Primary Care, Preventive Medicine, and Medical Ethics/Professionalism
Core concepts
This domain tests integration of preventive care with ethical practice. Know age-appropriate screening (cervical, breast, colorectal), immunization schedules, cardiovascular risk assessment, osteoporosis screening, and sexually transmitted infection screening. Ethics topics include informed consent, confidentiality, reproductive autonomy, surrogate decision-making, conflicts of interest, and professionalism in challenging scenarios. Understand shared decision-making, capacity assessment, and the limits of parental or third-party authority in reproductive care.
Traps
- Screening intervals: know that cervical cancer screening intervals differ by test modality and age; avoid over-screening.
- Confidentiality in adolescents: reproductive and mental health confidentiality varies by jurisdiction and situation; the framework prioritizes patient welfare and legal requirements.
- Informed consent: requires capacity, disclosure, understanding, and voluntariness; a signature alone is insufficient.
- Capacity vs. competence: capacity is a clinical determination; competence is legal.
- Conflict of interest: disclosure and avoidance of undue influence are core professionalism expectations.
Worked example / rule of thumb
A patient refuses a recommended intervention after full discussion. Rule of thumb: a capacitated patient may refuse care; document the discussion, ensure understanding, and continue non-coercive support rather than override the decision.
Study strategy
Pair each preventive service with its population and interval, and rehearse an ethics framework (beneficence, autonomy, nonmaleficence, justice) for scenario stems.