HU Credits: 4

Degree/Cycle: 2nd degree (Master)

Responsible Department: Medicine

Semester: Yearly

Teaching Languages: Hebrew

Campus: Ein Karem

Course/Module Coordinator: Dr. Dodo Bart
Dr. Atarah Juravel-Jaffe

Coordinator Email: nivdaviddex2@gmail.com; atarah.jaffe@gmail.com;

Coordinator Office Hours: by appointment

Teaching Staff:
daniel raday,
helene mendelson,
avi goldberg,
Dr. avigail argov,
avraham fridman,
adam balin,
orit tapet,
adrian arlich,
irena karni,
ela levin,
eliezer vaisman,
eleksander king,
emma safurni,
moran alkobi,
,
efrat blumerzon,
gila nitay,
arkadi tzipovski,
ashraf karami,
baruch levit,
bat - sheva hershkovitz,
gideon lifshitz,
johnti Merski,
dvora radomsky,
dvora rozenblum,
david ramati,
david sheler,
duma ,
dima bitar,
daniel Youngerd,
hadas tzur,
vered heffes,
vered cohen naor,
ziv seser,
arin yechi,
hava harats,
cheftziba zer aviv,
tatyana pechyoni,
tal gizonterman,
tali haimsky,
talya cohen,
talya frenkel,
tasa manaim,
Dr. yan miskin,
yehudit halbershtat,
yuval barash,
Dr. yael ronen,
yael tapoohi armon,
itshak barash,
yakir aspir,
liat luwisch,
,
larisa shmulevitz,
lea mor,
muriel tandnik,
moriya tessler,
michael gimpel,
michael yoshfe,
michael kaufman,
michal cohen dedi,
michal shoam,
martina hammelborger,
maryan pizanta,
maria kaganov,
noam ofek,
nataly davidov,
nira eshel,
neomi freudenberger,
svetlana jorbel,
smadar avidan,
samiha aryan,
adi alkalay,
atar Grinfeld,
feda abu - kauder,
tamar altshuler,
tamar zemel,
tammy izak,
sharon silverman,
shalhevet roness,
shabtai brill,
rane Bishara,
rika turgeman,
reut klain,
rotem marek,
tzipi sabag,
keren jemal,
keren cohen nahum,
reuven dressler,
reuven zaritsky,
rivka laster,
rivka lashtz,
roni torten,
ronald ban,
chana meirovitz,
itzhak margolis,
michal yeshayauo,
michal poichtonger,
Dr. Aura Cohen,
Dr. Dodo Bart,
Dr. Brendon Stewart,
Prof Amnon Lahad,
Dr. Amani Zaitar,
Dr. Andrew Manning,
Dr. Ruhama Lehmann-Weiss,
Prof Israel Katz,
Dr. Yaarit Bodenheimer,
Dr. Yael Paldi,
Dr. Goldberg-Clein Tova,
Dr. Dan Rorman,
Dr. dalit may,
Dr. more dalhia,
Dr. Dina Herbet-Toberman,
Dr. John Borowski,
Dr. Ariel Israel,
Dr. Tikva Armon,
Dr. atarah jaffe,
Dr. OFER Gantz,
Mr. Gal Oded,
Dr. Alexander Kiderman,
Dr. Neomi Weizer polak,
Dr. Naama Sadot,
Dr. Michal Ronen,
Dr. Mici Phillips,
Dr. Ruth Kannai,
Dr. Ohad Avny,
Dr. Efrat Schreiber,
Dr. Vered Obel Neaman,
Dr. Maya Moss Yishay,
abdalla hijazi,
daniel rein,
david vered,
yan mastislevski,
itamar bernshtein,
Ms. rivka hanhart,
nosan peri,
tatiana baivski,
lina kasem,
eleonora karsani,
isabella toledano,
michal lwow,
tzvi beninja,
tamar zemel,
Penina Pogoda,
or arad,
Ms. Eitan Lavan,
Dr. OMER YAISH,
Elisheva Zerm,
Aya Falach,
Tal Fuchs,
harvey woolf,
Nina Luvman,
Dr. Naamah Fraenkel,
Naomi Sofer,
Omer Rosenblum,
Barry Knishkowy,
rachel Schechtman,
eitan amitai,
yigal schwarzman,
Iyas Ashav,
Eitan Gluskin,
Avraham Schwartz,
Dr. Dror Ohana,
shay dvir,
Thaer Shehadeh,
Suha Mashni,
Hila Leiman,
Dr. Yehudit Medizinsky,
tsvi eytan,
Dr. ariel rozitzky,
Tamer Abdin,
Dr. marina goldin isserlis,
Shachar Ben chaim,
Dan Sela,
Benjamin Bentolila,
Nitzan Aviram,
dima bitar,
Ms. aya Cohen,
Dr. Adina Nissim,
Zeev Maresky,
Dr. Amalia Walzer,
Noam Gardin,
Dr. Tom Axelrod,
Mr. Tomer Meir,
Dr. Rana Abu Ghannam,
Manal Muhareb,
Alex Goldstein,
Lital Shemesh Bar,
Adi Isaacson,
Vered Shayovitz,
Tanya Cardash,
natali lerner,
Dr. Omer Yair

