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MD ACUMEN · THE ACUMEN OBSERVATORY
New Vision University
Postgraduate programmes for extended-role and extended-scope practice in primary care

Certificates of
Advanced Studies

1Cardio-Renal-Metabolic Medicine
& Heart Failure
2Menopause
& Andropause
Awarded by New Vision University, Tbilisi, Georgia · 10 ECTS (20 UK credits) · first cohorts 2027
Course Director: Prof Rajesh Varma, PhD MRCGP MRCOG MBBS MA (Cantab)
Professor, New Vision University · Director and Course Convenor, Certificates of Advanced Studies
Welcome
Prof Rajesh Varma speaking at the ESC Congress 2026
Prof Rajesh Varma, PhD MRCGP MRCOG MBBS MA (Cantab)
Professor, New Vision University · Director and Course Convenor, Certificates of Advanced Studies
A welcome from the Course Director

Built for the clinicians who carry the load

Primary care now carries the long-term care of diabetes, kidney disease, heart failure and vascular risk, and of the menopause transition and male hormonal decline, for most of the population. The guidance that governs that work changes several times a year.

These two Certificates of Advanced Studies were designed for the clinicians who carry that load: general practitioners, pharmacist prescribers, advanced nurse and clinical practitioners who want to practise at an extended level with the knowledge, the evidence and the governance to do so safely.

Each programme teaches its whole syllabus. Every module is published with the guideline it rests on, every clinical statement is signed by a named clinician with the date and version relied on, and your award is re-dated every six months after graduation so that it does not quietly go out of date.

The capstone is a piece of work for your own service: an audit, a quality-improvement plan or a clinic design that you can run the week after you finish. I look forward to teaching you.

Prof Rajesh VarmaDirector and Course Convenor, Certificates of Advanced Studies
Professor, New Vision University
The programmes
The programmes

Two awards, one standard

The extended-scope clinician

The historical model of primary care as triage is giving way to extended-role practice: clinicians who assess, treat and govern complex long-term conditions in the community, within a multidisciplinary team and with clear referral thresholds. The NHS England multi-professional framework for advanced practice and the growth of neighbourhood teams make that scope explicit. The knowledge base for it is a postgraduate one.

Why a Certificate of Advanced Studies

A CAS is a short, credit-bearing postgraduate award in the European Higher Education Area tradition: ten ECTS, a defined syllabus, assessed at level 7, with a workplace capstone. It sits below a diploma or master's degree and above a CPD course, and it is the right size for a clinician who is already in practice.

What these two programmes equip you to do

Each programme equips the primary-care clinician with the advanced-level professional knowledge and governance required to practise as a GP with an extended role, or as an allied health professional with extended-scope practice, in its domain: cardio-renal-metabolic medicine and heart failure; menopause and andropause. Local accreditation of extended roles and employer governance remain separate processes, and the programmes are designed to give you what those processes ask for.

At a glance
Award
Certificate of Advanced Studies, New Vision University
Credit
10 ECTS · 20 UK credits · 250 notional hours
Level
Pitched at EQF level 7; equivalent in level to the FHEQ level 7 descriptors
Duration
12 weeks: nine module weeks, an integration week and the assessment weeks
Format
Distance learning on learn.mdacumen.com with two livestreamed London Saturdays at the Royal Society of Medicine, 1 Wimpole Street, London: 4 September and 30 October 2027 (mornings CAS CVRM-HF; afternoons CAS Menopause and Andropause)
First cohort
1 September to 31 December 2027: twelve study weeks within that window, with breaks between blocks · applications open 1 March 2027
Fee
£2,450 · founding cohort £2,150 · £250 deposit on application
Entry
GPs, pharmacist prescribers, advanced nurse and clinical practitioners with current professional registration and a level 7 professional qualification or equivalent experience

Certificate of Advanced Studies awarded by New Vision University, Tbilisi, Georgia; 10 ECTS (20 UK credits); pitched at EQF level 7, equivalent in level to the FHEQ level 7 descriptors. New Vision University is not a UK degree-awarding body; recognition of credit is at the discretion of receiving institutions.

How we teach
How we teach

A living syllabus with a clinician's signature on every line

The Golden Triangle

Every condition we teach sits in a triangle. Knowledge is the top apex: what the condition is and how it is managed. Evidence is the bottom-left apex: what the trials and the guidelines say. Real-world is the bottom-right apex: what actually happens, including access, the inverse care law and socio-demographic disparities, together with the ethics and character the clinician brings. Each apex is rated red, amber or green for a condition in a setting. The clinician at the centre pulls the apices inward; three greens, the Equinox, is the point of equal balance. You will rate the triangle for every core condition and argue how to pull its weakest apex.

