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Curriculum Map for Family Practice Residents from the American Academy of Family Physicians'

Attitudes

The resident should develop attitudes that encompass:

• The empathic concern for the health of the child in the context of the family
  
• The importance of continuity of and access to care for prevention of illness
  
• The promotion of health lifestyles in children and families
  
• The awareness of the unique vulnerabilities of infants and children that may require special attention, consultation and/or referral
  
• The impact of social, cultural and environmental factors that will affect the health and well-being of infants and children
  
• The important of educating the public about environmental factors that can adversely affect children and about development of community programs that promote the health of children
  
• Important of obtaining information about school performance and learning disabilities
  

Knowledge

• Fetal and Neonatal period
  • Risk factors determined by gestational age assessment
    
  • Effects of labor and delivery on the infant
    
  • Adaptations to extrauterine life
    
  • Diagnosis and role-appropriate management of:
    
    • Meconium-stained amniotic fluid
      
    • Perinatal asphyxia
      
    • Respiratory distress
      
    • Cyanosis
      
    • Apnea
      
    • Seizures
      
    • Hypoglycemia
      
    • Evaluations of possible sepsis
      
    • Developmental dysplasia of the hip
      
    • Birth-related injuries
      
    • Anemia
      
    • Rh and blood type incompatibility
      
    • Polycythemia
      
    • Jaundice
      
    • Premature and Post-date gestations
      
    • Maternal infections (HIV, Hepatitis, etc.)
      

• Well newborn and child care
  • Recommended schedule and content for examinations from birth to adolescence years of age
    
  • Anticipatory guidance appropriate to age and developmental stage
    
  • Circumcision
    
  • Feeding options and variations
    
  • Temperament and behavior
    
  • Developmental stages and milestones
    
  • Developmental screening tests
    
  • Family and social relationships
    
  • Effective parenting
    
  • School readiness
    

• Physical growth
  
  • Feeding
    
  • Growth and caloric requirements
    
  • Normal growth and variants including Dental development
    

• Prevention and Screening
  
  • Injury prevention
    
    • Motorized vehicles
      
    • Unmotorized vehicles (e.g., bicycles, skates, skateboards, etc.)
      
    • Drowning
      
    • Choking/asphyxiation
      
    • Poisoning
      
    • Firearms
      
    • Falls
      
    • Burns and Fire safety
      
  • Child abuse
    
  • Immunization
    
  • Screening
    
    • Anemia
      
    • Lead
      
    • Fluoride
      
    • High risk children, e.g. Lipids, Tuberculosis, Other infectious diseases
      
    • Hypertension
      
    • Other environmental health hazards
      

• Sudden infant death syndrome

• Psychological disorders
  
  • Recognize families at high risk for parent-child interaction or psychiatric problems
    
  • Evaluation, treatment and referrals for:
    
    • Feeding and elimination problems - Enuresis and Constipation/encopresis
      
    • Eating disorders
      
    • Somatic and Sleep disorders
      
    • Obsessive compulsive disorders
      
    • Mood disorders
      
    • Hyperactive/impulsive and inattentive behaviors
      
    • Conduct disorders
      

• Social and Ethical issues
  
  • Adoption
    
  • Divorce, separation and Death
    
  • Impact of Family violence, Drug and Alcohol abuse
    
  • Child abuse
    
  • Withholding and withdrawing life support
    
  • Nontraditional families
    

• Genetics
  
  • Screening issues, Metabolic disorders and Newborn screening
    
  • Appropriate referral for necessary genetic diagnosis and counseling
    

• Developmental disabilities
  
  • Developmental delays
    
  • Learning disorders
    

Medical problems of infants and children: recognition, management and appropriate referrals

