TABLE 1.

Core clinical skills for the training of family physicians (N = 17).

Consensus score (%)	Clinical skill
Perform common side-room tests
88	Use a glucometer
88	Use a haemoglobinometer
88	Perform a pregnancy test
94	Perform urinalysis
94	Venepuncture
Adult health – general
94	Femoral vein puncture
100	Lumbar puncture
88	Routine intravenous access in adults
88	Lymph node excision biopsy
77	Perform point-of-care testing for HIV
Adults – musculoskeletal
82	Measure shortening of the legs
94	Aspirate and inject the knee joint
94	Inject tennis elbow or golfer’s elbow
100	Interpret radiographs of joints
82	Inject carpal tunnel syndrome
76	Inject De Quervain’s tenosynovitis
82	Inject the shoulder and subacromial bursa
77	Inject trochanteric bursitis
Adults – abdomen
94	Test stool for occult blood
100	Incision and drainage of perianal haematoma
100	Interpret the abdominal radiograph in an adult
94	Proctoscopy
76	Interpret barium swallows
Adults – chest
100	Electrocardiogram set up, record and interpret
100	Interpret chest radiograph
100	Measure peak expiratory flow
94	Nebulise a patient
100	Pleural tap
100	Use inhalers and spacers
88	Exercise stress test
70	Perform and interpret office spirometry
Adults – urology
100	Penile block
100	Reduce a paraphimosis
100	Circumcision
100	Drain hydrocele
94	Insert a urinary catheter
94	Insert a suprapubic catheter
82	Interpret intravenous pyelogram
76	Vasectomy
Eyes
70	Subconjunctival injections
70	Use a Schiotz tonometer
100	Fundoscopy (diabetes, hypertension)
88	Instil drops or apply ointment
100	Remove foreign body from the eye
100	Test for squint
100	Washout of eyes (chemical burns)
Ear, nose and throat
82	Assess hearing loss
82	Reduce a fractured nose
100	Remove a foreign body from ear and nose
100	Syringe, dry swab an ear
94	Take a throat swab
100	Manage epistaxis (cautery, packing)
82	Perform Rinne and Weber tests
100	Suture a pinna lobe
82	Drain a peritonsillar abscess
Skin
82	Inject keloids
82	Phenol ablation of ingrown toenail
100	Excise sebaceous cyst (other lumps, bumps)
100	Apply a compression dressing to venous leg ulcer
100	Cryotherapy or cauterisation
100	Skin biopsy (punch and shave) or skin scrapes
100	Wide-needle aspiration biopsy lymph node
Pregnancy
94	Obstetric ultrasound
100	Interpret antenatal growth chart
94	Assess foetal well-being during labour
100	Episiotomy and suturing
94	Examine a pregnant woman
94	Examine progress during labour and use partogram
94	Normal vaginal delivery
100	Speculum examination
100	Apply and interpret the cardiotocograph
94	Assess foetal movement
100	Assisted vaginal delivery or vacuum extraction or forceps
94	Caesarean section
100	Evacuation of uterus
100	Manual removal of placenta
94	Repair of third-degree tear
82	Pelvic ultrasound (transvaginal)
Woman’s health
88	Culdocentesis
100	Hormone implants
82	Laparotomy for ectopic pregnancy
70	Termination of pregnancy
100	Insertion of intrauterine contraceptive device
100	Papanicolaou smears
88	Dilatation and curettage
88	Drainage of Bartholin’s abscess or cyst
76	Endometrial biopsy or sampling
94	Fine-needle aspiration biopsy of breast lump
88	Tubal ligation
71	Cervical polyp removal
Newborn
100	Well newborn check
100	Assess gestational age at birth
100	Kangaroo mother care
100	Resuscitate a newborn
94	Umbilical vein catheterisation
Consultation
100	Patient-centred consultation
100	Use genogram and eco-map
100	Develop and use flowcharts for chronic care
100	Motivate behaviour change
100	Assess and consult families, couples
100	Shared consultation to capacitate nurse practitioner
100	Counselling skills for HIV, termination of pregnancy, sexual assault
100	Break bad news
94	Mini–Mental State Examination
100	Use problem-orientated medical record
94	Conduct a family conference
100	Cope with language barriers
100	Holistic assessment and management
100	Sexual history and counselling
Emergency
100	Calculate % burn
100	Manage choking
94	Give oxygen
100	Immobilise spine
100	Intubate and manage airway
94	Measure the Glasgow Coma Scale
