1. Integration of Public Health Medicine in General Practice PHASE III/IV TUTORS DEVELOPMENT DAY Thursday 17 th May 2012 Dr Mike Crilly Senior Lecturer in Clinical Epidemiology MD MPH MRCGP MFPHM mike.crilly@abdn.ac.uk

2. Public Health Medicine “Improving health through the organised efforts of society” Based on epidemiology (‘population based’) PEST (political, economic, social, technology) Grand strategies Back page BMJ– Des Spence (Glasgow GP) – health promotion – medical nutrition – digital rectal examination – sports medicine

3. Evidence based medicine Based on clinical epidemiology ‘Old wine, new bottle’ Involves numbers ! (measure or count) Diagnosis & Prognosis Therapy & Harm

4. the Sackett Cube ‘How to get the most from CME’

5. Phase IV – Professional Practice Block

6. Phase III Student selected module (SSM3) – clinical effectiveness (RCT’s & systematic reviews) – GP under-represented (only 1 out of 35 groups)

7. Most likely diagnosis? A.Multiple Sclerosis B.Bell’s Palsy C.Lyme Disease D.Acoustic Neuroma E.Stroke

8. Most likely diagnosis? A.Multiple Sclerosis B.Bell’s Palsy C.Lyme Disease D.Acoustic Neuroma E.Stroke

9. Phase III Student selected module (SSM3) – clinical effectiveness (RCT’s & systematic reviews) – GP under-represented (only 1 out of 35 groups) Community block – START: needs assessment & evidence based med. – END: case presentation & discussion topics

11. Case Presentation High standard & variety of cases Focus on ‘single condition’ Relevant evidence/guidelines Co-morbidity & multiple morbidity Poly-pharmacy Indications for current drug therapy Adherence with medication

12. Discussion Topics Practice population – urban/rural; young/old Evaluation in practice – audit & screening Evidence based practice – guidelines

14. GP Groups Integration of Public Health Medicine in General Practice General Practice Digital rectal examination Health Promotion Modern Medicine

15. Feedback from Groups Integration of Public Health Medicine in General Practice General Practice Digital rectal examination Health Promotion Modern Medicine