A
Surgeon’s Musings- Producing competent medical graduates
Dear viewers,
Greetings from “Surgical Educator”
The ultimate aim of any medical
institution or any medical educator is to produce competent medical graduates
who can diagnose and manage many common ailments irrespective of the specialty.
They should be able to save many patients with their theoretical knowledge and
practical skills. At the turn of this millennium, the Accreditation Council on
Graduate Medical Education (ACGME) in US introduced the six core competencies
into medical education. Medical educators must now verify that trainees are
skilled in these competencies: Patient Care, Medical
Knowledge, Practice-Based Learning and Improvement, Interpersonal and
Communication Skills, Professionalism, and Systems-Based Practice.
You can watch all my surgical teaching video casts in
the following link: surgicaleducator.blogspot.com
ACGME GENERAL
COMPETENCIES:
1. PATIENT
CARE:
The
competent graduate must be able to provide patient care that is compassionate,
appropriate, and effective for the treatment of health problems and the
promotion of health. He/she will be required to construct appropriate
management strategies (diagnostic and therapeutic) for patients with common
health care problems that may be emergent, acute or chronic, across the
spectrum of disciplines, while considering costs for the patient and others.
The graduate must be able to combine knowledge of basic biomedical, clinical,
and cognate sciences to accomplish the above.
The competent
graduate must be able to:
1.1 Obtain a full
appropriate medical history
1.2 Perform a
skillful physical examination
1.3 Formulate a
differential diagnosis and problem list
1.4 Perform
competently all medical and invasive procedures required for graduation
1.5 Perform,
order and interpret diagnostic investigations that result in accurate diagnosis
and treatment
1.6 Utilize data
to reason and solve problems
1.7 Develop
management plans
1.8 Consider
cultural and socioeconomic factors in management options
1.9 Form an effective
therapeutic relationship
1.10 Recognize
life threatening health problems and institute appropriate initial therapy
1.11 Construct
a therapeutic plan for relieving pain, ameliorating suffering and directed
toward specific resolution of health problems
1.12 Counsel
and educate patients and their families
1.13 Apply the
principles of epidemiology and evidence-based medicine.
2. Medical Knowledge:
Competencies
must include mastery of the necessary body of knowledge within the basic,
clinical, and cognate sciences to manage patients’ health. Moreover, graduates
must demonstrate the skills that will enable them to utilize the concepts and
knowledge that will be discovered throughout the years following medical
school.
2.1 Scientific
principles of basic and clinical sciences that will enable him/her to
competently practice evidence-based medicine
2.2
Determinants of poor health, disease-based risk factors, factors for disease
prevention and healthy lifestyles (principles of preventive medicine)
2.3 Principles
of health education
2.4 Principles
of epidemiology and population-based medicine
2.5 Principles,
risks, and possible benefits of complementary and alternative medicine
2.6 Concepts,
principles, and application of evidence-based medicine
2.7
Investigatory and analytical thinking approach to clinical situations to be able
to translate new and emerging concepts to improve patient care
2.8
Psychological, social, economic, and cultural factors pertaining to health
2.9 Legal and
ethical concepts relating to health care.
3. Practice-Based Learning and Improvement:
The
competent graduate must be able to study, reflect, and evaluate patient care practices,
appraise and assimilate scientific evidence, and understand their learning needs.
He/she must be committed to lifelong learning. The
competent graduate sets clear learning goals, pursues them, and continuously
integrates knowledge gained and applies it to improve medical care
3.2 Assesses
his/her strengths and weakness in order to improve performance and identify effective
ways to address limitations and enhance expertise
3.3 Accesses
information effectively, efficiently, critically appraises the information and
relates it to their patients’ health problems
3.4 Admits
his/her limits of knowledge, knows what to do when those limits are reached,
can deal with uncertainty, and respects the opinions of others
3.5 Recognizes
the need to learn is continuous.
4. Interpersonal and Communication Skills:
The
competent graduate provides compassionate, effective, culturally sensitive
patient care while respecting patient autonomy.
4.1 Listens
attentively and effectively
4.2
Communicates clearly with colleagues and consultants
4.3
Communicates clearly with patients, and patients' families
4.4 Manages
difficult patients and/or difficult relationships such as angry or manipulative
patients
4.5 Works
effectively with other members of interdisciplinary health care teams,
including translators.
5. Professionalism:
The
competent graduate approaches medicine with integrity and respect for human dignity.
They must demonstrate awareness of and commitment to the principles and responsibilities
of medical professionalism.
5.1 Is aware of
the unique doctor/ patient relationship
5.2 Knows and
admits to his/her limits of knowledge
5.3 Recognizes
the need to learn is continuous
5.4 Balances
personal and professional commitments to ensure that the patient's medical
needs are always addressed
5.5 Recognizes
and avoids conflicts of interest in financial and organizational arrangements
for the practice of medicine
5.6
Demonstrates integrity
5.7 Demonstrates
respect for human dignity
5.8 Recognizes
key ethical dilemmas and applies ethical principles
5.9
Demonstrates a commitment to ethical principles pertaining to provision or withholding
of clinical care, confidentiality of patient information, and informed consent
5.10
Demonstrates a commitment to excellence and on-going professional development.
6. System-Based Practice:
The
competent graduate demonstrates an awareness of and responsiveness to the larger
context and systems of health care.
6.1 Understands
the principles of health care delivery and can describe the organization, strengths
and limits of various models of health care delivery systems
6.2 Defines
health in terms of the community in which the patient lives (population-based
medicine)
6.3 Describes
how to appropriately utilize and integrate the services of multidisciplinary
health providers
6.4 Practices
cost-effective health care that does not compromise quality
6.5 Evaluates
and integrates hospital and community resources well minimizes overuse of
health care resources
6.6 Works
collaboratively with other health professionals to optimize the quality of care
rendered, reduce medical error and increase patient safety.
