Department of Family Medicine

Faculty of Medicine

Content Objective: Preventive Health Care

Periodic/preventative health care involves relating to an asymptomatic patient for the purpose of case finding and screening for undetected disease and higher risk behavior. It is also an opportunity for health promotion and disease prevention. The elements of the Periodic Health Exam (PHE) can be delivered by dedicated planned visits or opportunistically in the context of other health care visits.

The decision to include or exclude a medical condition in the PHE should be based on the burden of suffering caused by the condition, the quality of the screening, and effectiveness of the intervention.

By the end of the Family Medicine Clerkship, the medical student will be able to:

  1. Conduct a patient interview in order to identify any significant factors that may increase risk for health conditions.  Examples include:
    • Demographics (age, genetics/family history, race/ethnicity, sex, gender identity
    • Lifestyle (Exercise, deit, substance use)
    • Immunization status
    • Socioeconomics/environment and/or geographical influences
  2. Conduct a focus and evidence based physical exam, based on the patient information collected in the patient interview. Examples include:
    • Blood pressure
    • Weight
    • Waist circumference
    • Breast exam (where applicable)
    • Peripheral neuropathy testing
    • rectal examinations (where applicable)
  3. Discuss pertinent screening tests and explain their purposes & limitations, including:
    • Diabetes screening
    • Colorectal cancer screening
    • Dyslidipemia screening
    • Osteoporosis/bone mineral densitometry
    • Cervical cancer screening/Pap test
    • Breast cancer screening/mammography
    • Prostate cancer screening/PSA testing (describe the conflicting evidence)
  4. Counsel patients on relevant health promotion/disease prevention strategies. Examples include:
    • Immunizations
    • Exercise
    • Diet
    • Calcium/Vitamin D
    • Smoking cessation
    • Screening for sexually transmitted infections
  5. For infant/child visits:
    1. use an evidence-based standardized health maintenance tool to guide the visit
    2. assess growth, nutrition and development
    3. address parental concerns, social context and safety and provide relevant anticipatory guidance
    4. identify patients who require further assessment
    5. inform caregivers of appropriate routine follow-up

Mandatory Clinical Encounter

  • Preventive Health Exam/Preventative Care (adult)
  • Preventive Health Exam/Preventative Care (infant/youth/child)
  • Newborn exam

Resources*

* Where a specific resource is not listed for a particular objective, please refer to recommended general texts/websites. Resources have often been selected from the Clinical Practice Guidelines and Protocols in British Columbia and Alberta’s Towards Optimized Practice Clinical Practice Guidelines. These are often concise summaries of national guidelines.