• Allergic
  
  • Asthma
    
  • Atopy
    
  • Allergic rhinitis
    

• Inflammatory
  
  • Juvenile rheumatoid arthritis
    
  • Vasculitis syndromes
    

• Renal/urologic
  
  • Glomerulonephritis
    
  • Hematuria and Proteinuria
    
  • Urinary tract infections, including Pyelonephritis
    
  • Vesicoureteral reflux
    
  • Hypospadius, Urethral prolapse and Fused labia
    
  • Enuresis
    
  • Undescended testis
    

• Endocrine/metabolic and Nutritional problems
  
  • Thyroid disorders
    
  • Diabetes mellitus, type 1 and type 2
    
  • Obesity
    
  • Failure to thrive
    
  • Abnormal growth patterns: short and tall stature
    

• Neurologic problems
  
  • Seizure disorders
    
  • Headache
    
  • Syncope
    
  • Psychomotor delay and Cerebral palsy
    
  • Tic and movement disorders
    

• Common skin
  
  • Atopic dermatitis
    
  • Viral exanthems and enanthems
    
  • Bites and stings
    
  • Bacterial and Fungal infections
    
  • Lice and Scabies
    
  • Diaper rash
    
  • Acne
    
  • Urticaria and erythema multiforme
    
  • Burns
    

• Musculoskeletal
  
  • Club foot
    
  • Developmental dysplasia of the hip
    
  • Rotational problems/gait abnormalities
    
    • In- and out toeing
      
    • Metatarsus adductus
      
    • Medial tibial torsion
      
    • Femoral anteversion
      
  • Scoliosis, idiopathic or acquired
    
  • Aseptic necrosis of the femoral head (i.e. Legg-Calvé Perthes)
    
  • Slipped capital femoral epiphysis
    
  • Common sprains, Dislocations and Fractures
    
  • Limping
    

• Gastrointestinal
  
  • Gastroenteritis, viral and bacterial
    
  • Constipation/ encopresis
    
  • Hepatitis
    
  • Colic
    
  • Gastroesophageal reflux
    
  • Food intolerance and malabsorption
    
  • Pyloric stenosis
    
  • Intussusception
    
  • Appendicitis/peritonitis
    
  • Recurrent/chronic abdominal pain
    
  • Hernias
    

• Cardiovascular
  
  • Congenital heart disease and Valvular disease
    
  • Evaluation of heart murmurs
    
  • Chest pain
    
  • Hypertension
    

• Respiratory tract - Pulmonary and Otolaryngology
  
  • Viral upper respiratory tract infections
    
  • Reactive airway disease/asthma
    
  • Cystic fibrosis
    
  • Bronchiolitis
    
  • Foreign body aspiration
    
  • Viral or bacterial pneumonia
    
  • Pertussis
    
  • Tonsillitis, Pharyngitis and Sinusitis
    
  • Epiglottitis versus croup
    
  • Epistaxis
    

• Ear
  
  • Otitis media, acute and with effusion
    
  • Otitis externa
    
  • Hearing loss
    
  • Wax and Foreign body in ear canal
    

• Eye
  
  • Amblyopia
    
  • Strabismus
    
  • Lacrimal duct stenosis
    
  • Decreased visual acuity
    
  • The red eye
    
  • Congenital cataracts
    

• Other serious infections
  
  • Sepsis and sepsis syndromes
    
  • Meningitis and Encephalitis
    
  • Invasive streptococcal and Staphylococcal disease
    
  • Osteomyelitis
    
  • Human immunodeficiency virus
    

Skills

See also Critical Care, Emergency Medicine and Neonatology for commonly performed procedures.

• Assign APGAR scores accurately
  
• Resuscitation of newborns, infants and children
  
• Perform and document age-appropriate history and physical examination, including use of growth charts
  
• Administer and interpret developmental screening tests
  
• Perform appropriate history and physical examination for physical or sexual abuse
  
• Interpret behavior questionnaires for parent/teacher assessment of attention/deficit problems
  
• Interpret hearing and vision screening tests
  
• Perform and interpret pneumatic otoscopy and tympanograms
  
• Bladder catheterization and suprapubic aspiration
  
• Vascular access, emergency and elective
  
• Perform lumbar puncture
  
• Calculate maintenance and replacement fluid and electrolyte requirements
  
• Coordinate patient care and specialty services when required