The Living CAS: self-detecting, human-updated

The programmes run on the Acumen Observatory, a registry in which every clinical assertion is a dated, signed atom linked to its source. Watchers detect new NICE, MHRA, ESC, KDIGO, EASD, EASL and BMS publications; a clinician reviews the change and signs the revised material; nothing reaches a learner unsigned. Your certificate states the period over which its content is warranted current, and a short Currency Update every six months after graduation re-dates the award.

How a module is taught

Each module is a five-path living lesson, a live workshop and a confidence-rated knowledge check, built as a mastery loop: encode, retrieve, space, calibrate, master, refresh. Two London Saturdays at the Royal Society of Medicine, 1 Wimpole Street, London (4 September and 30 October 2027), livestreamed for those who cannot travel, carry the case-based teaching and the practical sessions: the morning belongs to the CVRM-HF programme and the afternoon to the Menopause and Andropause programme.

Where AI sits

Every clinical statement is signed by a named GMC-registered clinician with the date and the guideline version relied on. Nothing reaches a learner unsigned. AI assists the drafting of our material, and no AI decides a mark. Every surface shows its class: deterministic; AI-drafted, clinician-signed; or adaptive and formative. Adaptive features recommend and never grade.

DeterministicAI-drafted, clinician-signedAdaptive, formativeThe three class labels every learner sees on every surface.
Programme 1 · Cardio-Renal-Metabolic Medicine & Heart Failure
Programme 1

Cardio-Renal-Metabolic Medicine & Heart Failure

Diabetes, cardiac, renal and metabolic care, taught as one connected system
Prof Rajesh Varma presenting cardio-renal-metabolic research at the ESC Congress 2026

Diabetes, heart failure, chronic kidney disease, obesity and vascular risk are usually taught, and too often managed, as separate problems. They share one pathophysiology of insulin resistance, inflammation and fibrosis, and the same organ-protective therapies now cut across all of them. This programme teaches that connected reality, anchored to the 2026 AHA/ACC/ADA/ASN cardiovascular-kidney-metabolic guideline, the ESC and ESC/ERA 2026 guidelines, KDIGO 2024, ADA 2026 and the NICE guidance you must use in UK practice, and it ends with the service you will design where you work.

By the end you will be able to

  1. Stage any patient on the CKM continuum (0–4, including 4a and 4b) and explain how stage changes management, using QRISK3, PREVENT and SCORE2 to risk-stratify and case-find.
  2. Run a structured lifestyle and behaviour-change consultation and set up a proactive three-visit cardiometabolic clinic.
  3. Select and sequence organ-protective therapies across diabetes, heart failure and chronic kidney disease: SGLT2 inhibitors, GLP-1 and dual incretin agonists, finerenone and modern lipid-lowering.
  4. Individualise targets and prescribe safely in multimorbidity, frailty and polypharmacy, including deprescribing.
  5. Run an integrated cardio-renal-metabolic consultation and shared-decision conversation with confidence.
  6. Critically appraise the pivotal evidence and act soundly where guidelines are silent or disagree.
  7. Design, lead and quality-improve a cardio-renal-metabolic or neighbourhood service, and build its value case.

The spine

Stage
CKM staging and shared pathophysiology
Module 1
Metabolic
Diabetes · obesity · lipids · MASLD
Modules 2–5
Cardio-renal
Cardiac axis · CKD · the four pillars
Modules 6–7
Integrate and lead
Multimorbidity · evidence · service design
Modules 8–9

The Golden Triangle today

Cardiovascular disease prevention
K G · E G · R R
Hypertension
K G · E G · R R
Dyslipidaemia
K G · E G · R R
Heart failure
K G · E G · R R
Chronic kidney disease
K G · E G · R R
Type 2 diabetes
K G · E G · R A
Obesity
K G · E G · R R
Knowledge · Evidence · Real-world, as rated on the programme page, UK setting, October 2026. Three greens is the Equinox; the Real-world apex is where you will work.
Programme 1 · Cardio-Renal-Metabolic Medicine & Heart Failure
CAS CVRM-HF · modules 1–3
Module 1

