Module 1: Urinary incontinence and pelvic organ prolapse
In this module, urinary incontinence and pelvic organ prolapses are covered, with diagrams demonstrating how they can occur. The module also looks at the types of incontinence, symptoms, diagnosis, prevalence, the causes and risk factors. Prolapses covered are the anterior and posterior vaginal walls, cervix or uterus and the apex of the vagina. Lifestyle prevention treatment options are discussed including pelvic floor exercises. Managing these presentations includes taking a detailed medical and obstetric history, and investigating risk factors, physical examination and further investigation options. Questionnaires are provided as a guide for these consultations. changes are discussed as well as continence aids. Various treatment options including lifestyle interventions, physical therapies, bladder training, medicines and continence aids are outlined. Surgical intervention and the associated risks of surgical intervention are considered.
Module 2: Complementary medicines
The definition of complementary medicine according to WHO and the RACGP are outlined in this module. Three main topics in this module include how to approach of the topic of complementary medicine with your patients, how to review and discuss the evidence for complementary medicine with your patients, and the use of some clinical scenarios to put these strategies into practice. A feature of this module gives two scenarios of patients with urinary incontinence and with pregnancy-induced emesis. In both cases the patients prefer “natural” options rather than traditional medication. The module concludes that the GP should advise patient of all potential treatments for their condition, including benefits and risks. The GP should not recommend any treatment that does not have reasonable evidence for its effectiveness.
Module 3: Family planning (Advanced 2)
This module builds on the knowledge learned in the advanced certificate. It starts with the description of the different phases of the menstrual cycle and natural family planning methods options. These include fertility awareness, lactational amenorrhoea and withdrawal methods, their effectiveness, advantages and disadvantages and contraindications. Unit 2 outlines contraceptive needs in women with Intellectual Disability including legal considerations. Unit 3 addresses the complexities for women who are culturally and linguistically diverse, including the clinical challenges associated with this group. Information includes statistics, factors influencing contraceptive choices and GP management recommendations are included. Key points of diagnosis, investigations, management, expected response and potential side effects are suggested. This unit also lists resources including public funded interpreter information. Information for GPs working with ATSI women is also featured. At the end of this module an overview of new contraceptive products is given.
Module 4: Pregnancy complications (Advanced 1)
Unit one outlines the considerations for advanced maternal age pregnancies and potential complications for the mother and the child. It examines fertility decline and possible early pregnancy complications including spontaneous abortion, ectopic pregnancy, chromosomal abnormalities and congenital malformations. Late pregnancy complications discussed include hypertension, pre-eclampsia, gestational diabetes mellitus, placental complications and increased risk of caesarean sections. Possible foetal complications including low birth weight, preterm delivery and stillbirth. The definitions of twin pregnancies and possible maternal and foetal complications are listed. Antenatal care, timings and mode of birth are included. Unit three defines pre-eclampsia, identifying women at risk, the effects on the body, and the pathophysiology and management of this condition. The complexity of managing this condition in rural areas is discussed. Finally benign pregnancy-related skin concerns are reviewed including skin pigmentation, stretch marks and thinning of hair. Benign and sinister specific dermatoses of pregnancy are described and examples are shown.
Module 5: Pregnancy complications (Advanced 2)
This module lists possible infections and how the immune system in pregnancy may respond. These include chlamydia, syphilis, Hep B/C, HIV, GBS, rubella and varicella, HSV, listeria, parvovirus, cytomegalovirus, toxoplasma and COVID- 19. Clinical management of these conditions is outlined. Unit 2 defines and outlines the causes of antepartum haemorrhage. It includes risk factors and clinical management of this condition.
Preterm birth/labour (PTL) is the topic of unit 3 and discusses the causes, risk factors, risk reduction, assessment and management of this condition. Unit 4 describes vaginal/perineal tears and episiotomies, including definitions, risk factors and tear-associated morbidity. The types of episiotomy incisions is described and when this procedure should or should not be performed. Possible complications are included. The last part of this unit looks at faecal and anal incontinence after pregnancy and childbirth; definition, assessment history, examination and management of this condition.
Module 6: Familial risk of breast and ovarian cancer
Genetics are discussed in unit one including information, counselling and statistics for hereditary, familial and sporadic distribution of cancer. The role of genes is also examined. Unit two looks at hereditary breast and ovarian cancer and the associated genes. Referral guidelines, BRCA carrier risks, genetic counselling, identifying and managing patients who are at high risk of hereditary cancers are addressed. Genetic testing information including advances, testing processes and possible funding options are outlined in unit 3. This includes consent requirements, possible results and genetic variant classifications. The module moves on to management strategies for high risk breast and ovarian cancer patients including psychological and lifestyle choices for high risk women, communicating genetic results and informing family members. Counselling considerations are reproductive options, prenatal testing, pre and implantation genetic diagnosis and the role of IVF, and their pro’s and con’s.
Module 7: Anorexia Nervosa and Bulimia Nervosa
This module describes eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding and eating disorders. The role of the medical practitioner is discussed including advocacy for changing societal norms and healthy lifestyle perspectives and targeting at risk individuals. High risk groups are noted. The module provides screening tools to be used in conjunction with behavioural, psychological and physical signs – a comprehensive list of signs for these categories are listed. The module then provides assessment information and guides and when immediate referral is appropriate. Patient engagement may be challenging and the suggested approach by the clinician is included. At the end of this module, treatment goals and guidelines are given including suggested multidisciplinary team involvement, medical practitioner management, pharmacotherapy and eligibility criteria.
Module 8: Premature Ovarian Insufficiency (POI)
In the first unit of this module definitions of early and premature menopause are given. Risk factors and causes of spontaneous POI are listed. Iatrogenic POI, caused by chemotherapy, radiotherapy or surgery is mentioned. Information about clinical presentations of POI, diagnosis criteria, patient history, examinations, investigations and ongoing monitoring are listed in unit 2. Health consequences may include psychological distress, osteoporosis, cardiovascular disease, cognitive impairment, sexual dysfunction and other health concerns. Finally, management of POI from initiating care and coordinating care (may include a multidisciplinary approach. Information is provided on managing symptoms of menopause, sexual health difficulties and psychological issues. When managing patients with this condition, consideration needs to be given regarding prevention of bone loss, osteoporosis and prevention of cardiovascular disease.