CHRONIC CARE

MEDICAL EXPERT 

  1. Knowledge: Demonstrate an overall effective level of knowledge and understanding of the basic science and clinical knowledge relevant to the chronic care population (with main emphasis on schizophrenia) of: 
    1. History, conceptual issues and classification of psychoses
    2. Etiology and symptoms of psychotic disorders 
    3. Variations in presentation and gender and age specific issues 
    4. Psychotic experiences in general populations
    5. Prodromal symptoms
    6. Concurrent problems and disorders (medical, psychiatric) 
    7. Diagnosis and differential diagnosis
    8. Phenomenology, pathology and investigations 
    9. Course and outcome, functional impairments and illness trajectories 
    10. 10.First episode issues 
    11. 11.Early intervention strategies
    12. 12.Evidence-based treatments  
    13. 13.Emergency, crisis, outpatient and inpatient treatment 
    14. 14.Assessment and management of refractory patients 
    15. 15.Psychopharmacology and somatic treatments 
    16. 16.Suicide and violence – assessment and management 
    17. 17.Treatment adherence issues and psychoeducation 
    18. 18.Continuum of care, long-term treatment issues and relapse prevention strategies 
    19. 19.Cultural/ethnic issues – theoretical, clinical and therapeutic 
    20. 20.Community resources 
    21. 21.Psychotherapeutic constructs – individual, family, group 
    22. 22.Rehabilitation issues 
    23. 23.Legislations and laws related to: Mental Health , Personal Health Information Protection, Substitute Decisions and Power of attorney; and its application 
    24. 24.Critical appraisal, scientific method, quality assurance, epidemiology and population health issues 
    25. 25.Parenting, family, homelessness and housing issues 
    26. 26.Basic science knowledge and application to psychoses (genetics, neurophysiology, neuroanatomy, neurochemistry, neuropsychology) 
  2. Skills: Demonstrate the general ability to assess, diagnose, consult on, and treat the full range of psychiatric disorders in the chronic care (with emphasis on schizophrenia) population in all ages, males and females, and in all clinical contexts, using an evidence based approach. Need to be proficient in technical and procedural skills and minimize risks and discomforts to the patient and be able to: Assessment: 

 2.1 Establish and maintain rapport and an effective therapeutic alliance 

 2.2 Conduct and organize an appropriate interview 

2.3 Perform an appropriate mental status examination with correct techniques and thoroughness, and evaluate, organize, interpret and present observations 

2.4 Perform an appropriate psychosocial assessment, including assessment of substance use and the family 

2.4 Perform an appropriate medical and neurological assessment 

2.5 Show expertise in obtaining collateral information from additional sources

Formulation

2.6 Synthesize a diagnosis according to DSM 5 criteria 

2.7 Integrate and present a bio-psycho-social understanding/formulation 

Treatment Plan: 

2.8 Develop and implement an integrated biopsychosocial treatment plan 

2.9 Use appropriate psychiatric, psychological, medical and imaging diagnostics and/or investigations 

2.10 Make appropriate referrals to other professionals and community resources 

2.11 Assess suitability for, prescribe and use appropriate psychological treatment 

2.12 Assess suitability for, prescribe and use appropriate social and environmental interventions 

2.13 Assess suitability for, prescribe and use appropriate psychopharmacological treatment 

2.14 Assess suitability for, prescribe and use appropriate somatic therapies (ECT, rTMS, etc) 

Treatment Implementation: 

2.15 Show expertise in early intervention, crisis management and relapse prevention strategies 

2.16 Show expertise in identifying and addressing unique issues in working with those from diverse cultural backgrounds 

2.17 Show skills in medico-legal issues and the appropriate application of relevant legislation, including use of mental health forms and presentation at consent and capacity review boards 

2.18 Show expertise in continuity of care issues 

2.19 Attend to safety issues, including the management of the suicidal or violent patient, as well as the recognition and appropriate referral of medically urgent issues 

COMMUNICATOR

Demonstrate the following abilities: 

  1. Listening effectively 
  2. Communicating and negotiating with patient, family, and health care team, an accurate, clear, coherent and timely account of the diagnoses, treatment plans and prognosis in all clinical cases 
  3. Conveying pertinent information and opinions to medical colleagues in a timely, efficient and effective manner, in both verbal and written formats 
  4. Preparing documentation that is accurate, timely and succinct 

COLLABORATOR 

Demonstrate the following abilities: 

  1. Consulting effectively with other physicians, health care professionals, and agencies as appropriate 
  2. Working collaboratively with other members of the health care team: – recognizing their roles and responsibilities – contributing to inter-disciplinary team activities 
  3. Facilitating the learning of patients, students and other health professionals 

SCHOLAR 

Demonstrate the following abilities: 

  1. Critical appraisal of medical information, successful integration of information from a variety of sources, and conforming to evidence-based principles of practice in relation to chronic care patients 
  2. Participation in the educational program and facilitation of the learning of other students, residents, and colleagues through guidance, teaching and constructive feedback 

PROFESSIONAL 

Demonstrate: 

  1. Integrity, compassion and respect for diversity 
  2. b) Realistic but hopeful, positive and anti-stigmatizing attitudes towards patients with serious mental illness 
  3. Fulfillment of the medical, legal and professional obligations of the psychiatrist, practicing within the Code of Ethics Annotated for Psychiatry and Ministry of Health guidelines 
  4. Collaborative and respectful patient relationships that demonstrate gender and cultural awareness 
  5. Responsibility, dependability, self-direction, and punctuality 
  6. Acceptance and constructive use of supervision and feedback 
  7. Awareness and appropriate response to personal limitations including reactions to patients 
  8. Responsibility in attendance and participation in educational opportunities, including schizophrenia seminars, grand rounds and other seminar.  

LEADER 

Demonstrate the following abilities: 

  1. Setting and implementing realistic priorities and using time effectively in order to optimize professional performance and balance patient care and learning needs 
  2. Competence and willingness to direct patients to relevant community resources 

HEALTH ADVOCATE 

Demonstrate: 

  1. Effective advocacy for the biopsychosocial and cultural needs of patients and their families within the health care system and community 
  2. Awareness of regional, national and international advocacy groups in mental health care 
  3. Ability to identify and understand the determinants of health affecting chronic care patients and communities, recognizing and responding to those issues where advocacy is appropriate for the patient or community