Foundations of integrated cardio-renal-metabolic medicine: CKM staging and risk

Aligned to 2026 AHA/ACC/ADA/ASN CKM guideline · DCRM 2.0 (2024) · Lancet 2026 cardiometabolic multiple long-term conditions Series · NICE NG238
Golden Triangle Cardiovascular disease prevention
You will be able to
  • Stage a patient on the CKM continuum 0–4, including 4a and 4b, and explain why staging is bidirectional and how a 10-year PREVENT-CVD risk of 20% or more counts as a stage-3 risk-equivalent.
  • Explain the shared insulin-resistance, inflammation and fibrosis axis that links the metabolic, cardiac and renal organs.
  • Risk-stratify and case-find with QRISK3 (NICE NG238), PREVENT and SCORE2, and with the eGFR, uACR and NT-proBNP case-finding triad, recognising sex- and ethnicity-related limits of the scores.
Syllabus
CKM staging and regression7-coreShared pathophysiology7-coreRisk scores and their limits7-coreThe case-finding triad7-coreCardiometabolic multiple long-term conditions: epidemiology, mechanisms, interventions7-adv
Module 2

Lifestyle, behaviour change and clinic set-up

Aligned to AHA Life's Essential 8 · CRM primary-care call to action (Säemann 2025) · NICE NG246 · NICE NG197
Golden Triangle Obesity
You will be able to
  • Deliver a structured lifestyle consultation on Life's Essential 8, using motivational interviewing, SMART target-setting and patient decision aids.
  • Design a proactive cardiometabolic clinic: a GP-coordinated multidisciplinary team, digital case finding, and a three-visit cycle of detect and baseline, activate and titrate, consolidate and sustain.
  • Apply the NICE NG246 weight-management tiers, referral criteria and bariatric surgery criteria.
Syllabus
Life's Essential 8 and the lifestyle consultation7-coreMotivational interviewing and decision aids7-coreThe three-visit clinic cycle and the multidisciplinary team7-advDigital case finding and patient-facing results7-advWeight-management pathways7-core
Module 3

The metabolic core: type 2 diabetes

Aligned to NICE NG28 (updated February 2026) · ADA Standards of Care 2026 · EASD
Golden Triangle Type 2 diabetes
You will be able to
  • Individualise HbA1c targets, including in frailty and where hypoglycaemia carries most risk.
  • Select organ-protective glucose-lowering therapy: an SGLT2 inhibitor with metformin as initial dual therapy for most adults, a GLP-1 receptor agonist first-line in atherosclerotic cardiovascular disease, and safe sequencing and stopping rules.
  • Run complications surveillance (uACR, retinal screening, foot risk) and apply sick-day rules, recognising diabetic ketoacidosis, the hyperosmolar hyperglycaemic state and euglycaemic ketoacidosis with SGLT2 inhibitors.
Syllabus
Diagnosis and individualised targets7-coreOrgan-protective sequencing7-advComplications surveillance7-coreSick-day rules, DKA, HHS and metformin at low eGFR7-core
Programme 1 · Cardio-Renal-Metabolic Medicine & Heart Failure
CAS CVRM-HF · modules 4–6
Module 4

Obesity, incretin therapy and MASLD

Aligned to NICE NG246 (2026) · NICE TA1152 · ADA and the Obesity Association · EASO · EASL-EASD-EASO 2024
Golden Triangle Obesity
You will be able to
  • Assess adiposity with BMI and waist-to-height ratio, using ethnicity-adjusted thresholds.
  • Initiate and monitor GLP-1 and GIP/GLP-1 receptor agonists: eligibility, dose escalation, adverse effects, stopping rules and weight regain.
  • Stage metabolic dysfunction-associated steatotic liver disease non-invasively with FIB-4, ELF and transient elastography, refer appropriately, and integrate nutrition and bariatric pathways with post-bariatric follow-up.
Syllabus
Adiposity assessment7-coreIncretin therapy7-advMASLD staging and cardiometabolic management7-advNutrition and bariatric pathways7-core
Module 5

