Competency

We require our medical students to develop competency in the areas of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. The expected level of competency attained must be sufficient to allow these new physicians to be successful in graduate medical education programs, and must also provide them with the attitudes, skills and values requisite to continually update these competencies over the lifetime of their careers. Students will be broadly trained and prepared to undertake advanced training for careers in patient care, academic medicine, public health, and/or research. Faculty members as teachers, mentors, and role models are committed to support the development of these student competencies.

Patient Care Competency

Graduates must be able to collaborate effectively to provide patient care that is compassionate, appropriate and effective both for the treatment of health problems and the promotion of health. Our graduates will:

1. gather essential information from all available sources, including other health care professionals, to obtain an accurate and relevant medical history that is developmentally, culturally, and age appropriate, and that identifies the patient’s view of the problems and needs.
2. perform a relevant and accurate physical examination, distinguishing normal and abnormal findings.
3. apply their knowledge of pathophysiology to the interpretation of history, physical examination and laboratory data.
4. create and prioritize a comprehensive problem list.
5. assess each problem appropriately, formulating and prioritizing a differential diagnosis when indicated.
6. use decision analysis, relative costs, and discussion with other health care professionals to order and accurately interpret common diagnostic procedures (including but not limited to blood tests, CXR, EKG, urinalysis).
7. learn and perform common medical procedures (including but not limited to obtaining a venous and arterial blood sample, insertion of a peripheral IV line, Foley catheter, and nasogastric tube, performing basic suturing, and performing a lumbar puncture).
8. document accurately, legibly and succinctly: historical and physical examination data; interpretation of test results; problem lists and management plans that include supportive clinical reasoning; discussions with patients/ families/ consultants; procedure notes; informed consent; and discharge or follow-up plans, including prescriptions.
9. develop diagnostic and therapeutic strategies for common medical conditions, acute care, emergencies, chronic care, end of life care, and wellness.
10. demonstrate the ability to work with the health care team to identify, assess and manage pain and suffering of patients, and provide support and comfort when cure may not be possible.
11. identify and address risk factors to prevent disease and promote health, including the use of screening tools to identify patients/families experiencing problems with literacy, environmental conditions, violence, substance use, physical, psychological and/or sexual abuse.
12. be able to identify appropriate resources and educational materials for patients, including community-based organizations, other health care professionals, support groups, Internet sources, and handouts.
13. provide appropriate, accurate and timely information when transferring a patient’s care to another provider.
14. recognize when additional help is needed and understand the role of a consultant as a member of the healthcare team

Medical Knowledge Competency

Our graduates will know the:

1. normal structure and function of the body and each of its major organ systems.
2. molecular, biochemical, genetic and cellular mechanisms important to maintaining the body's homeostasis.
3. pathogenesis of disease, including but not limited to altered structure and function and the pathophysiology of pain.
4. developmental changes and milestones, psychological development, and the differences between normal variation and disease across the human life span.
5. etiology, epidemiology, clinical manifestations, prognosis, and natural history of common illnesses.
6. principles of contemporary therapeutics, including but not limited to molecular, biological, pharmacological, surgical, and complementary and alternative medicine.
7. common sources of medical error and basic concepts of risk management in medical practice.
8. power and limitations of the scientific method and evidence-based medicine in establishing the causation of disease and the efficacy of traditional and non-traditional therapies, as well as the central role of research in medicine, including an appreciation of the contributions of basic science, translational research, public health, and clinical studies to the development of medical care.
9. principles of nutrition as they relate to health maintenance and the care of acutely and chronically ill patients.
10. principles of clinical epidemiology and biostatistics.
11. legal and ethical framework and principles that govern sound clinical decision making, including adherence to standards of care.
12. the role of communities in influencing health and illness, and providing resources for prevention and patient care.

Practice-Based Learning and Improvement Competency

Graduates should have the knowledge, skills and attitudes necessary to evaluate their method of practice and implement strategies for improvement of patient care. Our graduates will:

1. understand and utilize performance improvement processes (including but not limited to identifying areas for improvement, designing and implementing strategies for improvement, and assessing outcomes).
2. demonstrate the ability to practice evidence-based medicine by formulating clear clinical questions, knowing where and how to find best sources of evidence, evaluating and appraising the evidence for validity and usefulness with respect to particular patients or populations, and determining when and how to integrate new findings into practice.
3. appropriately utilize information technology and employ electronic communications to facilitate acquisition, storage, retrieval and analysis of patient and practice data.
4. understand the role and limitations of practice guidelines and clinical pathways to improve the quality of care for populations of patients.

