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Milestone competencies
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Capability
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Theme
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Entry
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Foundation
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Consolidation
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Fellowship
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Provide person-centred and comprehensive care, using a biopsychosocial approach
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Person-centred approach
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Discuss whole person-centred culturally appropriate care, and its interface with the biopsychosocial approach
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Identify psychological, social and cultural factors that impact the patient and the opportunities for person-centred care
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Acknowledge and respect patients’ experiences and perspectives and integrate these into care
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Accommodate patients’ experiences and perspectives and integrate these into the ongoing provision of whole person care
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Comprehensive care with continuity
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Identify opportunities for, and potential benefits of, comprehensive care and continuity of care
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Provide care considerate of the patient’s physical, mental and social health and facilitate continuity of care when possible
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Provide comprehensive care for a wide range of conditions and utilise the opportunities of continuity of care
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Provide comprehensive care with appropriate continuity
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Strengths based approaches with Aboriginal and Torres Strait Islander Peoples
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Respect and support the self-identification of Aboriginal and Torres Strait Islander Peoples, and identify specific cultural and health needs required to deliver whole-person care.
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Recognise the cultural strengths and values of Aboriginal and Torres Strait Islander Peoples to support the delivery of person-centred care.
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Integrate the cultural strengths, needs, and appropriate resources for Aboriginal and Torres Strait Islander Peoples to enable the delivery of person-centred care.
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Uphold the principle of self-determination by empowering Aboriginal and Torres Strait Peoples to have a voice in their healthcare decisions, fostering culturally safe, person-centred approaches that promote autonomy and equitable health outcomes.
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Trauma-informed
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Understand the health and wellbeing impacts of trauma, including intergenerational trauma and the effect on the therapeutic relationship
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Demonstrate an understanding of the health and wellbeing impacts of trauma, and describe the principles of trauma-informed care in practice
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Start applying trauma-informed care principles into clinical practice by creating a safe, supportive environment, actively listening to patients, and recognising the impact of trauma on their health
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Integrate trauma-informed care principles and adapt approaches through reflective practice, ensuring interventions promote healing, resilience, and trust in the therapeutic relationship.
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Conduct consultations to effectively facilitate care
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Consultation management
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Elicit the patient’s agenda and have a structured approach to consultations
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Demonstrate a structured approach to consultations including agenda negotiation, setting reasonable expectations for what is achievable, and planning follow up
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Demonstrate a structured approach to consultations including negotiating and prioritising agendas and health issues to optimise the consultation potential
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Utilises structured consultations with effective agenda prioritisation and time management, encompassing a holistic approach
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Apply expert medical knowledge and skills in assessing and diagnosing conditions
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Clinical information gathering
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Obtain relevant history, examination and investigations to inform diagnosis and care
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Obtain relevant history, perform a focused examination and rationally select investigations relevant to the general practice context to inform care
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Efficiently obtain relevant history, perform a focused examination and considering the general practice context, the appropriate investigations to inform care
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While considering the patient and context obtain relevant history, examination and investigations to inform care
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Diagnostic reasoning
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Use hypothetico-deductive reasoning to make diagnoses
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Interpret and synthesise complex clinical assessment and diagnostic information to reach high probability diagnoses
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Demonstrate proficiency in clinical problem solving with the ability to adapt reasoning based on emerging information and priorities
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Interpret, synthesise and prioritise clinical data in clinical reasoning, and reappraisal over time to integrate new information and modify diagnostic reasoning
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Manage the full range of presentations including providing first contact access
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Urgent, emergent, time sensitive care
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Assess presentations for red flags, identify when acute management is required and provide basic life support when needed
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Identify clinical deterioration, escalate care and manage appropriately within the general practice context
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Have a structured, rational approach to assessment that prospectively assesses deterioration risk to anticipate and manage urgent and emergent conditions, including provision of advanced life support
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Manage urgent, emergent, and complex acute situations in line with contemporary practice in the general practice environment
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Management planning
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Formulate safe and evidence-informed management plans, seeking timely help from colleagues
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Develop management plans that are considerate of patient preferences and evidence, identifying opportunities for patient self-care and management
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Develop management and follow up procedures, referral, appropriate review and safety netting.
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Develop holistic, rational, patient-centred management plans that are evidence-informed, implementable and revised as needed
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Prescribing
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Prescribe safely for common presentations
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Prescribe safely and lawfully, including management of polypharmacy
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Undertake rational, safe prescribing and medication monitoring
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Undertake rational, safe prescribing, deprescribing, and medication monitoring
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Procedures
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Safely undertake procedures under appropriate supervision
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Safely undertake procedures in general practice context with appropriate supervision
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Safely undertake procedures appropriate to context and skill levels
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Maintain currency in safely undertaking procedures relevant to the context of practice
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Manage uncertainty and assess undifferentiated presentations
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Management of uncertainty
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Recognise that uncertainty is a factor to be addressed in diagnosis and management
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Address uncertainty and complexity in clinical encounters in a safe manner
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Manage uncertainty and complexity with appropriate safety-netting and use of time as a diagnostic aid
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Manage uncertainty, complexity and ongoing undifferentiated presentations
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Assessment and management of undifferentiated presentations
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With support, assess and manage presentations and seek assistance as required
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Assess and manage a range of conditions, including first contact undifferentiated presentations, and seek assistance when needed
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Assess and manage a wide range of presentations with appropriate safety-netting
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Assess and manage the full range of presentations including safety-netting and empowering patient self-efficacy
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Promote health and deliver preventive care
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Promoting health and wellbeing
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Identify individuals with risk factors for common preventable conditions and opportunities to encourage health promoting behaviour and actions
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Identify and prioritise preventive care opportunities in consultations including opportunistic preventive actions and education
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Integrate understanding of stages of change and harm minimisation into evidence informed personalised preventive care
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Provide evidence-informed personalised preventive care and support relevant to the patient’s context, including access to screening and systems for recall
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Health education and health literacy
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Identify opportunities to provide patients or carers with health information including about normal life stages
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Proactively provide some opportunistic health education about potential future health needs
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Anticipate potential health knowledge needs and prospectively provide relevant information
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Use a range of strategies and resources to provide appropriately detailed health education relevant to the patient context
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Aboriginal and Torres Strait Islander Peoples
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Identify and understand the health patterns for Aboriginal and Torres Strait Islander Peoples, and recognise relevant opportunities for health promotion.
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Understand the importance of specific preventative health screening for Aboriginal and Torres Strait Islander Peoples and apply it in clinical practice.
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Integrate preventative healthcare with Aboriginal and Torres Strait Islander Peoples by understanding the importance of self-determination and community-led approaches.
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Incorporates strengths-based approaches into health promotion activities by recognising and building on the cultural, social, and community strengths of Aboriginal and Torres Strait Islander Peoples.
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Public health
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Recognise common health issues that may impact public health and any reportable disease requirements
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Identify public health risks seen in general practice and manage appropriately within the consultation
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Appropriately notify and/or intervene regarding public health risks
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Identify and manage emerging public health risks in the local community
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