Lipids and the atherogenic axis

Aligned to 2026 ACC/AHA multisociety dyslipidaemia guideline · ESC/EAS 2025 focused update · NICE NG238 · NICE TA733 · NICE CG71
Golden Triangle Dyslipidaemia
You will be able to
  • Reach lipid targets through the modern ladder: high-intensity statin, ezetimibe, PCSK9 inhibitors, inclisiran and bempedoic acid, including upfront combination therapy.
  • Use apolipoprotein B and once-in-a-lifetime lipoprotein(a) testing, and case-find familial hypercholesterolaemia.
  • Reconcile the NICE approach (atorvastatin 20 mg at QRISK3 of 10% or more, then escalate in secondary prevention to LDL-C 2.0 or non-HDL-C 2.6 mmol/L) with the ESC/EAS treat-to-goal approach, and manage statin intolerance.
Syllabus
Targets and the lipid-lowering ladder7-advApoB, Lp(a) and familial hypercholesterolaemia7-advPrimary and secondary prevention logic: NICE and ESC7-coreStatin intolerance7-core
Module 6

The cardiac axis: hypertension and heart failure

Aligned to NICE NG136 (updated February 2026) · ESC 2024 hypertension · NICE NG106 (updated September 2025) · ESC 2026 heart failure · NICE NG196 · ESC/ERA 2026
Golden Triangle Hypertension · Heart failure
You will be able to
  • Diagnose hypertension with clinic and out-of-office measurement, treat to age- and comorbidity-specific targets, and recognise resistant and secondary hypertension.
  • Diagnose heart failure using the NT-proBNP referral windows and echocardiographic phenotypes; start the four pillars as upfront quadruple therapy in HFrEF and titrate while monitoring potassium and renal function; treat HFpEF with an SGLT2 inhibitor and an MRA.
  • Manage secondary prevention in atherosclerotic disease and atrial fibrillation in the cardiometabolic patient, including CHA2DS2-VASc and ORBIT and the preference for a DOAC over a vitamin K antagonist down to an eGFR of 15.
Syllabus
Hypertension: diagnosis, targets, drug ladder, secondary causes7-coreHeart failure diagnosis and referral windows7-coreHFrEF: the four pillars, titration and iron deficiency7-advHFpEF: disease-modifying therapy7-advAtherosclerotic disease and cardiac rehabilitation7-coreAtrial fibrillation and anticoagulation in CKD7-core
Programme 1 · Cardio-Renal-Metabolic Medicine & Heart Failure
CAS CVRM-HF · modules 7–9
Module 7

The cardio-renal axis: chronic kidney disease

Aligned to KDIGO 2024 · NICE NG203 · NICE TA877, TA1075, TA942 · ESC/ERA 2026 (STAMP on CKD) · UK Kidney Association
Golden Triangle Chronic kidney disease
You will be able to
  • Stage CKD on the KDIGO heat-map with eGFR and uACR confirmed over three months, and use the Kidney Failure Risk Equation.
  • Sequence cardiorenal protection: RAS blockade, an SGLT2 inhibitor (dapagliflozin TA1075; empagliflozin TA942), finerenone (TA877) and a GLP-1 receptor agonist, guided by uACR and mapped to the UK funding gates.
  • Manage hyperkalaemia, including potassium binders, apply sick-day rules and avoid acute kidney injury, use the NICE referral thresholds, and test every patient with cardiovascular disease for kidney disease as ESC/ERA 2026 recommends.
Syllabus
KDIGO staging and the Kidney Failure Risk Equation7-coreThe cardiorenal protection sequence and funding gates7-advHyperkalaemia, sick-day rules and referral thresholds7-coreSTAMP on CKD7-adv
Module 8

Integration and evidence

Aligned to DCRM 2.0 · Lancet 2026 Series · the pivotal outcome trials
You will be able to
  • Run an integrated cardio-renal-metabolic consultation that sequences the organ-protective classes in multimorbidity, including deprescribing.
  • Critically appraise the pivotal trials (EMPA-REG OUTCOME, DAPA-HF, DAPA-CKD, CREDENCE, EMPA-KIDNEY, FIDELIO-DKD and FIGARO-DKD, SELECT, STEP-HFpEF) and act soundly where guidelines disagree.
  • Rate the Golden Triangle for each core condition, name the Real-world gap in your own population, and plan how the clinician pulls the weakest apex.
Syllabus
The integrated consultation and deprescribing7-advTrial appraisal and guideline divergence8-stretchGolden Triangle ratings and the Real-world apex7-core
Module 9

