Participate in providing care to adult patients who are acutely ill
Reinforce block learning objectives through clinical experiences
Develop (and prioritize) a differential diagnosis for core medical conditions
Use and interpret the important historical features
Identify the risk factors for the development of the core conditions
Use and interpret the important physical exam findings
Order and interpret laboratory tests to refine a differential diagnosis and guide management
Use decision tools/guidelines to evaluate a patient and the severity of the core conditions
Assess a patient for complications of the core conditions
List the basics of initial treatment, including the drug classes used to treat the core conditions
Explain the pathophysiology for the core medical conditions
Recognize the clinical and physical exam findings in an unstable patient
Determine whether a patient with the diagnosis should be admitted to the hospital and to what level of care
State indications for, and identify can’t-miss findings, on imaging tests used for the core conditions
Develop a basic understanding of how radiographic images are acquired
List safety concerns for imaging modalities
State contraindications for imaging modalities
Participate in appropriate communication with a radiologist to discuss results on a patient
Use interpersonal communication skills to provide effective medical care
Apply current evidence to patient care
Demonstrate effective use of health information technology
Identify and use skills that promote interprofessional and team-based care
Identify and use skills necessary to improve quality of medical care and patient safety
Demonstrate professionalism during every clinical encounter
Identify public health principles that are applicable to daily practice
Identify transitions of medical care for an acutely ill patient and participate in appropriate communication to facilitate such transitions
Care Across the Life Cycle
Participate in the care of patients in traditional pediatric, obstetrics and gynecology and geriatric inpatient and outpatient settings
Adapt the medical interview and complete or focused physical examination as appropriate to the patient and/or their caregivers, the patient’s age/level of development, as well as the presenting concern and clinical setting
Appropriately interpret objective data such as vital signs and commonly used diagnostic studies (including complete blood count, urinalysis, cerebrospinal fluid analysis, serum chemistries), accounting for the age of the patient, presence or absence of disease, and employed testing modality
Generate an appropriate differential diagnosis for the presenting problem and the patient’s age
Understand the relevant physiology and pathophysiology for the diagnosis and/or differential diagnosis
Begin to develop appropriate plans for patients of various ages presenting in different clinical scenarios, taking into account their invasiveness, benefits, limitations, costs and evidence-based practices
Describe the appropriate use of the following common medications (accounting for age/weight and other patient factors), including when it is NOT appropriate to treat with these medications: analgesics, antipyretics, antibiotics, bronchodilators, corticosteroids, intravenous fluids
Present the history, exam/objective data, assessment and plan for patients of all ages as is appropriate to the clinical scenarios (patient problems and setting: clinic vs. inpatient, admission vs. followup, team vs. family-centered rounds)
Share medical information with patient and/or caregivers in terms that are readily understandable while avoiding medical jargon
Counsel patients and/or their caregivers on plans (screening or diagnostic testing, health maintenance/prevention, treatment, supportive care) that are appropriate to the patient’s age/development ant their reason for presentation
Provide anticipatory guidance to a patient and/or family that is appropriate for their age and condition
Document the history, physical examination, assessment and plan in a format appropriate to the clinical situation (clinic vs. inpatient, admission vs. progress, procedure notes) while demonstrating best practices within the electronic health record
Observe the communication of life altering news to patients and/or their families
Develop an understanding for the important role of preventive counseling across the life cycle
Develop an understanding for the ethical and medico-legal implications of working with patients of various ages and their proxies, including issues of capacity, competency, decision-making/health care power of attorney, guardianship and confidentiality
Develop an understanding for the physician’s role in mandated reporting and safety, including how it varies for patients of different ages in cases of neglect and abuse (physical, sexual, verbal/psychological)
Identify member of the health care team and describe how they contribute to the care of patients (nurse, pharmacist, respiratory therapists, PT, OT, speech therapy, child-life specialists, etc.)
Discuss the importance/benefits of a multidisciplinary care team and/or care coordination
Identify transitions of medical care throughout the life cycle and participate in appropriate communication to facilitate such transitions
Discuss ways to advocate for patients on an individual, community, regional, state or national level; consider barriers and health inequity pertinent to diverse populations
Demonstrate skills necessary to embark on a quality improvement project
Chronic and Preventive Care
Participate in providing care to adult patients in ambulatory setting, including primary care, behavioral health and other ambulatory settings that focus on chronic disease diagnosis and management
Participate in a community setting on a team-based health engagement project
Reinforce block learning objectives through clinical experiences
Identify the key clinical features of common, chronic conditions managed in the outpatient setting, with attention to initial presentations, disease progression and potential complications
Distinguish the varying causes of common, chronic conditions managed in the outpatient setting, including both modifiable and non-modifiable factors
Develop a clinical strategy to evaluate and treat common medical conditions managed in the outpatient setting
Describe the disease burden effects of various chronic conditions at the levels of individual patients, families, communities and society
Make evidence-based recommendations for screening and presentation of common conditions encountered in outpatient settings
Demonstrate ability to link Phase 1 foundational science concepts with clinical knowledge
Identify the roles of physicians, interdisciplinary providers, health care systems and communities in screening, treating and preventing common, chronic conditions
Communicate effectively with patients and families to identify goals and barriers related to health and arrive at individualized treatment plans
Outline the key components, stakeholders and steps required for a community health intervention
Participate in the design, implementation or assessment of a community health intervention
Surgical and Procedural Care
Relate anatomy to pathophysiology and apply knowledge of anatomic relationships to procedural care as a therapeutic modality
Explain the pathophysiology of the core clinical conditions
Participate in providing care to adult and pediatric patients who require an operation or procedure as part of their medical care
Perform a history and physical examination that is appropriate for age, gender, clinical problem and setting
Develop and prioritize a differential diagnosis for core medical and surgical conditions
Use and interpret the important historical and physical exam features
Identify the risk factors for the development of the core conditions
Order and interpret laboratory tests and imaging studies to refine a differential diagnosis and to guide management
Use decision tools/guidelines to evaluate a patient and the severity of the core conditions
Identify common post-operative and post-procedural complications
Develop an assessment and management plan for patients with core clinical conditions in the pre-operative and post-operative settings
List the basics of initial treatment, including indicated operations and procedures, to treat the core clinical conditions
Determine what pre-operative evaluation is needed to safely undergo anesthesia or sedation
Recognize the clinical and physical exam findings in an unstable patient
Demonstrate the basics of resuscitation, including the basics of intravenous access and safely managing an airway
Develop familiarity with common procedures
Scrub, gown and glove appropriately
Perform skin closure for wounds and surgical incisions
Use interpersonal communication skills to provide effective medical care by modeling accurate, clear and concise oral and written presentations
Access, analyze and evaluate scientific and medical literature to address learning needs and apply current evidence to patient care
Using self-reflection, peer feedback and mentor feedback, continue to develop the skills and attitudes necessary for clinical practice
Demonstrate effective use of health information technology
Identify and use skills necessary to improve quality of medical care and patient safety
Demonstrate professionalism during every clinical encounter
Apply HIPPA confidentiality into patient care
Identify and apply public health principles that apply to daily practice
Identify the physician’s role in patient care in a resource-limited setting