Course/Module description:
A clinical rotation in family practice clinics. The students will be exposed to primary care in the community and will recognize their place in the medical system as a whole. The students will become familiar with common morbidities in primary care and their acute and chronic management with a multi-disciplinary and holistic approach. The student will enhance their knowledge in preventive medicine and improve their communication skills.

Course/Module aims:

Learning outcomes - On successful completion of this module, students should be able to:
1. To review the priciples of family madicine and the characteristics of the primary care physician and team including:
* Continuing and long term relationship with the patient and family
* Caring for heterogenous populations
* Varied work environments and prevalence of medical conditions related to varied populations
* Multi-purpose medical appointments
* Graded diagnostic approach
* Opportunity for long term care
2. To become be familiar with' will understand, analyze and implement models in family medicine in a final assignment
3. To become familiar with the diagnosis and treatment of common diseases in the primary care setting
4.To implement a clinical approach to common symptomatology in the primary care setting
5. To perform follow up visits for chronic diseases
6. To develop an evidence based approach to preventive medicine and health advocacy and to provide concrete patient-tailored recommendations
7. To demonstrate proficiency in history taking, communication, physical examination, clinical reasoning and case management
8. To perform problem oriented history taking for common medical problems in primary care
9. To perform general and problem oriented physical examination
10. To complete training in physical examination necessary to treat common problems in primary care including the neurological examination, primary care orthopedics and otolaryngology
11. To review the essential role of the family physician in the healthcare system

Attendance requirements(%):
Full attendance of at least 25 clinical hours in the community clinic and full attendance in all the lectures and workshops.

Teaching arrangement and method of instruction:

Course/Module Content:
Lifestyle medicine
Nutrition, general recommendations, diet types, disease-dependent recommendations
Physical activity, EBM recommendations
Sleep medicine
Obesity
Smoking cessation
Adult vaccinations, special populations (pulmonary disease, immune deficiency)

Screening tests
Colon cancer screening
Breast cancer screening
Osteoporosis screening
Prostate cancer screening
Cervical cancer screening

Acute disease
Upper Respiratory Tract Infection
Acute Otitis Media
Otitis Externa
Pharyngitis
Community Acquired Pneumonia
Gastroenteritis
Urinary Tract Infection
Common rashes
Lower back pain
Fever in children
Sexually transmitted disease

Chronic disease
Hypertension
Diabetes
Ischemic heart disease – primary prevention (hyperlipidemia, aspirin treatment)
Ischemic heart disease – management of chronic disease
Congestive heart failure - management of chronic disease
COPD
Asthma
Approach to chronic pain
Palliative care / End of life care

Somatic disease / Psychiatry in the community setting
Irritable bowel syndrome
Fibromyalgia
Medically unexplained complaints – approach
Depression and anxiety

Approach to the family in crisis
Family medicine models

Clinical approach / symptomatology
Approach to abdominal pain
Approach to headache
Approach to fatigue and malaise
Approach to dizziness
Approach to common orthopedic problems in the clinic
Approach to chronic cough