Leadership, quality and service governance

Aligned to NHS England multi-professional framework for advanced practice · CaReMe UK · NICE quality standards
You will be able to
  • Design a cardio-renal-metabolic or neighbourhood service: population search criteria, multidisciplinary roles, referral thresholds and a value case.
  • Run audit and quality improvement (PDSA cycles, driver diagrams) and prescribing governance, and apply basic health economics.
  • Mentor colleagues and scaffold your capstone from this module.
Syllabus
Service design and the value case7-advAudit, quality improvement and prescribing governance7-coreHealth economics and mentorship7-core
Weeks 10–12. Integration week with the second London day; capstone writing with supervision; applied-knowledge assessment and viva. Level bands: 7-core is the pass standard; 7-adv is expected of an extended-role clinician; 8-stretch is Professor Mode enrichment, never a hurdle to pass.
Programme 2 · Menopause & Andropause
Programme 2

Menopause & Andropause

Confident, current, extended-scope practice across the menopause transition and male hypogonadism

Menopause care has moved decisively into primary care, and demand for safe, confident hormone prescribing has never been higher. This programme equips you to assess and manage the menopause transition across its full symptom range and, in parallel, to recognise and manage male hypogonadism on the same evidence-led, benefit–risk footing. It is built on NICE NG23 as updated in April 2026, the guidance of the British Menopause Society, the International Menopause Society and RCOG, and the Endocrine Society and BSSM guidance for the male strand. Throughout, the emphasis is individualised, shared decision-making: the right preparation, route and dose for the person in front of you.

By the end you will be able to

  1. Identify and stage the menopause transition, including premature ovarian insufficiency, and recognise male hypogonadism on symptoms plus consistently low morning testosterone.
  2. Individualise HRT, choosing preparation, route and dose while weighing benefits and risks, including VTE and breast considerations, and the timing of initiation.
  3. Manage the full symptom range: vasomotor, genitourinary syndrome of menopause, mood, musculoskeletal and sexual health.
  4. Offer evidence-based non-hormonal options and lifestyle care where HRT is declined or contraindicated, and manage bone and cardiovascular risk after the menopause.
  5. Initiate and monitor testosterone therapy in men with confirmed hypogonadism safely, including haematocrit and prostate surveillance.
  6. Run a confident, shared-decision menopause or andropause consultation, and design or quality-improve a service where you work.

The spine

Foundations
The transition · diagnosis
Module 1
Prescribe
HRT · routes · benefit–risk
Module 2
Symptoms
Domains · special situations · non-hormonal care
Modules 3–5
Men and lead
Hypogonadism · integration · service design
Modules 6–8

The Golden Triangle today

Menopause, perimenopause and POI
K G · E G · R R
Cardiovascular disease in women after the menopause
K A · E A · R R
Osteoporosis and fragility fracture
K A · E A · R R
Male testosterone deficiency
K A · E A · R R
Knowledge · Evidence · Real-world, as rated on the programme page, UK setting, October 2026. Three greens is the Equinox; the Real-world apex is where you will work.

Who it is for

GPs, prescribing pharmacists and advanced clinical practitioners who want structured, current, assessed expertise in menopause and midlife men's health, and who will prescribe, review and govern hormone therapy in their own service. The baseline is pitched at level 7; an optional Professor Mode stretch reaches the research frontier for those who want it.

Programme 2 · Menopause & Andropause
CAS Menopause & Andropause · modules 1–3
Module 1

Foundations and the menopause transition

Aligned to NICE NG23 (updated April 2026) · British Menopause Society · ESHRE POI guideline 2024
Golden Triangle Menopause, perimenopause and POI
You will be able to
  • Diagnose perimenopause and menopause clinically, without FSH at 45 and over, using FSH under 45 and the criteria for premature ovarian insufficiency under 40.
  • Use staging language, explain what to expect, and counsel on the symptom range.
  • Diagnose and manage premature ovarian insufficiency, including HRT or combined hormonal contraception until at least the natural age of menopause and its bone and cardiovascular implications.
Syllabus
Clinical diagnosis across the ages7-coreStaging and counselling7-corePremature ovarian insufficiency7-adv
Module 2

