The Six Core Competencies

Using the ACGME six core competencies as a model, we have defined enabling
objectives of each, the achievement of which is necessary to graduate.

Table 1 shows the six core competencies and enabling objectives for medical
students. These are expressed in general terms. Each of the core specific sections,
which follow this one, lists the specific objectives for each specialty.

Table 1 - ACGME Core Competencies for Medical Students

Patient Care - Students will demonstrate an ability to:

• Provide patient-focused individualized care of individuals of all ages and

            socio-demographics

• Perform organized, efficient, and empathic diagnostic interviews;
• Obtain comprehensive histories including a review of patient’s prior medical

            record and collateral data;

• Demonstrate proficiency in performing a complete mental status

            examination;

• Order relevant diagnostic tests and consultations;
• Develop a differential diagnosis;
• Interpret data and make appropriate decisions in collaboration with each patient;

• Prioritize appropriately;
• Engage patients and families in treatment and promote adherence to treatment;

• Manage high risk patients and emergencies;
• Provide crisis intervention;
• Use precautions such as special levels of observation, as needed;
• Provide ongoing treatment with a full-range of medications;
• Monitor medication side effects;
• Provide patient and family education;
• Engage actively in discharge planning;
• Refer patients for follow up treatment.

Medical Knowledge – Students will demonstrate medical knowledge sufficient to:

• Demonstrate a strong fund of knowledge of pathology and pathophysiology;
• Formulate cases and develop differential diagnosis;
• Actively use knowledge to solve problems;
• Develop treatment plans;
• Utilize creativity and flexibility in implementing treatment plans;
• Develop decision making skills for treatment options.

Practice-Based Learning & Improvement – Student will demonstrate ability to:

• Continually analyze practice performance & patient outcomes and carry out
• needed improvements;
• Locate and apply scientific evidence to the care of patients;
• Critically appraise the scientific literature as it relates to each patient;
• Use on-line resources to support learning and patient care;
• Appropriately seek supervision.

Interpersonal Skills and Communication – Student will demonstrate ability to:

• Become proficient with succinct and thorough presentations;
• Maintain legible, appropriate and timely documentation;
• Provide appropriate support for families and other collaterals of patients;
• Manage relationship with patients, families, supervisors and multidisciplinary
• team members;
• Demonstrate effective problem solving skills;
• Use verbal and non-verbal skills to communicate effectively with patients and their families.

Professionalism – Student will demonstrate ability to:

• Show respect, compassion, and integrity for each patient;
• Maintain punctuality for patients, families and supervisors;
• Be accessible and available to patients and families;
• Recognize limits of his/her own knowledge and curative abilities;
• Maintain equilibrium under stress;
• Arrange appropriate coverage for absences;
• Accept responsibility;
• Act in the best interest of the patient;
• Demonstrate sensitivity to patients’ culture, ethnicity, age, sexual orientation, sex and disabilities.

Systems-Based Practice – Student will demonstrate ability to:

• Show awareness of complex systems of care that affect patients;
• Effectively use outside resources to advocate for patients;
• Provide cost-effective care;
• Advocate for high quality inpatient care;
• Work with interdisciplinary teams and hospital management to improve patient care.

EDUCATIONAL OBJECTIVES

The twelve-week core clerkship in Internal Medicine takes place in acute care
medical centers and is designed to provide students with the formal instruction and patient care experience so as to enable them to develop the knowledge, skills and attitudes necessary to begin mastering the following six basic clinical competencies essential to becoming a knowledgeable, well-rounded, caring physician.

Students gain these and the additional skills outlined below by functioning as
integral members of the patient care team, participating in resident work rounds and teaching attending bedside rounds every weekday, admitting patients when on-call and following them until discharge under the continuous supervision of the residents, by meeting with their preceptor at least three times per week (conferences for students only) and by attending daily didactic conferences. An orientation at the start of the clerkship outlines the educational goals and objectives of the clerkship as well as the responsibilities of the third year clerk, and his or her assignments and schedules. Clerks are provided feedback on their progress during both mid-course and final summative reviews with their preceptor or clerkship director.