94	Administer rabies prophylaxis
100	Advanced cardiopulmonary resuscitation – Adult
94	Advanced cardiopulmonary resuscitation – Child
100	Debride wounds or burns
100	Gastric lavage
100	Give a blood transfusion
100	Incision and drainage of abscesses
100	Insert chest drain
100	Insert nasogastric tube
100	Interpret radiographs in trauma
88	Intravenous cut down
94	Manage snake bite
100	Primary survey
100	Relieve tension pneumothorax
100	Remove a splinter fish hook
100	Secondary survey
88	Selecting emergency equipment for doctors’ bag or emergency tray
94	Suture lacerations
82	Transport critically ill
76	Cricothyroidotomy
70	Insert central line
Orthopaedics
94	Apply finger and hand splints
94	Apply casts to upper and lower limb
100	Closed reductions for hand, forearm, tibia, fibula
88	Set up traction skeletal and skin
94	Reduce elbow dislocation
82	Reduce hip dislocation
94	Reduce radial head dislocation
100	Reduce shoulder dislocation
82	Excise ganglion
88	Amputations – fingers
76	Apply club foot cast
76	Debridement of open fractures
76	Fasciotomy
Anaesthetics
94	Injections – intra-dermal, subcutaneous, intramuscular, deep intramuscular, sub-conjunctival
100	Ring block
94	Administer oxygen
88	Check Boyle’s machine
94	Control airways with mask
82	General anaesthetic
82	Inhalation induction
82	Intravenous induction
94	Intubate and ventilate patient
82	Ketamine anaesthesia
88	Monitor patient during anaesthetic
88	Recover patient – recovery room
82	Reverse muscle relaxation (mixed drugs)
88	Set airflow – Magill Circle, T-piece
94	Spinal anaesthetic
70	Sterilise equipment
94	Ventilate patient mask and hand
76	Biers block
82	Brachial block
Child health
100	Assess growth and classify malnutrition
94	Capillary blood sampling – finger and heel
94	Chest radiograph in child
100	Developmental assessment
100	How to do and interpret Tine and Mantoux tests
94	Intraosseous line
100	Intravenous access in a child
94	Lumbar puncture in a child
100	Manage problems using the integrated management of childhood
94	Suprapubic bladder puncture
100	Venepuncture – upper limb and external jugular vein
94	Manage neonatal jaundice with phototherapy
Clinical administration
100	Complete sick certificates
100	Complete death certificates
100	Certify patient under Mental Health Care Act
100	Making appropriate referrals and letters
100	Managing a clinic for chronic care, for example, HIV and ARVs
76	Perform work assessment and complete disability grant forms
Forensic
100	Assess, manage and document drunken driving
100	Assess, manage and document interpersonal violence
100	Assess, manage and document sexual assault
100	Complete J-88 form following assault
Palliative care
100	Counselling of a dying patient
70	Hypodermoclysis (subcutaneous infusion)
76	Set up a syringe driver
Clinical governance
100	Able to contribute to the development or revision of guidelines
100	Able to facilitate the implementation of clinical guidelines within the subdistrict
100	Able to improve quality of care by facilitating quality improvement cycles (including the audit of clinical care as one step in the cycle)
100	Able to improve cost-effectiveness through reflection on routinely collected data, particularly rational prescribing and use of investigations
100	Build capability and quality care through teaching, training and mentoring
100	Able to critically appraise new evidence
76	Able to appraise the competence of new clinicians and set appropriate levels of independence versus support
94	Able to evaluate the quality of care in relation to the relevant clinically orientated national core standards
Community-orientated primary care
94	Able to do a home visit
100	Able to make a community diagnosis, and interpret and prioritise health indicators
100	Able to promote health in communities
Teaching and training
100	Able to plan and implement a teaching or continuing professional development activity
100	Able to use a portfolio of learning
100	Able to mentor a colleague
100	Able to facilitate small group learning
100	Able to prepare and give a presentation