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Introduction
Health Regulation department (HRD) is responsible for regulating medical practice in the
Emirate of Dubai, United Arab Emirates. Scope of Practice (SOP) refers to the activities that
licensed Medical Doctors are educated, authorized and competent to perform as well as their
decision making capacity. Such activities are established through the legislated definition of
licensed medical practice, complemented by standards, limits, conditions and education and
influenced by setting, environment and health needs of the population.
This document is the result of a collaborative effort from specialists in family medicine,
regulatory, legal experts and others from within both the public and private health care sectors
of Dubai, which has provided a broad and enabling framework which supports Medical Doctors
to make decisions about and within their scope of practice. The framework has been rigorously
benchmarked against international best practice and provides mechanisms to ensure that
specialist family medicine practitioners are competent and fit to practice their profession.
The scope of practice for the specialist in family medicine is determined by the scope of human
needs. There are, however, predictable points in the life cycle of the individual and family
where the Medical Doctor fits uniquely into the experience of health and illness. These nodal
points include pregnancy and childbirth, the newborn child, life-threatening and life-altering
illness, loss and grief, and care at the end of life.
The scope of practice for the specialist in family medicine is endorsed by HRD and should be
read in conjunction with HRD Code of Conduct for Physicians.
The American Academy of Family Physician (AAFP) defines the SPECIALIST Family
Medicine as: a physician who is educated and trained in family practice, a broadly
encompassing medical specialty. SPECIALIST Family Medicine possess unique attitudes,
skills, and knowledge which qualifies them to provide continuing and comprehensive medical
care, health maintenance, and preventive services to each member of the family regardless of
sex, age, or type of problem, be it biological, behavioral or social. The family physician, is the
best qualified to serve as the patients advocate in all health related matters, including the
appropriate use of consultant, health services and community resources.
The SPECIALIST Family Medicine must::
Competency Standards
This document sets out the scope of practice for Specialists in Family Medicine (SFM). SFM
have obtained a postgraduate qualification which entitles them tom practice Family Medicine
in the country of education. This additional qualification further entitles to practice as SFM in
the emirate of Dubai, United Arab Emirates.
It is recognized that the role and responsibilities of the Specialist Family Medicine are broad
and complex. The following sets out the competency framework within which Specialist in
Family Medicine must be judgment-safe and competent. The indicators are neither
comprehensive nor exhaustive but rather provide examples of evidence of competence.
The following competency framework for the SFM has been organized into seven (7)
domains of competence
Medical Expert
Communicator
Collaborator
Manager
Health Advocate
Professional Development
Professional
Domain 1 Medical Expert: A specialist Family Medicine (SFM) is a general family doctor who
integrates all roles to provide optimal, ethical and patient centered care. SFM is mandated to ensure
primary care which is comprehensive, preventive, and continuous and community based care.
Competency 1.1 Specialists in Family Medicine possess a defined body of knowledge and procedural
skills, which are used to collect and interpret data, make appropriate clinical decisions, and carry out
diagnostic and therapeutic procedures within the boundaries of their discipline and expertise. Their
care is characterized by up-to-date, ethical, and cost-effective clinical practice and effective
communication in partnership with patients, other health care providers, and the community. Such
fields require from SFMs to attain sufficient knowledge, diagnostic expertise, judgment and skills in
performing techniques and procedures to manage patients.
Indicator
1.1.1 Demonstrate
diagnostic and
therapeutic skills for
effective patient care by
using evidence based
medical practices
1.1.3 Demonstrate
effective referral
services with respect to
patient care and
education.
