associated with common conditions and procedures and implement steps to predict or mitigate them.
  • Provide appropriate aftercare and arrange follow-up for all procedures.
  • Identify patients suitable for, and refer to, aged care, rehabilitation or palliative care programs.
  • Apply the criteria for referral or consultation relevant to a particular problem or condition.
  • Have ongoing awareness of gaps in own knowledge and address these.
  • Audit own and team performance in relation to patient progress and outcome.
  • Review and update unit protocols manual regarding pre-operative assessment and care, operative procedures and post-operative care.