Competency Based Objectives of Training

Patient Care

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:

  • communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families
  • gather essential and accurate information about their patients
  • make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
  • develop and carry out patient management plans
  • counsel and educate patients and their families
  • use information technology to support patient care decisions and patient education
  • perform competently all medical and invasive procedures essential for the practice of general internal medicine
  • This includes competency in performing, using appropriate indications, contraindications and informed consent and evaluating the results of the following procedures: nasogastric tube placement, Foley catheterization, pelvic examination and pap smears, EKG interpretation, PFT interpretation, CXR interpretation, basic life and advanced life support, phlebotomy, arterial puncture, paracentesis, thoracentesis, arthrocentesis injection of the knee and shoulder, central venous line placement, and lumbar puncture.
  • provide health care services aimed at preventing health problems or maintaining health
  • work with health care professionals, including those from other disciplines, to provide patient-focused care

Medical Knowledge

Residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. Residents are expected to:

  • demonstrate an investigatory and analytic thinking approach to clinical situations
  • demonstrate a sufficient level of understanding of the clinical, basic and social sciences that underlie the practice of internal medicine and be able to demonstrate that they can apply their knowledge to patient care, patient education, and the education of other members of the health care team
  • areas of knowledge will include understanding the pathogenesis, pathophysiology, epidemiology, historical issues, relevant physical findings, test utilization, means of confirming a diagnosis, treatment, monitoring and prevention of the most common inpatient and outpatient clinical disorders cared for by internists
  • understand how various aspects of disease are affected by gender, age, ethnicity, culture and disability

Practice-Based Learning and Improvement

Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. Residents are expected to:

  • analyze practice experience and perform practice-based improvement activities using a systematic methodology
  • learn how to self-evaluate cognitive, technical, attitudinal and procedural aspects of care
  • locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems
  • obtain and use information about their own population of patients and the larger population from which their patients are drawn
  • apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness
  • use information technology to manage information, access on-line medical information; and support their own education
  • facilitate the learning of students and other health care professionals
  • prior to the completion of training, all residents will demonstrate scholarly activity.

At a minimum this will include:

  • presentation of a 50-minute senior talk
  • presentation of original research or case report at a regional or national meeting
  • the application of evidence-based medicine skills through ongoing participation in journal club, resident rounds and subspecialty case conferences

Interpersonal and Communication Skills

Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients families, and professional associates. Residents are expected to:

  • demonstrate effective written, verbal and non-verbal communication when participating in patient care, consulting and collaborating with colleagues and coworkers, teaching and presenting in the academic center and most importantly during information exchange and collaboration with patients and their families
  • create and sustain a therapeutic and ethically sound relationship with patients
  • use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills
  • work effectively with others as a member or leader of a health care team or other professional group


Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. Residents are expected to:

  • demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development
  • demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices
  • demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities

Systems-Based Practice

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care associated with the ability to effectively call on system resources to provide care that is of optimal value. Residents are expected to:

  • understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice
  • know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources
  • practice cost-effective health care and resource allocation that does not compromise quality of care
  • advocate for quality patient care and assist patients in dealing with system complexities
  • know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance
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