Sub Indicator
1.1.1.1 Select medically appropriate investigative tools, interpret the
results of common diagnostic tests and demonstrate an
understanding of their cost effectiveness, limitations and
complications
1.1.1.2 Formulate a comprehensive patient problem list, synthesize
an effective diagnostic and therapeutic plan and establish
appropriate follow up
1.1.1.3 Generate a rational plan of diagnostic and therapeutic
measures with use of information on cost benefit ratio
1.1.2.1 Elicit, present, and document a history that is relevant,
concise, accurate and appropriate to the patient's problems
1.1.2.2 Perform, interpret the findings of present and document a
physical examination that is relevant and appropriate
1.1.2.3 Retrieve, critically appraise and apply relevant information to
clinical practice
1.1.2.4 Knowledge of normal body structure and function as
expressed in a bio psychosocial model of human
development
1.1.2.5 Knowledge of disturbed body structure and function
1.1.2.6 Be able to assess, diagnose, and manage patients with
common and uncommon diseases in the appropriate
setting.
1.1.2.7 Demonstrate an understanding of basic pharmacology
and its application to clinical practice
1.1.2.8 Appropriate application of knowledge derived from critical
appraisal of the literature
1.1.3.1 Demonstrate effective referral services in presenting welldocumented assessments and recommendations in written
and/or verbal form
1.1.3.2 Demonstrate knowledge of promotion, maintenance of
optimal functioning in biological and psychological aspects
1.1.3.3 Establish a professional relationship and interact with the
patient and parent, guardian or other caregivers in order to
obtain a history, conduct a physical examination and provide
ongoing care
1.1.3.4 Establish an atmosphere of open communication
appropriate to the situation and convey interest, sensitivity,
empathy and support
1.1.3.5 Recognize personal limitations and demonstrate a
willingness to call upon others with special expertise and
1.1.4 Demonstrate an
understanding of
medico-legal issues
Sub Indicator
2.1.1.1 Recognize that being a good communicator is an essential
function of a SFM and understand that effective doctorpatient communication can foster patient satisfaction and
compliance as well as influence the manifestations and
outcome of a patient's illness
2.1.1.2 Establish relationships with the patient characterized
by understanding, trust, respect, empathy & confidentiality
2.1.1.3 Demonstrate caring and empathy for patients and their
families, & especially for those individuals who are
vulnerable
2.1.1.4 Develop strategies for managing challenging communication
issues such as obtaining informed consent, delivering bad
news, identifying situations which could lead to angry
exchanges, confusion or misunderstandings.
2.1.2.1 Interact with community care-givers and other health
resources to obtain and synthesize relevant information
about the patient
2.1.2.2 Gather information not only about the disease but also
about the patient's beliefs, concerns and expectations
about the illness, while considering the influence of factors
such as the patient's age, gender, ethnic, cultural and
socioeconomic background, & spiritual values on that illness
2.1.2.3 Provide close attention to the impact of factors such as age,
gender, disability, ethno-cultural background, social support,
and emotional influences on a patient's illness
2.1.3.1 Understand and demonstrate the importance of cooperation
and communication among health professionals involved in
the care of individual patients such that their roles are
3.1.2 Contribute
effectively to other
interdisciplinary team
Sub Indicator
3.1.1.1 Develop an ability to work effectively and harmoniously with
other health care workers
3.1.1.2 Participate in the interdisciplinary team meeting,
demonstrating the ability to accept, consider and respect the
opinions of other team members, while contributing
specialty-specific expertise
3.1.1.3 Function competently in the initial management of
conditions that, in major centres, fall within the Family
Medicine Specialty.
3.1.2.1 Identify and describe the role, expertise and limitations of all
members of an interdisciplinary team required to optimally
achieve a goal related to patient care, a research problem,
activities
Sub Indicator
4.1.1.1 Recognizes the structure, resourcing, and operation of the
Dubai health care system, and function effectively within it,
as well as being capable of playing an active role in its
evolution
4.1.1.2 Understand knowledge of the definitions and role of audits,
quality improvement, risk management, occurrence /
incident reporting, and complaint management in a hospital
and ambulatory setting
4.1.1.3 Utilize appropriate time management for effective patient
care, administrative duties and continuous professional
development activities.