Required Reading:
Syllabus - required reading

1. Preventive medicine

• הנחיות קליניות, קידום בריאות ורפואה מונעת, המלצות כח המשימה הישראלי,
בעריכת פרופ' חוה טבנקין, פרופ' אמנון להד
https://www.ima.org.il/userfiles/image/clinical_09_preventive.pdf

עמודים:
6-8 מבוא
13 רפואה מונעת מלידה עד גיל שנתיים.
16 רפואה מונעת מגיל 2-6
19 רפואה מונעת מגיל 7-12
22 רפואה מונעת מגיל 13-19
28 רפואה מונעת מגיל 20-39
34 רפורה מונעת מגיל 40-64
41 רפואה מונעת מגיל 65 ומעלה
42-49 המלצות ליישום הנחיות לקידום בריאות ורפואה מונעת במרפאה ראשונית
59-65 לוח חיסוני השגרה בילדות, בית ספר ומבוגרים
66-74 חיסונים חדשים
75-82 תזונה נבונה למניעת מחלות
83-95 פעילות גופנית
112-131 נזקי העישון והדרכים למניעה וגמילה
132-149 מניעה ואיתור מוקדם של מחלות ממאירות
169-178 מניעה באמצעות תכשירים תרופתיים – Chemoprevention
179-185 אוסטיאופורוזיס מניעה, איתור מוקדם וטיפול
186-190 הערכת הרגלי שינה והפרעות שינה במרפאה הראשונית
193-199 אלימות במשפחה

 טיפול בהיפרליפידמיה
 ההנחיות הישראליות לטיפול בהיפרליפידמיה http://www.ias.org.il/hyperlipidemia2014.pdf

2. Chronic disease

• Diabetes
 Standards of Medical Care in Diabetes – 2018 Abridged for Primary Care Providers
Clinical Diabetes 2018 Jan; 36(1): 14-37
http://clinical.diabetesjournals.org/content/36/1/14
• Hypertension
 הנחיות קליניות - יתר לחץ דם בישראל - אבחנה, טיפול ואיזון
כולל ההנחיות העדכניות לאבחון וטיפול ביתר לחץ דם במבוגרים ובילדים – 2019 בעריכת פרופ' עדי לייבה ד"ר שוקי לשם ד"ר סוהיר אסדי פרופ' אהוד גרוסמן
https://www.ima.org.il/userfiles/image/clinical_04_bloodpressure.pdf
עמודים:
12-54, 61-63, 74-76, 102-128

 Optional reading
2018 ESC/ESH Guidelines for the management of arterial hypertension European Heart Journal, Volume 39, Issue 33, 1 September 2018, Pages 3021–3104
https://academic.oup.com/eurheartj/article/39/33/3021/5079119

• Congestive heart failure
 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)
Developed with the special contribution of the Heart Failure Association (HFA) of the ESC
European Heart Journal, Volume 37, Issue 27, 14 July 2016, Pages 2129–2200
https://academic.oup.com/eurheartj/article/37/27/2129/1748921

*יש להתמקד בפרקים 3-11

• Primary prevention of cardiovascular disease

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease - guidelines made simple
*(הנחיות להיפרליפידמיה – לפי ההנחיות הקליניות הישראליות מטה)
http://www.onlinejacc.org/sites/default/files/additional_assets/guidelines/Prevention-Guidelines-Made-Simple.pdf
* (עדכון ההנחיות לטיפול בהיפרליפידמיה 2014)
http://www.ias.org.il/hyperlipidemia2014.pdf
• Ischemic Heart Disease
 Stable Ischemic Heart Disease BMJ Best Practice
https://bestpractice.bmj.com/topics/en-us/148

• Osteoarthritis
 Osteoarthritis BMJ Best Practice
https://bestpractice.bmj.com/topics/en-us/192

• Allergy
 נזלת כרונית קווים מנחים קליניים
https://www.ima.org.il/userfiles/image/clinical_57_nazelet.pdf

