College of Medicine Competency-Based Curriculum

  Updated: April 6, 19100

Graduation Competencies

Recognition, Evaluation, Triage

  1. Recognize/triage patients of all ages with life threatening conditions.
  2. Evaluate/triage patients with chronic illness.
  3. Evaluate/triage elderly patients.
  4. Evaluate/triage children with medical needs.
  5. Evaluate/triage patients with pain.
  6. Evaluate/triage patients via telephone.

Patient, History Taking And Screening Exams

  1. Conduct thorough patient history.
  2. Conduct focused or problem specific history.
  3. Conduct thorough screening exam (age and gender appropriate).
  4. Perform mental status exam (and assess patient competence) as appropriate.
  5. Recognize overt and covert signs of illness (depression, dementia).
  6. Perform specialized histories: sexual, substance abuse, domestic violence.

Physical Exam (Organ System Exam)

The student will be able to perform:

  1. Vital signs
  2. Skin exam
  3. HEENT/neck (thyroid) exam
  4. Pulmonary exam
  5. Cardiovascular exam
  6. Abdominal exam
  7. Genito reproductive system (female) exam:
    1. pelvic (including recto-vaginal)
    2. breasts
  8. Genito reproductive system (male) exam:
    1. rectal
    2. testicles
  9. Musculoskeletal exam
  10. Neurological exam
  11. Lymph node exam
  12. PE on obstetrical patient
  13. PE on infants and children
  14. PE on elderly

Problem Definition And Hypothesis Formulation

  1. Create a data base that succinctly prioritizes and synthesizes positive and negative information from history and physical examination.
  2. Provide accurate problem formulation with data available--including organic, psychological and social that may be responsible for commonly encountered problems.
  3. Analyze the significance of data with contemporary understanding of the basic mechanisms underlying the patient's problems.
  4. Synthesize data into concise statements.
  5. Generate initial working hypotheses.
  6. Demonstrate competency in appropriate inquiry/information gathering strategies including accessing databases.
  7. Generate new hypothesis for determining condition responsible for patients problem.
  8. Develop diagnostic and/or therapeutic plan.

Management and Diagnosis

  1. Demonstrate an understanding of diagnostic utility, including the concepts of sensitivity, specificity, positive predictive value, and negative predictive value.
  2. Select appropriate tests and diagnostic procedures.
  3. Appropriately prioritize diagnostic procedures in terms of cost effectiveness and risk/benefit ratio consideration.
  4. Develop an appropriate management plan based on initial assessment, patient's expectations and psychosocial barriers which may exist.
  5. Demonstrate ability to write admission orders and outpatient treatment plan.
  6. Recognize basic nutritional needs of patient.

Diagnostic and Therapeutic Procedures

The student will be able to perform:

  1. Pap smear
  2. Cervical cultures
  3. Venipuncture
  4. N/G tube insertion
  5. Catheterization of bladder
  6. Suture of minor lacerations
  7. Blood culture
  8. Urinalysis, including a dip stick and microscopic examination of the spun and unspun sediment
  9. Interpretation of xray of chest, abdominal and long bone for common problems
  10. Stool guaiac (hemoccult)
  11. Intradermal test
  12. CPR (establish and maintain airway)
  13. Assessment of newborn (APGAR)
  14. Universal precautions
  15. Insertion of intravenous line
  16. Throat culture
  17. Basic EKG interpretations
  18. Mematocrit
  19. Blood gases
  20. Lumbar puncture
  21. Administration and interpretation of PPD test
  22. Therapeutic injection
  23. Aseptic technique and proper scrubbing technique

Collaboration/Communications

  1. Produce organized, readable, concise written reports.
  2. Give organized, concise verbal presentations.
  3. Write progress notes that communicate status of identified problems, new findings and management in a problem oriented approach.
  4. Appropriately recognize need for and utilize consultation services with other health professionals.
  5. Accurately determine patients expectations and provide information as to correctness of these.
  6. Demonstrate respect for and appreciation of other health professionals' abilities, skills and roles in patient care.
  7. Access ancillary and support services within the institution and with the community.

Communication With Patient and/or Family

  1. Demonstrate an understanding of the concept of the patient/physician contract and its impact on the treatment plan.
  2. Communicate effectively with the patient and his or her family the current concept of the patient's problem.
  3. Communicate available treatment options, advantages vs disadvantages and recommendations.
  4. Communicate with the patient and his or her family about the patient's role in the care program.
  5. Take steps to ensure that patient understands and intends to comply with proposed management plan.
  6. Demonstrate ability to work with patients with communication problems.
  7. Explain a planned procedure to a patient in understandable terms and obtain informed consent when required.
  8. Develop effective telephone communication skills.
  9. Demonstrate willingness to communicate lack of knowledge and/or ignorance about the patient's medical condition.

Psychological Aspects of Treatment

  1. Demonstrate compassion for patients and respect for patient's rights and privacy.
  2. Treat patients as individuals who have important personal, family and community values, goals and concerns.
  3. Recognize factors in the student's own sexuality that may influence the perception and management of patients.
  4. Demonstrate ability to work with hostile or uncooperative patients.
  5. Demonstrate empathy.

Legal, Ethical and Value Concerns

  1. Demonstrate a recognition of ethical and legal concerns related to clinical practice, e.g. patient autonomy, justice, beneficence.
  2. Demonstrate a recognition of the conflict of values that arise in clinical practice.
  3. Demonstrate a recognition of religious issues that may arise in clinical practice.
  4. Demonstrate recognition of the contribution of religious values and beliefs to patient strength and healing (recovery).
  5. Demonstrate a recognition of patient's rights including the right to refuse treatment and the ability to execute advanced directives.
  6. Evaluate situations that involve death and dying.
  7. Demonstrate recognition of reporting requirements related to medical practice.
  8. Demonstrate a clear understanding of problem that may arise with personal relationships with patients in the practice of medicine.
  9. Be aware of issues surrounding care of self and/or family members.

Health Promotion, Risk Assessment and Patient Education

  1. Explain to the patient self-examination techniques for cancer screening, e.g., breast, testicles, skin.
  2. Identify and analyze health risks in given patients, families and communities (epidemiology and genetic assessment).
  3. Identify persons at risk for common health problems.
  4. Utilize health promotion and disease prevention screening protocols appropriate to age, sex and patient risk factors.
  5. Evaluate and update immunizations.
  6. Counsel patients on safe sex and birth control.
  7. Provide AIDS counseling.
  8. Provide dietary counseling.
  9. Recognize strategies to keep patients out of the hospital.
  10. Provide counseling on lifestyle modification that will positively impact on health outcomes.
  11. Provide psychological health promotion.

Clinical Presentations

Principles for Medicine

Reticuloendothelial System

Muscoloskeletal System and Skin

Cardiovascular System

Respiratory System

Renal-Electrolytes System

Endocrine

Neuroscience

The Mind

Reproductive

Gastrointestinal System

Human Development

Integrative