4.1.1.4 Understand population-based approaches to health care
services and recognize their implication for medical practice
4.1.2.1 Utilize resources to effectively balance patient care and health care
economics
4.1.2.2 Understand the interplay between governments & the health care
sector in allocating finite health care resources
4.1.2.3 Recognize the business and financial skills needed for a successful
medical practice and/or academic career.
Understand the advantages, disadvantages and relative costs of
preventive and therapeutic health care programs
4.1.2.4 Understand the advantages, disadvantages and relative costs of care
in different settings, including an appreciation of the various
forms of health care provision, including hospitals, ambulatory
clinics, home care, chronic care and rehabilitation facilities as
they relate to quality assurance
4.1.2.5 Avoid unnecessary investigation and/or hospitalization
4.1.3.1 Understand how to function effectively in health care
organizations, ranging from individual clinical practice to local,
regional and national associations
4.1.3.2 Demonstrate an awareness of the need to continually balance
professional, personal, institutional and social commitments
4.1.3.3 Work to develop effective and efficient patient management
4.1.4 Utilize
information technology
appropriately to
optimize patient care
Domain 5 Health Advocate: Specialists in Family Medicine must use their expertise and influence to
advance the health and well-being of individual patients, families, communities, and populations.
Competency 5.1 Specialists in Family Medicine recognize the importance of advocacy activities in
responding to the challenges represented by those social, environmental, and biological factors that
determine the health of patients and society. They recognize advocacy as an essential and fundamental
component of health promotion that occurs at the level of the individual patient, the practice
population, and the broader community.
Indicator
5.1.1 Identify the
important determinants
of health affecting
patients
5.1.2 Contribute
effectively to improved
health of patients and
communities
Sub Indicator
5.1.1.1 Demonstrate an appreciation of health care needs.
Appreciate the existence of global health advocacy and initiatives
for elimination of poverty and disease (e.g. tuberculosis, malaria,
Acquired Immune Deficiency Syndrome)
5.1.1.2 Recognize, assess, and respond to the psychosocial, economic,
societal and biologic factors influencing the status of health
5.1.2.1 Encourage promotion of active family involvement in
decision-making & continuing patients management
5.1.2.2 Adapt management accordingly and assess the patient's ability to
access various services in the health and social system
5.1.2.3 Demonstrate the ability to contribute effectively to improved
health of patients and communities
5.1.3.1 Apply the principles of quality improvement and quality
assurance, to promote equitable health care
5.1.3.2 Educate patients and families about and promote the importance of
long-term healthy behaviours and preventive health care (e.g.
smoking cessation, screening tests, vaccinations, exercise, and
nutrition)
5.1.3.3 Be familiar with the underlying research evidence and apply this
understanding to common problems and conditions of such
specialty
5.1.3.4 Respect and empower patient autonomy
5.1.3.5 Work collaboratively with other specialty and identify current "at
risk" groups and application of available knowledge regarding
prevention to "at risk" groups
5.1.3.6 Intercede on behalf of their patients as the patient weaves his/her
way through complex health care institutions and services
Domain 6 Professional Development: This domain assumes primary responsibility for maintaining
competence and fitness to practice as a Specialist in Family Medicine (self regulation). It includes a
commitment of life long learning, as well as the creation, dissemination, application and translation of
medical knowledge.
Competency 6.1 Specialists in Family Medicine engage in a lifelong pursuit of mastery of their
domain of professional expertise. They recognize the need for continuous professional development
(CPD) activities and set example for others. Through CPD activities, they contribute to the appraisal,
collection, and understanding of health care knowledge, and facilitate the education of their, patients,
students and others.