HRT: preparations, routes and benefit–risk

Aligned to NICE NG23 · BMS · IMS · BMS joint guideline on unscheduled bleeding on HRT (May 2026) · NG23 discussion aid (November 2024) · MHRA Drug Safety Update (2019)
You will be able to
  • Select the regimen by uterus and stage: oestrogen-only or combined; sequential while perimenopausal and continuous combined once twelve months since the last period, with the BMS rule to switch within five years of sequential use or by age 54.
  • Choose the route and the progestogen: transdermal first where VTE risk is raised, including BMI over 30, and the oral-not-transdermal stroke signal; micronised progesterone, the levonorgestrel intrauterine system and dose adequacy for endometrial protection.
  • Hold the benefit–risk conversation in absolute numbers, including breast cancer (59 of 1,000 women never taking HRT; 69 with five years of oestrogen-only HRT from 50; 79 with combined HRT), VTE, stroke and the timing hypothesis, and manage unscheduled bleeding on HRT with the expected-bleeding windows and the BMS 2026 triage.
Syllabus
Regimen selection and the switch rule7-coreRoute selection: the NICE-anchored core and the consensus tail7-coreProgestogens and endometrial protection7-coreBenefit and risk in absolute numbers7-advUnscheduled bleeding on HRT7-adv
Module 3

Symptom domains

Aligned to NICE NG23 · NICE TA1143 (March 2026) · MHRA Drug Safety Update on fezolinetant (April 2025) · BMS
You will be able to
  • Manage vasomotor symptoms with HRT and the non-hormonal options, including fezolinetant with the MHRA liver-monitoring rules.
  • Treat the genitourinary syndrome of menopause with vaginal oestrogen, moisturisers and ospemifene, including long-term use.
  • Separate menopausal low mood from depression (HRT or CBT for depressive symptoms; the depression guideline alongside where criteria are met), and address musculoskeletal and sexual health, including testosterone for low sexual desire in women on BMS guidance.
Syllabus
Vasomotor symptoms7-coreGenitourinary syndrome of menopause7-coreMood and cognition7-coreMusculoskeletal and sexual health, including female testosterone7-adv
Programme 2 · Menopause & Andropause
CAS Menopause & Andropause · modules 4–6
Module 4

Special situations

Aligned to NICE NG23 · BMS · RCOG · FSRH and UKMEC
You will be able to
  • Manage surgical and medical menopause, and menopause after breast and gynaecological cancer.
  • Prescribe after venous thromboembolism or with a thrombophilia, with haematology involved first where NG23 requires it.
  • Provide contraception in the perimenopause with the stopping rules, and know when to refer to a menopause specialist service.
Syllabus
Surgical, medical and post-cancer menopause7-advContraception in the perimenopause7-coreReferral7-core
Module 5

Non-hormonal and lifestyle care; bone and cardiovascular risk

Aligned to NICE NG23 · BMS · NOGG (2021, updated 2022) · NICE CG146 and TA464 · NICE NG238 · ESC 2021 prevention guideline
Golden Triangle Osteoporosis and fragility fracture · Cardiovascular disease in women after the menopause
You will be able to
  • Offer CBT, SSRIs and SNRIs, and other non-hormonal agents where appropriate, with exercise, weight, alcohol and smoking advice, for women who decline or cannot take HRT.
  • Assess fracture risk with FRAX or QFracture and DXA, and prescribe bone protection (bisphosphonates, denosumab, HRT for bone) on published NICE and NOGG guidance.
  • Manage the post-menopausal cardiometabolic transition: lipid and blood-pressure change, central adiposity, and the sex-specific risk enhancers (pre-eclampsia, gestational diabetes, polycystic ovary syndrome, early menopause) that the standard risk scores omit.
Syllabus
Non-hormonal therapy and lifestyle care7-coreBone health and fracture prevention7-advThe post-menopausal cardiometabolic transition7-adv
Module 6

Male hypogonadism (andropause)

Aligned to Endocrine Society clinical practice guideline on testosterone therapy · BSSM guidelines on adult testosterone deficiency · the TRAVERSE trial
Golden Triangle Male testosterone deficiency
You will be able to
  • Diagnose testosterone deficiency on symptoms plus two consistently low morning total testosterone samples, with SHBG and calculated free testosterone, LH, FSH and prolactin, and the exclusion of secondary causes.
  • Initiate and monitor testosterone therapy: preparations, contraindications (prostate cancer, polycythaemia, untreated sleep apnoea, a wish for fertility), haematocrit, PSA and symptom review, and cardiovascular safety after TRAVERSE.
  • Recognise erectile dysfunction as a cardiovascular marker and treat it within the cardiometabolic assessment.
Syllabus
Diagnosis7-coreTherapy and monitoring7-advErectile dysfunction and cardiovascular risk7-core
Programme 2 · Menopause & Andropause
CAS Menopause & Andropause · modules 7–8
Module 7