• Asthma
 GINA - Global Initiative for Asthma, pocket guide
https://ginasthma.org/wp-content/uploads/2019/04/GINA-2019-main-Pocket-Guide-wms.pdf/

• COPD
 GOLD – Global Initiative for Chronic Obstructive Lung Disease
Pocket guide to COPD diagnosis, management and prevention
https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-POCKET-GUIDE-FINAL_WMS.pdf

• Approach to chronic cough
 Chronic cough: evaluation and management
Am Fam Physician. 2017 Nov 1;96(9):575-580
https://www.aafp.org/afp/2017/1101/p575.html

• Palliative care
 Care of the dying patient in the community
BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4085
 הנחיות ליישום חוק החולה הנוטה למות - חוזר מנכ"ל 3/2008
בבית ולא במוסד, בעריכת ישראל דורון, 2006

• Approach to chronic pain
 The Management of Chronic Overlapping Pain Conditions
https://www.practicalpainmanagement.com/pain/neuropathic/management-chronic-overlapping-pain-conditions
3. Approach to somatic and mental health problems

• Chronic headache
 Guideline for Primary Care Management of Headache in Adults; Canadian Family Physician Vol 61: August 2015 http://www.cfp.ca/content/61/8/670.full.pdf

• Dizziness
 Dizziness: Approach to Evaluation and Management; American Family Physician. 2017 Feb 1;95(3):154-162.
https://www.aafp.org/afp/2017/0201/p154.html

• Fatigue and malaise
 Fatigue: an overview. Rosenthal TC, Majeroni BA, Pretorius R, Malik K. American Family Physician. 2008 Nov 15;78(10):1173-9.
https://www.aafp.org/afp/2008/1115/p1173.html

 קווים מנחים לבירור וטיפול בעייפות ברופאה ראשונית
https://www.ima.org.il/userfiles/image/clinical_27_tired.pdf

• Depression and anxiety
 Overview of Depression; BMJ Best Practice
https://bestpractice.bmj.com/topics/en-us/1083

• Fibromyalgia
 אבחון וטיפול בפיברומיאלגיה (דאבת השרירים) - הנחיה קלינית
הגישה דרך אתר וויקירפואה:
https://www.wikirefua.org.il/w/index.php/%D7%90%D7%91%D7%97%D7%95%D7%9F_%D7%95%D7%98%D7%99%D7%A4%D7%95%D7%9C_%D7%91%D7%A4%D7%99%D7%91%D7%A8%D7%95%D7%9E%D7%99%D7%90%D7%9C%D7%92%D7%99%D7%94_(%D7%93%D7%90%D7%91%D7%AA_%D7%94%D7%A9%D7%A8%D7%99%D7%A8%D7%99%D7%9D)_-_%D7%94%D7%A0%D7%97%D7%99%D7%94_%D7%A7%D7%9C%D7%99%D7%A0%D7%99%D7%AA_-_Fibromyalgia_diagnosis_and_management

• Irritable bowel syndrome
 Irritable Bowel Syndrome
Alexander C. Ford, et al, June 29, 2017
N Engl J Med 2017; 376:2566-2578

• Medically unexplained symptoms
 Assessment and management of medically unexplained symptoms
BMJ 2008; 336 doi:
https://doi.org/10.1136/bmj.39554.592014.BE
(Published 15 May 2008) Cite this as: BMJ 2008;336:1124

4. Acute disease

• Pharyngitis
 Group A Streptococcal (GAS) Disease; CDC Center for Disease Control and Prevention
https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html

• Upper respiratory tract infection
 Current Concepts in Adult Acute Rhinosinusitis, Ann M. Aring MD, Miriam M. Chan, PharmD, American Family Physician. 2016 Jul 15;94(2):97-105.
https://www.aafp.org/afp/2016/0715/p97.html

• Pneumonia
 Diagnosis and Treatment of Adults with Community-acquired Pneumonia An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America
https://www.atsjournals.org/doi/pdf/10.1164/rccm.201908-1581ST

