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1. Practise medicine within their defined scope of practice and expertise
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1.3. Apply knowledge of the clinical and biomedical sciences relevant to Internal Medicine
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1.3.8. Pharmacology as it relates to pharmacokinetics, pharmacodynamics, mechanism of action, routes of delivery and elimination, and adverse effects of medications
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1.3.8.3. Cardiovascular medications
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1.3.8.10. Supplementary and complementary medications
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1.4. Apply knowledge of the following systems, clinical scenarios, conditions, diseases and therapies applicable to Internal Medicine, including the manifestations, investigation, and management
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1.4.1. Cardiac
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1.4.1.1. Symptoms
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1.4.1.1.1. Chest pain
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1.4.1.1.2. Dyspnea
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1.4.1.1.3. Palpitations
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1.4.1.1.4. Syncope
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1.4.1.2. Findings and investigations
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1.4.1.2.1. Abnormal cardiac enzymes
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1.4.1.2.2. Cardiac murmurs
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1.4.1.3. Disorders
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1.4.1.3.1. Acute coronary syndromes and their complications
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1.4.1.3.2. Cardiomyopathies
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1.4.1.3.3. Congestive heart failure
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1.4.1.3.4. Coronary artery disease
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1.4.1.3.5. Pericarditis, pericardial effusion, and tamponade
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1.4.1.3.6. Pulmonary hypertension
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1.4.1.3.7. Valvular heart disease
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2. Perform a patient-centred clinical assessment and establish a management plan
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2.2. Elicit a history, perform a physical exam, select appropriate investigations, and interpret their results for the purpose of diagnosis and management, disease prevention, and health promotion
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2.2.1. Elicit information relevant to the risk profile for disease
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2.2.2. Assess risk factors for disease progression, as well as a patient’s need for health promotion and/or health surveillance
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2.2.3. Obtain relevant information from the family history
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2.2.4. Elicit an accurate occupational history, as appropriate, with documentation of the patient’s exposure to occupational health hazards, safety risks, and job demands
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2.2.5. Perform a complete and appropriate assessment of complex medical presentations, including consideration of competing treatment needs
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2.2.6. Assess the patient’s capacity to make decisions about his/her medical care
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2.2.7. Perform a functional assessment of basic and instrumental activities of daily living, mental status examination, and assessment of gait and balance
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2.2.8. Perform a quantitative measure of performance status for patients with malignancy
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2.2.9. Select investigation strategies, demonstrating awareness of the availability and access to resources in various clinical settings
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2.2.10. Apply criteria for use of diagnostic imaging and nuclear medicine examinations, including their risks and contraindications
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2.2.11. Interpret cardio-pulmonary diagnostic testing, including electrocardiograms, and related reports
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2.2.12. Interpret reports of medical imaging and pathology in the context of the patient
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2.2.13. Integrate, synthesize and summarize information gathered through the clinical assessment and investigations
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2.3. Establish goals of care in collaboration with patients and their families1, which may include slowing disease progression, treating symptoms, achieving cure, improving function, and palliation
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2.3.1. Recognize and respond to changes in patient status that indicate a need to reassess goals of care
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2.3.2. Identify and respond to symptoms affecting patient comfort
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2.3.3. Recognize when ongoing resuscitation efforts are no longer effective and should be discontinued
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2.4. Establish a patient-centred management plan
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2.4.1. Develop and implement plans for
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2.4.1.1. Critically ill patients, including provision of hemodynamic support, non-invasive ventilation and monitoring
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2.4.1.2. Hospitalized patients with acute illness, or acute exacerbations of chronic illness
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2.4.1.3. Ambulatory patients with common acute presentations and/or chronic medical conditions
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2.4.1.4. Patients with multiple medical conditions, including consideration of competing priorities, conditions or treatments as well as drug interactions
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2.4.1.5. Safe discharge of patients with acute and chronic conditions, including medication reconciliation
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2.4.1.6. Safe transition to another health care setting, including anticipation, prevention, and management of changes in health status during transition
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2.4.1.7. Referral to comprehensive or interprofessional care
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2.4.2. Identify and address interactions between different diseases and different treatments
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2.4.3. Implement primary and secondary prevention strategies as part of the overall management plan
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2.4.4. Incorporate consultant recommendations into diagnostic and treatment plans
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2.4.5. Integrate recommendations from other health care professionals
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2.4.6. Monitor clinical status and adapt management plans during the evolution of the patient’s clinical course
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