Integration and shared decisions

Aligned to NICE NG23 review structure · NICE NG197 shared decision making · the Observatory's Golden Triangle design note
You will be able to
  • Run the shared-decision menopause or andropause consultation, including media-driven concerns, and document it defensibly.
  • Carry out structured review and deprescribing.
  • Rate the Golden Triangle for menopause, premature ovarian insufficiency, post-menopausal cardiovascular disease, osteoporosis and testosterone deficiency, and plan how to pull the Real-world apex in your own population.
Syllabus
The shared-decision consultation7-coreStructured review and deprescribing7-coreGolden Triangle ratings and the Real-world apex7-core
Module 8

Leadership, quality and service governance

Aligned to NHS England multi-professional framework for advanced practice · NICE quality standards
You will be able to
  • Design a menopause or midlife-health service and its multidisciplinary pathways.
  • Audit HRT route and regimen against NICE and BMS, and run prescribing governance, including off-label testosterone.
  • Apply basic health economics, mentor colleagues and scaffold your capstone from this module.
Syllabus
Service design7-advAudit and prescribing governance7-coreHealth economics and mentorship7-core
Weeks 9–12. Integration week with the second London day; capstone writing with supervision; applied-knowledge assessment and viva. Level bands: 7-core is the pass standard; 7-adv is expected of an extended-scope clinician; 8-stretch is Professor Mode enrichment, never a hurdle to pass.
Assessment
Assessment and the capstone

Assessed at level 7; distinction reaches to level 8

Three elements, completed in the final weeks. The pass standard sits at level 7; the optional Professor Mode material earns distinction and is never a hurdle to pass.

45%
Applied-knowledge assessment
Confidence-calibrated single-best-answer questions · 2 hours
45%
Workplace capstone
3,000 words · your own setting
10%
Presentation and questions
A short defended viva with New Vision University examiners

Your capstone is a workplace asset

Quality improvement or service set-up

A QI or new-service plan with aims, measures and an implementation route, ready to run where you work.

Practice audit, before and after

For CVRM-HF, the heart-failure four pillars and SGLT2 inhibitor eligibility; for Menopause & Andropause, HRT route and regimen against NICE and BMS.

Critical appraisal

A structured appraisal of recent pivotal evidence with explicit implications for practice.

Aligned complex case series

Related complex cases with guideline-referenced management justified throughout.

Appraisal-ready

Every certificate comes with appraisal-ready records: a one-page reflection record in the fields UK appraisal expects, and a Quality Improvement Activity record for the capstone audit. They are plain PDFs that any appraisal toolkit accepts.

Academic integrity

You declare any use of AI in assessed work. The viva is where you defend your own reasoning.

The Living CAS

At enrolment Every lesson, reference and item is current with the latest NICE, ESC, ADA, KDIGO and BMS positions.
Throughout the programme When a cornerstone guideline moves while you are studying, the affected material is reviewed, re-signed and refreshed.
Your award carries a currency window The certificate states the period over which its content is warranted current, not only a date of issue.
Every six months after graduation A short Currency Update micro-lesson with a brief self-assessment re-dates your award, indefinitely.
Faculty and quality
Faculty, examiners and quality

Who teaches, who examines, and how the standard is held

Course Director

Prof Rajesh Varma, PhD MRCGP MRCOG MBBS MA (Cantab)

Professor, New Vision University · Director and Course Convenor, Certificates of Advanced Studies

Prof Rajesh Varma is Professor of Medicine and Life Sciences at New Vision University, Tbilisi, and Professor in Clinical Sciences at East-West University, Tbilisi. He holds a PhD from the University of Birmingham, is a visiting researcher at the University of Cambridge Department of Public Health and Primary Care, and trained as a consultant obstetrician and gynaecologist at St Thomas' Hospital, London, before moving to general practice. He is a practising general practitioner in Hertfordshire, where he runs a weekly cardio-renal-metabolic and heart-failure clinic, and his research on digital phenotyping and very-high-risk secondary prevention was presented at the ESC Congress 2026. He is the founding Editor-in-Chief of the Global Journal of Primary Care and Director of MD Acumen Ltd, which delivers the programmes.

Teaching faculty

A UK clinical faculty of guest specialists and primary-care clinicians teaches the live workshops and the London days; a second clinical signer shares verification. Faculty are named on the programme page before applications open.

Examiners

New Vision University faculty act as examiners for the viva and moderate the capstone marks; an external examiner reviews each cohort. University faculty examine; they do not teach the programme.