Interpersonal and Communication Skills Competency

Graduates must demonstrate the skills and attitudes that allow effective interaction with patients, families and all members of the health care team. Our graduates will be able to:

1. demonstrate empathy and respect for others, including sensitivity to cultural, gender and sexual orientation differences, personal preferences and level of understanding.
2. demonstrate an appreciation of the impact of an illness and its treatment on patient, family, and significant others.
3. demonstrate effective interviewing skills, including attentive listening, eliciting a patient’s concerns, establishing rapport, skilled use of open and closed questions, appropriate use of verbal and nonverbal facilitation techniques, clarifying and summarizing information, and exploration of a patient’s context/ perspective/ beliefs/ emotions.
4. demonstrate the ability to provide information with sensitivity and clarity and in a language understood by the patient/family, while checking for understanding and encouraging questions (including but not limited to such skills as giving bad news, discussing risks and benefits of treatments, discussing medical errors, and utilizing interpreters).
5. share decision-making and negotiate management plans with patients, families, and other healthcare professionals, incorporating information about patients’ perspectives, experiences, and available supports and resources (including end-of-life decisions, behavioral counseling, informed consent, and discussion of alternative treatment options).
6. demonstrate effective oral presentation skills (e.g., accurate content and efficient process).
7. critique in oral and/or written format scientific publications (e.g., basic science, educational or clinical research articles, case reports, consensus guidelines).
8. demonstrate the ability to constructively give feedback to, and receive feedback from, preceptors, peers, and team members.
9. appropriately engage faculty, peers, or other health care providers to elicit and/or clarify information.
10. use appropriate techniques for collaborating with and teaching other students (e.g., effective participation in small learning groups).

Professionalism Competency

Graduates must demonstrate the knowledge, skills, attitudes, and behaviors necessary to promote the best interests of patients, society, and the medical profession. Our graduates will demonstrate:

1. honesty and integrity with patients/families, peers, the healthcare team, community members, faculty, and others.
2. reliability and responsibility by completing duties in a timely fashion and not engaging in patient care responsibilities if emotionally or physically impaired.
3. the ability to maintain appropriate confidentiality.
4. respect for others, including appropriate grooming, punctuality, courtesy, non-derogatory backroom discussions, inclusiveness, and use of socially acceptable language and humor.
5. compassion and empathy in words and deeds when dealing with patients/families, peers, the healthcare team, community members, faculty, and others.
6. awareness of appropriate professional boundaries and the inappropriateness of the exploitation of patients for any sexual advantage, personal financial gain, or other private purpose.
7. a commitment to self-improvement, including being open and responsive to feedback, reflection and self-evaluation, and actively setting and pursuing learning goals and applying knowledge gained.
8. the ability to accept responsibility for errors and evaluate failures in education and patient care.
9. recognition and acceptance of personal limitations in knowledge, skill and behavior, seeking guidance and supervision when appropriate.
10. the ability to recognize the role of personal wellness, values, and priorities in their practice of medicine.
11. the ability to identify and appropriately respond to unprofessional behavior in others.
12. the willingness and capability to work collaboratively and resolve conflicts in a variety of settings to achieve common patient care and educational goals of all involved.
13. altruism and advocacy demonstrated by a commitment to promoting health care needs of patients and society, and to improve quality and access to care and a just distribution of finite resources.
14. recognition of and sensitivity to culture, race, disabilities, age, and other differences in order to prevent health care discrimination.
15. the ability to identify potential conflicts of interest arising from the influence of marketing and advertising, as well as financial and organizational arrangements.
16. the ability to apply legal and ethical principles to patient care, clinical research, and the practice of medicine.
17. participation in defining, organizing, and evaluating the educational process for current and future students.

Systems-Based Practice Competency

Graduates must demonstrate the knowledge, skills, and attitudes necessary to provide high quality care for their patients within the context of the larger healthcare system. Our graduates will:

1. demonstrate knowledge of various approaches to the organization, financing, and delivery of healthcare.
2. demonstrate an understanding of biological, social, psychological, and environmental risk factors for inadequate healthcare or inadequate access to healthcare.
3. advocate for patients and/or communities by implementing strategies to access healthcare services and assistance.
4. demonstrate collaborative practice by identifying key personnel, understanding the role of each healthcare team member, and participating in a coordinated effort to optimize patient care.
5. consider cost-effectiveness and resource allocation in developing diagnostic and treatment strategies that promote quality of care.
6. understand the nature of systems errors and strategies to minimize them, such as failure modes/effects analysis, root cause analysis, electronic medical records, and order entry.