Indicator
6.1.1 Develop,
implement and monitor
a personal continuing
professional
development strategy
6.1.3 Contribute to
development of new
knowledge
Sub Indicator
6.1.1.1 Recognize the importance of self-assessment of
professional competence and acceptance of the
responsibility for self-directed learning as a life long goal, to
develop, implement and monitor a personal CPD strategy
6.1.1.2 Identify clinical problems and practice areas for research
6.1.1.3 Recognize and identify gaps in knowledge and expertise
6.1.1.4 Monitor the outcome of professional development
6.1.2.1 Demonstrate the ability to teach medical students, residents,
patients, colleagues and other health care professionals
6.1.2.2 Demonstrate an understanding of, and the ability to apply
the principles of adult learning, with respect to oneself and
others
6.1.2.3 Demonstrate an understanding of preferred learning
methods in dealing with students, residents, and colleagues
6.1.2.4 Facilitate teaching of patients about their health problems
directly or through the involvement of other professionals
6.1.3.1 Specialists in Family Medicine will maintain a questioning
and inquisitive attitude towards medical information and an
appreciation of the necessity for ongoing research to
develop new knowledge
6.1.3.2 Attend academic day to develop learning skills in evidencebased medicine, medical ethics, physical examination skills,
acquisition of medical knowledge, etc.
6.1.3.3 Attend other available rounds to enhance learning
Sub Indicator
7.1.1.1 Display attitudes commonly accepted as essential to
professionalism.
7.1.1.2 Evaluate one's abilities, knowledge and skills, recognize one's
limitations and use appropriate strategies to maintain and advance
professional competence
7.1.1.3 Acquire the training and experience to maintain competence as a
Specialist in Family Medicine.
7.1.2 Exhibit
appropriate personal
and interpersonal
professional behaviours
7.1.3 Practice as
specialist ethically with
consistency
APPENDIX 1
PRIMARY CARE SERVICES
General Health Services Across the Life Span
1. The provision of continuity of care: the Doctor Patient Relationship.
2. The appropriate assessment and management of all acute physical or psychological
symptoms.
3. The management of chronic diseases: heart disease, diabetes, asthma, COPD,
epilepsy, Thalassaemia, sickle cell, G6PD Deficiency.
4. Screening for cancers: breast, cervical, bowel, prostate.
5. Screening for chronic diseases for example - diabetes, hypertension, G6PD,
dysliepedemia.
6. Health Education and Health Promotion. (the science and art of helping people
change their lifestyle to move toward a state of optimal health)
7. Provision of all adult vaccinations.
8. The assessment and management of Mental Health Disorders.
9. Continual liaison with other medical Professionals.
10. A Family Medicine Specialist with a Special Interest and relevant further
qualifications may also be involved in the delivery of more specialist medical care,
for example Care of the Elderly, Pain Management, Sports, Sleep and Hospice
Medicine.
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2. Delivery Care
Referral of pregnancies to hospital for delivery
3. Cancer Screening
Breast
Breast assessment - Mammography for those 40-69 years every 1 - 2 yearly
Referral of suspected cases
Cervix
Cervix assessment - Pap smear for those women within 3 years of onset of
sexual activity or age 21 then every 3 years
Referral of suspected cases
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References
1. Royal College of Physician and Surgeon of Canada, Can MEDS 2005 framework,
http://meds.queensu.ca/medicine/obgyn/pdf/CanMEDS_2005_Framework.pdf
2. Department of Health and Medical Services, Dubai (2007); Dubai Residency
Program.
3. Department of health and medical services, Dubai, UAE: Job description card of
General Practitioner.
4. Department of Health and Medical Services, Dubai (2007); Senior House Officer Job
Description.
5. Victoria, Queensland, Australia: World Organization of National Colleges,
Academies, and Academic Associations of General Practitioners/ Family physicians
(1991); WONCA: the role of the general practitioner/ family physician in health care
systems.
6. General Medical Council (1999): Management in health care: the role of doctors.
7. Good Medical Practice. RCGP Curriculum Statement 1 (2005); Being a General
Practitioner,
8. Dubai Health Authority (2008); Scope of Practice for Registered Nurse.
9.