ACGME CORE COMPETENCIES

Good interpersonal and communication skills result in the effective exchange of information and collaboration with patients, their families, and other health professionals.

Communication and Information Sharing with Patients and Families

At the end of the program of study, the student should demonstrate the ability to:

  • Apply the principles and techniques of patient centered interviewing and gathering data to explore the patient’s perspective—including their feelings, character, beliefs about health and well-being, fears, and expectations—across a broad spectrum of cultural and socioeconomic backgrounds
  • Apply the principles and techniques of patient centered interviewing in the closing of the interview which includes information sharing and addressing patient concerns in the negotiation of diagnostic and treatment plans with patients and/ or families across a broad spectrum of cultural and socioeconomic backgrounds
  • Apply the principles and techniques of patient centered interviewing to seek out emotions and handle them in an empathic manner with patients and/ or families across a broad spectrum of cultural and socioeconomic backgrounds
  • Apply the principles and techniques of patient centered interviewing in the discussion of serious or sensitive topics in an open, empathic, and nonjudgmental approach with patients and/ or families across a broad spectrum of cultural and socioeconomic backgrounds
  • Communicate with people with special communication needs such as older persons, those with impaired hearing, and those who speak a language not spoken by the student
Communication with a Medical Team

At the end of the program of study, the student should be able to demonstrate the ability to:

  • Orally present a patient encounter or clinical situation in an organized, accurate and logical fashion, including the assessment and plan. (EPA 5)
  • Document a patient encounter in an organized, accurate and logical manner including reflection of clinical thinking in the assessment and plan. (EPA 6)
  • Communicate effectively and respectfully with all members of the inter-professional health care team and health related agencies both orally and in writing. (EPA 9)
  • Pose an appropriate clinical question when requesting consultation from other members of the health care team.
  • Maintain accurate, timely and legible medical records.
  • Function as a collaborative member of the health care team. (EPA 11)
Doctor–Patient Relationship

At the end of the program of study, the student should be able to demonstrate the ability to:

  • Define the components of a therapeutic relationship.
  • Establish a relationship with patients and/ or families across a broad spectrum of cultural and socioeconomic backgrounds based on respect and empathy with the patient’s wellbeing as the primary goal.
Inquiry and Discovery

At the end of the program of study, the student should be able to:

  • Formulate a clinical question or hypothesis and develop a plan of investigation to evaluate the evidence and its application to patient care. (EPA 7)
  • Use the principles of biostatistics and research design to analyze the results of scientific inquiry and investigation, including existing and new therapies
Knowledge for Practice

This competency demonstrates knowledge of the structure and function of the human body—from the molecular to the behavioral level—necessary to develop a differential diagnosis and formulate a diagnostic treatment plan. At the end of the program of study, the student should demonstrate the ability to:

  • Formulate and prioritize a differential diagnosis based on the presentation and epidemiology of disease. (EPA 2)
  • Discuss the principles of prevention and health promotion in the context of socioeconomic diversity and global population health.
  • Discuss recommendations for prevention and health promotion in the context of socioeconomic diversity and global population health.
  • Discuss the biopsychosocial model as it impacts health care utilization and outcomes.
Problem Solving and Diagnosis

At the end of the program of study, the student should be able to:

  • Select and interpret diagnostic clinical tests based on a differential diagnosis. (EPA 3)
  • Explain clinical problems and the presentation of disease with an understanding of the pathophysiology.
Treatment

At the end of the program of study, the student should be able to:

  • Recommend treatment options based on the pathophysiology and prognosis of a disease.
  • Apply preventive care principles and motivational interviewing techniques in health promotion and disease prevention when treating patients across a broad spectrum of cultural and socioeconomic backgrounds.

 

Provide patient-centered care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health

History Taking

By the end of program of study, the student should be able to demonstrate the ability to:

  • Gather information in a complete or focused history needed to recognize a patient’s health problems, develop a differential diagnosis and identify risks. (EPA 1)
Medical Notes

By the end of program of study, the student should be able to demonstrate the ability to:

  • Document patient encounters in the chart or in consultation reports efficiently and accurately and legibly including assessment and plans.
Oral Case Presentation

By the end of program of study, the student should be able to demonstrate the ability to:

  • Orally present a patient encounter including relevant information and the development of an assessment and plan of care.
Patient Management

By the end of program of study, the student should be able to demonstrate the ability to:

  • Use the information gathered including history, physical examination and laboratory or radiological data to develop management plans appropriate for the patient’s identified problems.
  • Engage a patient and / or their family in patient education and counseling including appropriate use of behavior modification techniques and shared decision making both for the treatment of disease and disease prevention.
  • Recognize a patient requiring emergency or urgent care and initiate evaluation and management. (EPA 10)
  • Recognize and provide appropriate referral for patients who require specialized care.
  • Give or receive a patient handover to transition patient care responsibility. (EPA 8)
  • Enter and discuss with patients or other members of the health care team orders and / or prescriptions. (EPA 4)
Physical Examination

By the end of program of study, the student should be able to demonstrate the ability to:

  • Gather accurate information though the conduction of complete or clinically relevant focused physical examinations. (EPA 1)
  • Interpret the results of a physical exam and use these results in the development of a differential diagnosis. (EPA 1)
Procedure and Skills

