Family Medicine and Primary Care
What OMRSE tests
Family Medicine and Primary Care tests continuity, prevention, multimorbidity, and community-based management. Questions often ask what should be done first in a primary care setting, where over-investigation and specialist referral are common errors.
Core rules
- Use a biopsychosocial formulation: symptoms, mood, social context, adherence, and health beliefs.
- Confirm chronic diagnoses with repeated measures before intensifying lifelong therapy.
- Address smoking, diet, activity, alcohol, and vaccination at every chronic-disease review.
- Deprescribe when polypharmacy increases falls, bleeding, or hypoglycemia risk.
Worked example
A 58-year-old man with type 2 diabetes, hypertension, obesity, and smoking has HbA1c 8.2%, BP 150/90 on two readings, and LDL cholesterol 3.8 mmol/L. First check adherence, home BP, hypoglycemia, and diet; then intensify metformin, add a statin, and offer smoking cessation. Consider an SGLT2 inhibitor if albuminuria or heart failure is present. Aspirin is not routine primary prevention. Arrange follow-up in 4-12 weeks rather than ordering a full body scan for fatigue.
Traps that cost marks
- Treating an incidental lab abnormality without confirming it.
- Adding drugs without checking adherence or cost.
- Missing depression or intimate partner violence behind repeated somatic complaints.
- Referring every stable chronic disease to a specialist instead of managing in primary care.