Independence

Independent: no pharmaceutical funding of any credit-bearing or paid programme. Teaching, assessment and the content of every module are decided by the faculty alone. A sponsor register for the company's CPD events is published separately.

The six-block quality framework

1
Curriculum

Mapped to the cornerstone guidelines and to the published GMC and RCGP maps, through the Syllabus Registry.

2
Assessment

Blueprinted to the learning outcomes; standards held at the award's level; external examiner.

3
Faculty

Director-level clinical sign-off on every module and item before it goes live; a second clinical signer.

4
Risk governance

An auditable trail; nothing publishes unsigned; currency actively maintained.

5
Student feedback

Structured feedback on every object feeds programme enhancement each cycle.

6
Programme monitoring

Quarterly review of currency, statistics and learner voice.

Every clinical statement is signed by a named GMC-registered clinician with the date and the guideline version relied on. Nothing reaches a learner unsigned. AI assists the drafting of our material, and no AI decides a mark.

Admission
Admission, dates and fees

How to apply

Entry requirements

Current professional registration (GMC, GPhC, NMC or HCPC or the equivalent in your country) and a level 7 professional qualification or equivalent experience in an advanced or extended-scope role. Applicants describe the service in which the capstone will be delivered.

Dates

Applications and deposits open 1 March 2027. First cohort April 2027; second intake autumn 2027. Twelve weeks, with two London days livestreamed for those who cannot travel.

Fees

£2,450, or £2,150 for the founding cohort, with a £250 deposit on application. The fee includes the two London days, all materials, the Currency Updates after graduation and the appraisal-ready records. Cohort licences are available for training hubs and employers.

Apply

Apply or join the waiting list at mdacumen.com/programmes, or write to enquiry@mdacumen.com.

Questions we are asked

Is a Certificate of Advanced Studies a degree?

No. It is a short, credit-bearing postgraduate award (10 ECTS, 20 UK credits) pitched at EQF level 7. It is not a UK degree, GMC registration or specialist registration, and recognition of credit is at the discretion of receiving institutions.

Who awards it?

New Vision University, Tbilisi, Georgia. New Vision University is a Georgian university; it is not a UK degree-awarding body. The programmes are delivered by MD Acumen Ltd with a UK teaching faculty; New Vision University faculty act as examiners and an external examiner moderates.

Does it make me a GP with an extended role?

It equips you with the advanced-level knowledge and governance expected for extended-role or extended-scope practice in its domain. Local accreditation of extended roles and employer governance remain separate processes.

What does my employer get?

A capstone built for your own service: an audit, a quality-improvement plan or a clinic design, with a Quality Improvement Activity record, and a clinician whose award is re-dated every six months.

Certificate of Advanced Studies awarded by New Vision University, Tbilisi, Georgia; 10 ECTS (20 UK credits); pitched at EQF level 7, equivalent in level to the FHEQ level 7 descriptors. New Vision University is not a UK degree-awarding body; recognition of credit is at the discretion of receiving institutions.

New Vision University
Certificates of Advanced Studies
Cardio-Renal-Metabolic Medicine & Heart Failure · Menopause & Andropause
mdacumen.com/programmes
enquiry@mdacumen.com

Every clinical statement is signed by a named GMC-registered clinician with the date and the guideline version relied on. Nothing reaches a learner unsigned. AI assists the drafting of our material, and no AI decides a mark.

Aligned with the published GMC MLA content map and the RCGP GP Curriculum 2025; not affiliated with or endorsed by the GMC or the RCGP. A Certificate of Advanced Studies is an academic award; it is not a UK degree, GMC registration or specialist registration.

Certificate of Advanced Studies awarded by New Vision University, Tbilisi, Georgia; 10 ECTS (20 UK credits); pitched at EQF level 7, equivalent in level to the FHEQ level 7 descriptors. New Vision University is not a UK degree-awarding body; recognition of credit is at the discretion of receiving institutions.

MD Acumen Ltd · Registered in England and Wales · Company no. 16538952 · ICO registration ZC105897 · Delivered by MD Acumen Ltd · Syllabus Registry v1.0.0 · 10 October 2026

Editorial review 10 October 2026 · next refresh 10 January 2027. Aligned with the published GMC MLA content map and the RCGP GP Curriculum 2025; not affiliated with or endorsed by the GMC or the RCGP. A Certificate of Advanced Studies is an academic award; it is not a UK degree, GMC registration or specialist registration.