Formal Clerkship Objectives

Formal Clerkship Objectives

1. Elicit a through and pertinent patient history, adapting it to the urgency of the time allowed for the interaction. Include the following history:
A. Chief complaint

B. History of present illness: Describe the significant attributes of a symptom, including location and radiation, intensity, quality, temporal sequence (onset, duration, frequency), alleviating factors, aggravating factors, setting associated symptoms, functional impairment, and patient's interpretation of symptom.

C. Past medical history

D. Health maintenance history

E. Family and social histories, etc.

F. Review of Systems

2. Conduct a thorough physical examination. Include the following:

A. Describe the four methods of physical examination (inspection, palpation, percussion, and auscultation), including where and when to use them, their purposes, and the findings that they elicit.

B. Position the patient properly for each part of the physical examination.

C. Perform the physical examination for a patient in a logical, organized, respectful, and through manner, giving attention to the patient’s general appearance, vital signs, and pertinent body regions.

3. Use information gathered from the patient’s history and physical to complete the following:

A. Describe physiologic mechanisms that explain key findings in the history and physical. B. Include a discussion of the diagnostic value of the history and physical examination information.

C. Formulate a differential diagnosis (problem list) based on the findings from the history and physical examination.

D. Formulate a plan of patient evaluation and management, including diagnostic studies and consultations, therapeutic efforts, education of patient, and follow-up plans using an evidence- based approach.

4. Participate in the selection of diagnostic studies with the greatest likelihood of providing useful results at a reasonable cost.

5. Interpret laboratory data including basic metabolic panels, liver functions tests, blood counts, arterial blood gases.

6. Assess each problem further by synthesizing and analyzing the data obtained from the diagnostic studies.

7. Demonstrate familiarity with basic clinical procedures of internal medicine.

8. Prepare written, comprehensive, and focused new patient workups. Include the following features when clinically appropriate:

A. Provide a history of the present illness accurately, objectively, chronologically, without repetition, omission, or extraneous information.

B. Provide comprehensive physical exam information with detail pertinent to the patient’s problem.

C. Provide a succinct and unified list of all problems identified in the history and physical examination.

D. Provide a differential diagnosis for each problem.

E. Provide a diagnosis/treatment plan for each problem.

9. Present orally, clearly, and concisely the plan of problem evaluation and patient management.

10. Participate in discussion with the patient care team (faculty, staff, etc.) during teaching sessions.

11. Communicate positive interpersonal skills with patients and staff. Include the following:

A. Demonstrate respect and appropriate listening skills, including both verbal and nonverbal techniques.

B. Demonstrate effective verbal skills, including appropriate use of open- and closed-ended questions, repetition, facilitation, explanation, and interpretation.

C. Describe how patients’ and physicians’ perceptions, preferences, and actions are affected by cultural and psychosocial factors, including how these factors affect the doctor-patient relationship.

12. Relate successfully to patients, families, and professionals. Include the following:

A. Demonstrate appropriate listening skills, including both verbal and nonverbal techniques.

B. Demonstrate interest and responsibility in patient care and patients’ needs.

13. Display professional attitudes to learning. Include the following:

A. Demonstrate good, consistent work habits.

B. Demonstrate inquisitiveness.

C. Demonstrate evidence of a desire to learn and improve by reading, studying, and discussing.

D. Demonstrate an ability to respond positively to constructive criticism.

14. Recognize, evaluate, and treat common adult medical problems in both inpatient and outpatient settings. Include the following:

A. Cardiovascular Diseases

1. Valvular heart disease

2. Congestive heart failure

3. Ischemic heart disease

4. Pericardial disease

5. Peripheral vascular disease

6. Arrhythmias

B. Respiratory Diseases

1. COPD/asthma
2. Pulmonary vascular disease
3. ARDS and pulmonary critical care
4. Lung cancer

C. Renal Disease
1. Fluid and electrolyte disorders
2. Hypertension/vascular disorders of kidney
3. Acute renal failure
4. Chronic renal failure

D. Gastrointestinal Disease
1. Neoplasms of the GI tract
2. Pancreatitis

3. Peptic Ulcer Disease

4. Gastrointestinal bleeding

5. Diseases of the Liver and Biliary System
a. Jaundice
b. Cirrhosis, complications
c. Gallstones

E. Hematology
1. Anemia
2. Leukocyte disorders
3. Hemostasis
4. Coagulation disorders

5. Leukemia / lymphoma

6. Myelodysplastic syndromes

F. Oncology

1. Oncologic emergencies

2. Solid tumors
G. Metabolic Diseases

1. Principles of nutritional support
2. Hyperuricemia and gout

3. Lipids

H. Endocrine Diseases

1. Thyroid disorders

2. Diabetes

I. Diseases of Bone and Bone Mineral Metabolism

1. Hypercalcemia

2. Osteoporosis

J. Musculoskeletal and Connective Tissue Disease

1. Rheumatoid arthritis

2. SLE

3. Osteoarthritis

4. Crystal-induced arthropathies

5. Infections of joint spaces

K. Infectious Diseases

1. Host defenses

2. Fever and febrile syndromes

3. Bacteremia and septicemia

4. Meningitis

5. Pneumonia (includes tuberculosis)

6. Urinary tract infections

7. Immunocompromised host

8. Management of/approach to the HIV+ patient

9. Cellulitis and osteomyelitis

L. Neurologic Diseases

1. Disorders of consciousness and higher brain function, including syncope

2. Drug and alcohol abuse, including alcohol withdrawal

3. Autonomic dysfunction

4. Sensory dysfunction

5. Cerebrovascular disease

6. Seizure disorders

M. The Aging Patient

1. Biology of Aging

2. Identify preventive standards for the various adult age groups, to include counseling and guidance

3. Evaluate the effects of illness on the adult and his/her family

N. Cutaneous Disease

1. Infectious Disease (Impetigo, HPV, Herpes, Tinea)

2. Psoriasis

3. Eczema

4. Skin Cancer

5. Skin breakdown and wound care