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Clinical Competencies
3rd Year
The third year of medical school begins a transition for students as they move from classroom-based learning in the first two years to an apprenticeship model with clerkship experiences through a series of rotations in Madison and across the state. Students have their first extended exposure to the culture of medicine and the expectations of independent learning and critical thinking in a clinical setting. Owing to our statewide campus, students are given the opportunity to examine the unique health care needs of the diverse populations across Wisconsin. Required clerkships provide broad exposure to many aspects of medicine and public health. Part of the clinical learning experience involves documentation and self assessment of their learning across competency areas.
- Medical Knowledge
In the third year, students demonstrate an ability to integrate and recall concepts learned in the first two years and develop a coherent and logical differential diagnosis. They learn that a single “correct answer” is not always readily available. They are able to integrate knowledge of social, cultural and behavioral factors and preventive measures to advance patient wellbeing. They have longitudinal experiences with patients which enable them to see the natural history and social/economic impact of illness over time.
- Problem solving and Clinical Skills (Patient Care)
Students not only show compassion and provide solace to patients, but also extract information of clinical relevance using culturally competent patient interview techniques. They are able to think calmly, coherently and intelligently about the medical needs of the patient, integrating relevant clinical guidelines. They learn to perform key clinical skills (e.g. starting an IV). They also learn to recognize ethical dilemmas in the clinical setting and develop skills at working through them.
- Lifelong learning (Practice Based Learning and Improvement)
Students develop their skills in assembling and integrating the most current and relevant information from multiple sources to create a coherent assessment of the patient.
- Systems Based Practice
Students gain familiarity with the medical hierarchy and how health care systems, regulation, and resources affect the patient’s health and health care. This includes, for example an understanding of systemic issues related to medical errors, the physician’s role as an advocate within a disjointed health care system, and how reimbursement and health care financing affect the delivery of care. They acquire an understanding of quality of care issues, including national and local quality improvement goals. Students are also introduced to systems issues in bioethics, such as problems of health care rationing and access to care, and industry-physician relations.
- Professionalism
Patient interactions are challenging and students learn to shift their frame of reference and compartmentalize their emotional and intellectual effort on behalf of the patient. They appreciate that while in their previous education learning focused on them as students, in the clinical years the center of attention is the patient. They maintain their professionalism in an environment with a certain amount of chaos. They do not overstep their bounds and accept constructive feedback gracefully and apply it to improve their care of patients. They also demonstrate that they are reliable and responsible, always performing their duties in a timely, dependable manner.
- Interpersonal and Communication skills
Students participate and communicate effectively in the physician-patient relationship and as members of an interdisciplinary clinical team. They recognize the contribution of other team members and show respect for them. They demonstrate a sensitivity and skill in communicating to patients and families with varying communication needs.
4th Year
In the fourth year of medical school students are able to tailor their education, through electives, research and extramurals, to their evolving interests and career choices as they move toward their specialty and residency decisions. They experience a community preceptorship where they are immersed in a community-based clinical environment in a one-on-one relationship with a physician mentor. During this experience, students develop a greater understanding of the value of community resources in patient care and insights into the relationships between clinical care, public health and health of the community. Students are required to take a four-week Medicine sub-internship, as well as a four-week Surgery sub-internship. Students take Step 2 during their fourth year to assess their application of medical knowledge, skills, and understanding of clinical science with emphasis on health promotion and disease prevention.
- Medical Knowledge
Students’ clinical knowledge continues to build so that by the end of the fourth year they know how to use and interpret appropriate clinical and laboratory evaluation tools and suggest possible treatment options. Students deepen their knowledge in a field of special interest, such as international health, community health, research, integrative medicine or another area of choice.
- Problem solving and Clinical Skills (Patient Care)
Preceptorship and elective experiences enable students to apply and integrate their patient care skills in diverse settings. As they gain clinical experience over the two years, they become more adept at identifying and resolving ethical issues.
- Lifelong learning (Practice Based Learning and Improvement)
Students continue to develop their skills in acquiring and assimilating the latest evidence to diagnose and manage patients. They understand the role of researchers and clinicians in developing and integrating new data to improve care.
- Systems Based Practice
Community preceptorships provide students with the understanding of cultural variations in patient attitudes and practices, and the interface between public health and clinical care,
They gain a further understanding of quality of care issues at a local community level.
- Professionalism
Students prepare for residency having demonstrated respect, compassion, integrity and professional attitudes and behaviors in areas such as the doctor-patient relationship, ethical principles of the profession (i.e. confidentiality of patient information), and sensitivity to patients’ culture, age, gender, and disabilities. Students exhibit accountability to patients, society, and the profession; and a commitment to excellence, leadership, and lifelong professional development.
- Interpersonal and Communication skills
Students continue to develop effective listening skills and elicit and provide information using nonverbal, explanatory, inquiring and written skills. They continue to work effectively and respectfully with others on the health care team.
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