ACGME Competencies

FM Clerkship Curriculum Themes

Student Learning Objectives
By the end of the Family Medicine Clerkship, students will be able to:

Patient Care

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Acute and Chronic Illness Theme

• Collaborate with health care professionals, including those from other disciplines, to provide patient-centered care and preventive services across the lifespan.
• Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities when providing care.
• Collect and incorporate appropriate psychosocial, cultural, and family data into a patient management plan.
• Make informed decisions about diagnostic and therapeutic interventions using patient information and preferences, scientific evidence, and clinical judgment.
• Describe the continuing role & responsibility of the family physician in the care of patients during the process of consultation and referral.
• Develop and implement a management plan for common, acute illnesses using a focused, problem-oriented assessment.
• Participate in a chronic disease management plan in partnership with the patient, patient's family, and other health care professionals that enhances functional outcome & quality of life.
• Counsel and educate patients and families about acute and chronic illnesses.
• Perform office-based procedures under supervision of a family physician.
• Recognize the need for the family physician's continuing role and responsibility in the care of patients during the process of consultation and referral.

Prevention and Wellness Theme    

• Apply screening protocols based on guidelines and recommendations to identify risks for disease or injury and opportunities to promote wellness for the following care groups:
• Child care (e.g. nutrition, immunizations)
• Adolescent care
• Adult (e.g., hypertension, hypercholesterolemia, diet, CAD, CA, HRT, substance abuse, environmental exposure, occupational disease, STD)
• Maternity care
• Geriatric (e.g., advance directives)
• Counsel patients and their families about serious effects of harmful personal behaviors and habits and appropriate health maintenance strategies.
• Apply culturally appropriate behavioral change strategies (e.g., smoking cessation) to support patient wellness.
• Use appropriate technology (e.g., Web-based, handheld computer) to support patient education and disease prevention activities.

Community and Population Medicine

• Describe the social, community, and economic factors that affect patient care.
• Describe community-based interventions to modify or eliminate identified risks for disease or injury.

Medical Knowledge

Acute and Chronic Illness Theme

• Describe the prevalence and natural history of common problems and illnesses over the course of individual and family life cycles.
• Reflect upon and discuss the complexity of providing longitudinal, comprehensive, and integrated care for patients with common, chronic medical problems.
• Integrate and apply the basic and clinically supportive sciences, appropriate to the discipline of family medicine.
• Demonstrate an investigatory and analytic thinking approach to clinical situations.

Prevention and Wellness Theme

• Identify prevalent diseases, injuries, and conditions in which prevention plays a role.
• Demonstrate basic knowledge of the complex factors involved in behavioral change.
• Define primary, secondary, and tertiary prevention.
• Define characteristics of a good screening test (e.g., explain lead time bias).
• Describe the principles of behavioral change strategies (e.g., smoking cessation).
• Recognize the impact of cultural diversity on health promotion and disease prevention issues at the individual and community level.

Community and Population Medicine

• Compare and contrast the epidemiology of diseases seen in patients in primary and tertiary care settings and discuss the implications of this epidemiology for the care of patients in these settings.
• Recognize and interpret relevant laws and regulations relating to protection and promotion of public health.
• Interpret the findings of an outbreak or cluster investigation as it applies to prevention and patient education.

Practice-Based Learning and Improvement

Acute and Chronic Illness Theme

• Locate, appraise, and assimilate evidence from scientific studies related to patients' health problems.
• Demonstrate an understanding of the need to make basic diagnostic and treatment decisions that consider the limitations of clinical data.
• Describe the benefits of providing longitudinal, comprehensive, and integrated care for patients with common, chronic medical problems.
• Analyze the impact of referral patterns within a family practice context.
• Make informed decisions about diagnostic and therapeutic interventions using patient information and preferences, up-to-date scientific evidence, and clinical judgment.

Prevention and Wellness Theme

• Demonstrate basic knowledge needed for selecting protocols and strategies to reduce of identified health risks for patients and communities.

Community and Population Medicine

• Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.
• Use appropriate screening tools and protocols for health maintenance in specific populations, including immunizations across the age spectrum.
• Use information technology to manage information, access current medical information, and support personal education.
• Analyze practice experience and perform practice-based improvement activities using systematic methodology.
• Obtain and utilize information about populations of patients, including health risks to communities.
• Describe and discuss the forces that affect the process, timing, and reasons for the patient to seek medical care.
• Discuss the diagnosis of common, acute, and undifferentiated medical problems using probability estimates of disease prevalence specific to the geographic and socioeconomic community of the practice location.

Interpersonal Communication

Acute and Chronic Illness Theme

• Create and sustain therapeutic and ethically sound relationships with patients and families utilizing a patient-centered approach.
• Encourage patients with episodic or acute illnesses to seek continuing medical care.
• Document appropriate information for acute and continuing care in the patient record.
• Participate in consultation and referral to other health care professionals.
• Demonstrate effective, respectful communication with other health care professionals and clinical faculty.
• Demonstrate the ability to communicate effectively with patients and families through an interpreter.
• Effectively educate the patient and concerned person/caregiver in a triangular relationship.

Prevention and Wellness Theme

• Translate epidemiological findings and guidelines into patient recommendations for a specific disease prevention intervention.

Community and Population Medicine

• Develop a community education program.

Professionalism

Acute and Chronic Illness Theme

• Describe the importance of maintaining continuing professional responsibility for the patient's and family's health care.
• Demonstrate respect for patients and families in the referral and consultation process.
• Perform concise, problem-focused presentation of the patient that reflects critical thinking in clinical decision making.
• Demonstrate respect for patient confidentiality and privacy regulations.

Prevention and Wellness Theme

• Avoid imposing personal values by using non-directive counseling when appropriate.
• Demonstrate respect for patients whose lifestyles and values may be different from the students'.

Community and Population Medicine

Additional

• Recognize limits of personal knowledge.

Systems-Based Practice

Acute and Chronic Illness Theme

• Advocate for quality patient care and assist patients in dealing with system complexities.
• Recognize the barriers to coordination of health care and recommend improvements.
• Describe the role of the family physician as coordinator of care.
• Recognize appropriate consultation resources, both medical and non-medical, in discussing effective use of resources.
• Recognize and explain the various settings in which family physicians provide care and the integration of care that occurs across these settings.

Prevention and Wellness Theme

• Understand how the prevalence of disease in a population changes the predictive value of a screening test (e.g., PSA screening and ethnicity).
• Demonstrate knowledge of epidemiological studies, including data collection, biostatistical techniques, study design, and implementation of results.
• Describe strategies for patient education and disease prevention that can be implemented with those who do not present for care on their own.

Community and Population Medicine

• Analyze the health of a community, using census, vital statistics, public health data, and other appropriate sources of data.
• Describe methods of controlling health care costs and allocating resources that do not compromise quality of care.