By the end of program of study, the student should be able to demonstrate the ability to:

  • Follow universal precautions and sterile procedures in all patient encounters.
  • Perform general procedures correctly with attention to patient safety and comfort. (EPA 12)

Demonstrate the ability to investigate and evaluate one’s care of patients, to appraise and assimilate scientific evidence and to continuously improve patient care based on constant self -evaluation and life- long learning

Evidence Based Medicine

By the end of program study, the student should be able to demonstrate the ability to:

  • Identify a critical question in patient care and conduct an efficient literature search, building on the foundation of the basic science curriculum of the first five semesters.
  • Analyze the results of the literature and apply the evidence appropriately to individual care.
  • Analyze the results of the literature and apply the evidence appropriately to the care of a population.
Information Management

By the end of program study, the student should be able to demonstrate the ability to:

  • Use information technology to access medical information, manage the information and assimilate evidence into patient care.
Reflection and Self Improvement

By the end of program study, the student should be able to demonstrate the ability to:

  • Critically evaluate and reflect on personal work and use the reflection to guide self-directed learning.
  • Incorporate feedback into strategies for personal performance improvement and lifelong professional development.
  • Develop improvement goals and seek out opportunities to meet these goals.

Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles

Boundaries and Priorities

By the end of program of study, the student should be able to:

  • Describe the HIPAA rules and regulations.
  • Maintain the right to privacy as outlined in HIPAA regulations and ethical principles.
  • Practice within the defined boundaries of the patient physician relationship as outlined in ethical principles.
  • Establish a therapeutic relationship that prioritizes patient needs before their own in patient care.
  • Recognize when the student’s own needs or physical, mental or spiritual condition are negatively impacting patient care and seek help.
  • Avoid conflicts of interest such as the acceptance of gifts or remuneration or association with organizations or products that may undermine the integrity of their practice.
Ethical Principles

By the end of program of study, the student should be able to: Apply ethical principles in the recognition of and definition of ethical problems in clinical medicine.

  • Resolve ethical problems through the application of ethical principles.
  • Practice within the guidelines of ethical principles maintaining patient autonomy, confidentiality and beneficence.
  • Practice within the ethical guidelines and principles pertaining to the provision of or withholding care.
  • Educate patients and obtain appropriate informed consent for tests and /or procedures. (EPA 11)
  • Work with the health care team to develop a plan to respond to medical errors that is consistent with ethical principles.
Institutional, Regulatory and Professional Society Standards

By the end of program of study, the student should be able to:

  • Adhere to institutional and government regulatory standards for personal, public and patient safety.
  • Adhere to principles of ethical research.
Professional Relationships

By the end of program of study, the student should be able to:

  • Practice with sensitivity and responsiveness in the doctor patient relationship with patients of diverse backgrounds including but not limited to race, ethnicity, culture, sexual identities, political affiliation, disabilities, spirituality, gender and socioeconomic status.
  • Interact with all members of the health care team, patients, family and society at large with respect, accountability, honesty, integrity and compassion.
Work Habits, Appearance and Etiquette

By the end of program of study, the student should be able to:

  • Reliability report for assigned duties and fulfill expected responsibilities.
  • Take responsibility for their errors and work to correct them.
  • Be clean and neat and adhere to OSHA dress guidelines and institutional requirements.
  • Treat all members of the health care team, hospital staff, patients and families with courtesy, dignity, and respect.

This competency demonstrates an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.1

Health Care Delivery Systems

By the end of program of study, the student should be able to demonstrate the ability to:

  • Describe basic principles of multiple health care delivery systems, local and national, including infrastructure, determinants of health care costs, how health care is financed and the impact of costs on the delivery of health care and society.
  • Discuss current incentives to control costs and their potential impact on health care.
  • Use a patient centered, cost effective and efficient approach to patient care in a variety of settings.
  • Coordinate patient care within the health care system.
  • Work effectively with other members of the health care team to prioritize patient care responsibilities to ensure safe and efficient delivery of patient care.
Systems Improvement

By the end of program of study, the student should be able to demonstrate the ability to:

  • Identify quality gaps and use a systems approach to find solutions. (EPA 13)
  • Identify systems errors and understand how a wide range of potential solutions can be implemented to improve safety for patients and /or the health care team. (EPA 13)
  • Advocate for solutions to health care delivery problems for your patients and society as a whole.

 


1Competencies and their definitions are reproduced or adapted from Accreditation Counsel for Graduate Medical Education, General Competencies and Englander R, Cameron T, Ballard A, Dodge J, Bull J, Aschenbrener C.  Toward a Common Taxonomy of Competency Domains for the Health Professions and Competencies for Physicians.  Acad Med 2013;88:1088-94.

Definitions, competencies and objectives were reproduced or adapted from several sources including the ACGME General Competencies, University of California San Francisco Learning Objectives and Englander at al. “Toward a Common Taxonomy of Competency Domains for the Health Professionals and Competencies for Physicians” published in Academic Medicine September of 2013.  

Updated using Common Program Requirements (Residency) Tracked Changes Copy
©2020 Accreditation Council for Graduate Medical Education (ACGME).  ACGME-approved focused revision: February 3, 2020; effective July 1, 2020.