Internal Medicine Curriculum
Outline
I. Introduction
II. Core Competencies
III. Graded Expectations
IV. Assessment Tools
V. Goals & Objectives by Curriculum Component
VI. Medicine Residency Rules / Regulations and Policies
Appendix A: Documentation Guidelines and Formats
Appendix B: GME Policies and Procedures
Appendix C: Supplemental Readings
Appendix D: ACGME & ABIM Guidelines
I. Introduction
I.A. Program Philosophy
The goal of the Internal Medicine Residency Program at Berkshire Medical Center is to enable our residents to become expert and satisfied clinicians. Consistent with our programmatic emphasis on adult learning techniques, self-directed learning is a central feature of our educational programs.
Equally important, the role of residents as teachers is emphasized. Residents participate actively in the development and evaluation of their own educational curriculum through the Medical Residency Education Committee. They play a key role in residency governance.
The relatively small size of the residency program (36) and a relatively large full time faculty (>30) allows for personal faculty-resident interactions and permits the individualization of curriculum to our resident’s personal goals and needs, as we believe should be the case for the graduate education of adult learners. The regional importance of Berkshire Medical Center as the only major medical facility of the western-most area of the Commonwealth of Massachusetts – one that provides the majority of primary, secondary, and tertiary care for the region – means that residents encounter a remarkable diversity of challenging clinical problems that prepares them well for practice in Internal Medicine.
We strive to build a foundation of knowledge and skills in a training environment that is academically rigorous and challenging as well as emotionally supportive. We believe that our program goals and educational techniques, which are philosophically rooted in the principles of adult learning theories, will provide for our residents a foundation for life-long learning and excellence in the practice of primary care, hospitalist or subspecialty medicine.
Continuity, both in patient care and in education, is fundamental to general Internal Medicine training at Berkshire Medical Center. Residents begin to build their own continuity practice through developing patient panels at Community Health Center from the beginning of their internship. Primary care for these patients permits residents to learn the rewarding experience of longterm continuity with their own patients. Because residents have the opportunity to develop continuity practices in the offices of a large and dedicated group of communitybased full time faculty, they have the chance to observe how skilled internists develop and mold therapeutic relationships with patients as well as acquire important practice management skills. Continuity of education – the development of longterm mentoring relationships between faculty and residents – is facilitated by the size of the program and the high priority that our faculty places on teaching.
I.B. The Written Curriculum
The curriculum is designed to allow each trainee to gain expertise and mastery in the core clinical competencies of: Patient Care (PC), Medical Knowledge (MK), Practice-Based Learning and Improvement (PBLI), Interpersonal and Communication Skills (ICS), Professionalism (P), and Systems-Based Practice (SBP). The curriculum is balanced to integrate outpatient and inpatient experiences, and primary as well as high technology subspecialty care.
Comprehensive descriptions of each core clinical competency and the general methods used to train and evaluate that competency are reviewed under Roman Numeral II. The definitions used are adapted with permission from Outcomes Project literature. Although, all residents (PG1, 2, 3) are expected to gain mastery of each core clinical competency, there are graded expectations that must be met for successful completion of each year (Roman Numeral III). The tools designed and used for assessment and feedback are reviewed in Roman Numeral IV. The detailed descriptions of all formal clinical and non-clinical learning opportunities can be found under Roman Numeral V. Lastly, residency rules, regulations, and procedures are discussed under Roman Numeral VI.
Regular use of the written curriculum will allow both the faculty and trainee to define the key learning objectives and carefully assess against a defined standard.
Glossary of Acronyms
ICS Interpersonal and Communication Skills: Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange in teaming with patients, their families, and professional associates.
MK Medical Knowledge: Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences and the application of their knowledge to patient care and the education of others.
P Professionalism: Residents must demonstrate professionalism as manifested through a commitment to carryout professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
PBLI Practice Based Learning and Improvement: Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate the scientific evidence, and improve their patient care practices.
PC Patient Care: Residents are expected to provide patient care that is compassionate, appropriate, and effective for the promotion of health, preventions of illness, treatment of disease and at the end of life.
SBP Systems Based Practice: Residents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care and the ability to effectively call on system resources to provide optimal care.
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