Training Program for Physicians

SPECIALTY TRAINING PROGRAM IN GENITOURINARY MEDICINE

Manila Genitourinary Clinic, Manila, Philippines

• Expected Competencies of a Trainee in Genitoutinary Medicine The trainee is expected to possess and demonstrate knowledge in the following areas:

• Data Gathering (History and Physical Examination)
• Basic Science
• STI pathogens
• Syndromes
• Complications
• Laboratory Tests and Procedures
• Management
• Prevention
• Counseling

• The trainee must be able to:

1. 1. Discuss the anatomy, physiology, microbiology and immunology of the genitourinary and reproductive tract.
   2. Discuss the nature, variations, pathology, pathophysiology, signs and symptoms of common and uncommon STI process affecting the genitourinary and reproductive tract.
   3. Interpret, analyze and synthesize the various data gathered through history taking, physical examination and laboratory procedures and in the process derive a primary diagnosis and differential diagnosis as well.
   4. Enumerate or write the diagnostic and therapeutic plans to arrive at a definite diagnosis in the most efficient manner; prioritizing examinations and taking into consideration the comfort, risk, ethical and financial impact on the patient as well as the relevance and usefulness of the procedure.
   5. Recognize, interpret and analyze the effects of the diagnostic and therapeutic actions and decide on further interventions, when necessary.
   6. Discuss the natural course of the disease process, proper timing of diagnostic and therapeutic interventions, and the clinical course as influenced by the therapeutic interventions.
   7. Enumerate the natural complications of the disease process.
   8. Discuss the indications, contraindications and the cost of various diagnostic procedures.
   9. Discuss the clinical pharmacology, pharmacokinetics and pharmacodynamics of various therapeutic agents applied to different STIs.
   10. Discuss the methods of preventing the occurrence and recurrence of STIs and how to control the spread of the infection.
   11. Enumerate the available community resources for the achievement of the above and for follow up and rehabilitation.
   12. Utilize and cite medical literatures pertinent to specific STI cases.
   13. Define the pattern of STIs as they occur in the local setting or community
   14. Identify the root causes of STIs and propose control measures
   15. Generate realistic interventional measures as well as mobilize the community and its resources to implement them
   16. Identify necessary resources, whether locally available or unavailable, through linkages with government and non-government agencies or organizations.
   17. Discuss both sides of controversial issues regarding treatment of STIs.

• SKILLS

1. 1. Do microscopy studies
   2. Do culture isolation and identification
   3. Interpret Imaging studies
   4. Do surveillance studies

• RESEARCH

1. 1. Report of cases and review of literature
   2. Research project (write or present at least one paper)

• JOURNALS

1. 1. Know highlights of articles pertaining to STIs and venereology.
   2. Critical appraisals of medical literatures pertaining to STIs and its complications and other related genitourinary and reproductive problems.

• List of topics, diagnostic procedures and disorders that a trainee should know.
  • Historical Background of STIs
  • Definition and Classification of STIs
  • Sexual Psychology and Behaviors

• Basic Science
  • Anatomy, Histology, Physiology and Pathology of Male and Female Genitourinary and Reproductive Tract
  • Genitourinary Mucosal Defenses
  • Normal Genital Flora
  • Pathogenesis of Sexually Transmitted viral and bacterial infections
  • Microbiology and Immunology of STIs
  • Epidemiology of STI in the Philippines

• Evaluation and Treatment
  • Evaluation of the Patient
    • History Taking
    • Physical Examination
    • Specimen Collection
  • Management, Diagnosis and Treatment of Specific Etiologic Agents
    • Virus
      • Herpesvirus
      • Infectious Mononucleosis
      • Human Papilloma Virus
      • Cytomegallovirus
      • Hepatitis Virus
      • Molluscum Contagiosum Virus
      • Human Immunodefficiency Virus
    • Bacteria
      • Nisseria sp.
      • Chlamydia trachomatis
      • Gardnerella vaginalis
      • Enterics: shigella, salmonella, Campylobacter
      • Treponema pallidum
      • Haemophilus ducrei
      • Calymatobacterium granulomatis
      • Anaerobes
      • Mycoplasmas
      • Staphylococcus spp.
      • Streptococcus spp.
    • Fungus
      • Candida albicans
      • Blastomycosis
      • Cryptococcus, Histoplasmosis
    • Protozoa
      • Trichomonas vaginalis
      • Giardia lambdia
    • Ectoparasites
      • Phthirius pubis
      • Sarcoptes scabei
  • Problems Encountered in Diagnosis and Treatment
    • Complications
      • Lower Genital Tract Infection in Women: Cystitis, Urethritis, Vulvovaginitis, and Cervicitis.
      • Bacterial Vaginosis
      • Pelvic Inflammatory Disease
      • Prostatitis
      • Epididimmytis and Orchitis
      • Male and Female Infertility
      • Infection in Pregnancy
      • Infection in Children
      • Sexually Transmitted Proctitis and Diarrheal disease
      • Genital Ulcer Adenopathy Syndrome
      • Reiter’s Syndrome and Arthritis associated with STIs
      • Disseminated Infections
      • Fitz-Hugh-Curtis Syndrome
    • Pharmacology
      • Basic Concepts (Mechanism of action, pharmacokinetics, pharmacodynamics, dosage)
        • Penicillins
        • Cephalosporins
        • Aminoglycosides
        • Tetracyclines
        • Macrolides, Lincomycin, clindamycin
        • Chloramphenicol
        • Vancomycin
        • Metronidazole
        • Antituberculosis drugs
        • Quinolones
        • Sulfas and Urinary Antiseptics
      • Mechanism of Bacterial Resistance
    • Laboratory
      • Microscopy
        • Gram Staining
        • Tzanck Smear
        • Wright stain
        • KOH
        • Wet Mount
        • Dark field
      • Culture and Sensitivity Testing
      • Antigen Antibody Testing
        • Immunoflourescence
        • Enzyme Linked Immunoassay
        • Particle Agglutination
      • Molecular Diagnostic Procedures
        • Polymerase Chain Reaction
        • Ligase Chain Reaction
        • DNA Probe
    • Imaging Studies
      • Radiography
      • Sonography
• Prevention of STIs and its complications and other related genitourinary diseases
• Patient Education and Counseling

Prepared by: Noel E. de Vera, MD, CFP, DPSV / Antonio E. Feliciano, Jr, MD, FPSV