• Acute abdominal pain
 Evaluation of Acute Abdominal Pain in Adults, Sarah L. Cartwright MD, Mark P. Knudson MD, MSPH, American Family Physician. 2008 Apr 1;77(7):971-978
https://www.aafp.org/afp/2008/0401/p971.html

• Urinary tract infection
 Dysuria: Evaluation and Differential Diagnosis in Adults; Thomas C. Michels MD MPH, Jarret E. Sands DO, American Family Physician. 2015 Nov 1;92(9):778-788.
https://www.aafp.org/afp/2015/1101/p778.html

• Acute otitis media
 הנחיות קליניות - איבחון וטיפול בדלקת אוזן תיכונה חדה בילדים
https://www.ima.org.il/userfiles/image/clinical_25_ear.pdf

• Gastroenteritis
 המלצות לאבחון ולטיפול בגסטרואנטריטיס חדה בילדים בישראל
https://cdn.doctorsonly.co.il/2015/11/%D7%94%D7%A0%D7%97%D7%99%D7%95%D7%AA-%D7%92%D7%A1%D7%98%D7%A8%D7%95%D7%90%D7%A0%D7%98%D7%A8%D7%99%D7%98%D7%99%D7%A1-2015.pdf
 Acute diarrhea in adults
Am Fam Physician. 2014 Feb 1;89(3):180-189.
https://www.aafp.org/afp/2014/0201/p180.html

• Common rashes
 Amanda Almon MD et al Common Skin Rashes in Children, Am Fam Physician. 2015 Aug 1;92(3):211-216.
http://www.aafp.org/afp/2015/0801/p211.pdf

• Fever in children
 הנחיות קליניות – הורדת חום בילדים
https://www.ima.org.il/userfiles/image/clinical_38_lowerfever.pdf
 Evaluation of fever in infants and young children. Am Fam Physician
2013 Feb 15; Vol. 87 (4), pp. 254-60
https://www.aafp.org/afp/2013/0215/p254.html

• Sexually transmitted diseases
 Sexually Transmitted Diseases Treatment Guidelines, 2015 - MMWR Recomm Rep 2015;64
https://www.cdc.gov/std/tg2015/tg-2015-print.pdf

• Lower back pain
 הנחיות קליניות - מניעה וטיפול בכאבי גב תחתון, ערוך ע"י פרופ' שמואל רייס, פרופ' אמנון להד
https://www.ima.org.il/userfiles/image/clinical_34_lowerback.pdf
 Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians; Annals of Internal Medicine. 2017;166(7):514-530
http://annals.org/aim/fullarticle/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice#

• Common orthopedic problems

 Shoulder
Chronic Shoulder Pain: Part I. Evaluation and Diagnosis
Am Fam Physician. 2008 Feb 15;77(4):453-460
https://www.aafp.org/afp/2008/0215/p453.html

Chronic Shoulder Pain: Part II. Treatment
Am Fam Physician. 2008 Feb 15;77(4):493-497
https://www.aafp.org/afp/2008/0215/p493.html

Clinical Evidence Handbook, A PUBLICATION OF BMJ PUBLISHING GROUP Shoulder Pain Am Fam Physician. 2011 Jan 15;83(2):137-138.
https://www.aafp.org/afp/2011/0115/p137.html

 Elbow
Treatment of Lateral Epicondylitis
Am Fam Physician. 2007 Sep 15;76(6):843-848
https://www.aafp.org/afp/2007/0915/p843.html

 Knees
Knee Pain in Adults and Adolescents: The Initial Evaluation
Am Fam Physician. 2018 Nov 1;98(9):576-585.
https://www.aafp.org/afp/2018/1101/p576.html

 Foot
Update on Acute Ankle Sprains
Am Fam Physician. 2012 Jun 15;85(12):1170-1176
https://www.aafp.org/afp/2012/0615/p1170.html

Heel Pain: Diagnosis and Management
Am Fam Physician. 2018 Jan 15;97(2):86-93.
https://www.aafp.org/afp/2018/0115/p86.html

Additional Reading Material:

Grading Scheme :
Written / Oral / Practical Exam 30 %
Other 70 %

Additional information: