DEPARTMENT OF INTERNAL
MEDICINE
Residency Program
Curriculum
Rotation Educational
Goals and Objectives
Categorized by ACGME Competencies
June, 2006
The
Department of Internal Medicine
Residency Program Curriculum
Rotation Educational Goals and
Objectives
Categorized by ACGME Competencies
June, 2006
Edited by Sue Kostka
Residency Education Coordinator
This document reflects the
educational goals and objectives of the 32 rotations available for resident
physicians in the University of Texas-Houston Department of Internal Medicine
training program. The goals and
objectives indicated for each rotation are categorized by relevant competencies
of the Accreditation Council for Graduate Medical Education (ACGME). The six newly defined areas of competency
which residents must obtain over the course of their training were introduced
in July, 2001. The ACGME Core
Competencies are defined as: Patient Care, Medical Knowledge, Interpersonal and
Communication Skills, Professionalism, Practice-Based Learning and Improvement,
and Systems-Based Practice.
Teaching
hospitals for resident physicians at the
This document was prepared in a collaborative effort by the faculty,
residents and staff of the Department of Internal Medicine of the
Acknowledgements and special thanks to Department of Internal Medicine
House Staff Training Program Director Dr. Mark A. Farnie, Associate Program
Director Dr. Eugene V. Boisaubin, and the 2005-2006 Assistant Chiefs of Service
for their help in preparation of this document.
This document is organized by rotations as they are located at the
various teaching hospitals, with a separate category for outpatient rotations
and descriptions of the learning activities at each teaching hospital. A list
of the rotations is attached, as well as a list of the definitions of the ACGME
competencies.
University of Texas-Houston Internal
Medicine Residency Program
Educational Goals and Objectives –
Residency Curriculum
Overview
List of Rotations
List of ACGME Core
Competencies
Description of Memorial Hermann Learning
Activities
Description of Lyndon B. Johnson General
Hospital Learning Activities
Description of M.D. Anderson Cancer
Center Learning Activities
Description of St. Luke’s Episcopal
Hospital Learning Activities
Outpatient
Rotations:
Memorial Hermann/LBJ Ambulatory Block
Rotation
Memorial Hermann General Medicine
Services A - D
Memorial Hermann CCU and Cardiology Ward
Service
Memorial Hermann Medical Intensive
Care Unit
Memorial Hermann Renal Inpatient
Service
Consultation
Services:
Memorial Hermann/LBJ
Cardiology Consultation
Memorial Hermann/LBJ Endocrinology
Consultation
Memorial Hermann/LBJ Gastroenterology
Consultation
Memorial Hermann/LBJ General Medicine
Consultation
Memorial Hermann/LBJ Hematology
Consultation
Memorial Hermann Hepatology
Consultation
Memorial Hermann/LBJ Infectious Disease
Consultation
Memorial Hermann/LBJ Pulmonary
Medicine Consultation
Memorial Hermann/LBJ Renal Consultation
Memorial Hermann/LBJ Rheumatology
Consultation
Memorial
Hermann Oncology Consultation Service
LBJ
Oncology Consultation Service
LBJ Emergency Room & Holding Area
LBJ General Medicine Services A – E
LBJ Medical Intensive Care Unit
MDACC General Medicine Consultation
St. Luke’s Episcopal Hospital
Rotations
Elective
A. PATIENT CARE
Residents are expected to provide
patient care that is compassionate, appropriate and effective for the promotion
of health, prevention of illness, treatment of disease and at the end of life.
Gather
accurate, essential information from all sources, including medical interviews,
physical examinations, medical records and diagnostic/therapeutic procedures.
Make
informed recommendations about preventive, diagnostic and therapeutic options
and interventions based on clinical judgment, scientific evidence, and patient
preference.
Develop,
negotiate and implement effective patient management plans and integration of patient
care.
Perform
competently the diagnostic and therapeutic procedures considered essential to
the practice of internal medicine.
B. 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.
Apply an open-minded, analytical
approach to acquiring new knowledge.
Access and critically evaluate
current medical information and scientific evidence.
Develop clinically applicable
knowledge of the basic and clinical sciences that underlie the practice of
internal medicine.
Apply this knowledge to clinical
problem-solving, clinical decision-making,
and critical thinking.
C. INTERPERSONAL AND COMMUNICATION
SKILLS
Residents are expected to
demonstrate interpersonal and communication skills that enable them to
establish and maintain professional relationships with patients, families, and
other members of health care teams.
Provide effective and professional
consultation to other physicians and health care professionals and sustain
therapeutic and ethically sound professional relationships with patients, their
families, and colleagues.
Use effective listening, nonverbal,
questioning, and narrative skills to communicate with patients and families.
Interact
with consultants in a respectful, appropriate manner.
Maintain
comprehensive, timely, and legible medical records.
D.
PROFESSIONALISM
Residents are expected to
demonstrate behaviors that reflect a commitment to continuous professional
developmental, ethical practice, an understanding and sensitivity to diversity
and a responsible attitude toward their patients, their profession, and
society.
Demonstrate respect, compassion,
integrity, and altruism in relationships with patients, families, and colleagues.
Demonstrate sensitivity and
responsiveness to the gender, age, culture, religion, sexual preference,
socioeconomic status, beliefs, behavior and disabilities of patients and
professional colleagues.
Adhere to principles of
confidentiality, scientific/academic integrity, and informed consent.
Recognize and identify deficiencies
in peer performance.
E. PRACTICE-BASED
LEARNING AND IMPROVEMENT
Residents are expected to be able
to use scientific evidence and methods to investigate, evaluate, and improve
patient care practices.
Identify areas for improvement and
implement strategies to enhance knowledge, skills, attitudes and processes of
care.
Analyze and evaluate practice
experiences and implement strategies to continually improve the quality of
patient practice.
Develop and maintain a willingness
to learn from errors and use errors to improve the system or processes of care.
Use information of technology or
other available methodologies to access and manage information, support patient
care decisions and enhance both patient and physician education.
F. SYSTEMS-BASED
PRACTICE
Residents are expected to
demonstrate both an understanding of the contexts and systems in which health
care is provided, and the ability to apply this knowledge to improve and
optimize health care.
Understand, access and utilize the resources,
providers and systems necessary to provide optimal care.
Understand the limitations and
opportunities inherent in various practice types and delivery systems, and
develop strategies to optimize care for the individual patient.
Apply evidence-based, cost-conscious
strategies to prevention, diagnosis, and disease management.
Collaborate with other members of
the health care team to assist patients in dealing effectively with complex
systems and to improve systematic processes of care.
FOR MEMORIAL HERMANN HOSPITAL
ROTATIONS
UNIVERSITY OF
DEPARTMENT OF INTERNAL MEDICINE RESIDENCY PROGRAM
June, 2006
Morning
Report (MR) – These
sessions are held six mornings each week (M, T, W, Th,
F, from 8:00am to 9:00am, and on some Saturdays from 6:50am to 8:00am). All PGY1, PGY2 and PGY3s on inpatient floor
teams and all interns and residents on consult services meet with the Assistant
Chiefs of Service (CMRs) and one or more faculty
members to discuss two patients. The
patients are presented by the interns on the floor team or the PGY2 or PGY3 if
presented by a consult service, and then discussed by entire group of residents
and faculty members attending Morning Report.
The focus of the discussion is selected by the presenting resident. For example, some cases may be presented to
discuss a differential diagnosis, while others are
presented to discuss specific management issues.
Attending
Rounds (AR) –
Daily, including weekends, usually from 9:00am to noon, patients are presented
to the attending physician. Post call
rounds usually start at 6:00 am. Bedside
teaching is regularly included in the rounds.
Occasionally specialty cases are presented for discussion depending upon
the interests of the attending physician.
Learning activities include the physical exam, a discussion of
particular medical diseases, psychosocial and ethical themes, and management
issues.
Chairman’s
Rounds (CR) – The
Chairman of the Department of Internal Medicine meets weekly with the Memorial
Hermann team which is pre-call in the Kirkendall
Library at 2:00 pm on Tuesday afternoons for Chairman’s Rounds. The team who is presenting selects a patient for
presentation. The team presents the
patient, and the management and diagnosis of the patient is discussed.
Faculty Supervision (FS) – This learning activity occurs when a faculty
member is directly responsible for teaching and supervising a resident, often
on a one-to-one basis and typically in a team setting. The resident is responsible for direct
patient care, but the faculty member serves as a resource. The faculty member meets with the resident
often to supervise patient care and to provide feedback.
Directly Supervised Procedures - (DSP) – Residents learn
procedures under the direct supervision of an attending or fellow during some
rotations. For
example, in the Medical Intensive Care Unit the Pulmonary /Critical Care
attending or fellow, or the MICU attending, observe the placement of central
venous and arterial lines. Specific procedures used in patient care varies by
rotation.
Direct
Patient Care (DPC) – In
this teaching activity, residents admit their own patients and are responsible
for the ongoing care including management and discharge. Patient management is supervised by the
attending physician.
Noon
Conferences (NC) –
The noon conferences focus on monthly themes of the various specialty medicine
topics for eleven months of the year, i.e., Cardiology, Gastroenterology, Hematology,
etc. Exceptions to this are Grand
Rounds, held every Tuesday at noon throughout the year, and Senior Seminar,
where the topic is selected by the presenting resident. All residents on inpatient floor teams, as
well as those on ambulatory block rotations and electives, are expected to
attend. During the 12th month
of the year, the noon conferences are the Introductory Lecture Series.
Noon Conferences are comprised of the following:
(except for Journal Club):
Introductory
Lecture Series (ILS) –
These lectures are held during the month of July in place of other noon
conferences, except for Grand Rounds, which continues to be held every Tuesday throughout
the year. Various introductory topics
are presented by subspecialty and general medicine faculty to introduce interns
to basic and essential topics in internal medicine.
Core
Curriculum (CC) –
This noon conference is held on a weekly basis, and is structured in a board
review context where faculty members discuss a core topic in their specialty
field of medicine. Faculty members
review possible board questions related to the core topic with residents. By the end of an academic year, residents
should have had a thorough review of all topics covered in the Core Curriculum
of the residency training program.
Clinicopatholigic Conference (CPC) – This noon
conference are held once a month, and consists of discussions of
informative cases by clinicians, radiologists, and pathologists. The case is given to a discussant, an
internist or a specialist depending on the case, weeks ahead of the time of
presentation. The discussant is informed
of everything about the case except the diagnosis. The findings leading to the
ultimate diagnosis are discussed by a radiologist and pathologist at the end of
the conference.
Grand
Rounds (GR) – The
Department of Medicine hosts Grand Rounds every Tuesday from noon to 1:00pm . Speakers
from local, regional and national medicine training programs,
are invited to present topics from the broad spectrum of internal
medicine. All residents on inpatient
floor teams, as well as those on ambulatory block rotations and electives are
expected to attend.
Senior
Seminar (SS) - Senior Seminar is held in a noon
conference format. Upper level residents
present an in-depth review of a medical topic as well as their own
research. Residents are formally critiqued by both the associate program
director and their resident colleagues.
Medical
Jeopardy (MJ) –
Medical Jeopardy is held once a month at noon.
Residents form teams and compete against each other for various prizes
using a computerized medical game format.
Professionalism
Curriculum (PC) -
This is an organized series of recurring large and small group discussions
focusing upon current issues and dilemmas in medical professionalism and ethics
presented primarily by an associate program director. Lectures are usually presented in a noon
conference format.
Evidence
Based Medicine (EBM) – This is a series of noon monthly lectures
presented to allow residents to learn how to critically appraise journal
articles, stay current on statistics, etc.
The lectures are presented by an associate program director.
Morbidity and Mortality Conference (MM) – The M&M Conference is held occasionally at noon
throughout the year. A case, with an
adverse outcome, through not necessarily resulting in death, is discussed and
thoroughly reviewed. Faculty members
from various disciplines are invited to attend, especially if they were
involved in the care of the patient. The
discussion focuses on how care could have been improved.
Med/Path
Conference (MP) – This conference is presented once a month in a noon
conference format. A medicine resident
presents a case, and then the pathology resident discusses the pathology
finding including slides, involved in the case.
There are four to five cases discussed per meeting.
Autopsy Review (Au) – An Autopsy Review is held once a month in a noon
conference format, though there is no formal autopsy review. All autopsy reports are sent to the program
director each month who then forwards them to the residents and attending
involved with the case. When an autopsy
is conducted, the involved residents are invited.
Pathology
for Clinicians Conference (PathCl) – This
conference is presented once a month at noon by pathologists to teach residents
how to use the lab appropriately and to the maximum benefit of the
patient. Pathologists explain how to
interpret CBCs and blood smears, how to interpret lab
data, how a lab test is performed, when it is appropriate to order what lab
tests, and what the lab test means to the patient.
Journal Club (JC) - Journal Club is held once a month on Tuesday
evening. Residents and faculty
critically appraise a selected article; the article is discussed in an evidence
based medicine format. Dinner is provided for this optional resident learning
activity.
|
Legend
for Learning Activities |
||
|
AR
– Attending Rounds Au
– Autopsy Report CR
– Chairman’s Rounds CPC–Clinicopathologic Conf. CC-Core
Curriculum DPC
– Direct Patient Care |
DSP
– Directly Supervised Procedures EBM
- Evidence Based Med FS
– Faculty Supervision GR
– Grand Rounds IL-Introductory
Lecture Series JC
– Journal Club MJ
– Medical Jeopardy |
M&M-Morbidity
& Mortality MP
– Med/Path Conference MR
– Morning Report NC
– Noon Conferences PathCl- Path for Clinicians PC–Professionalism
Curriculum SS
– Senior Seminar |
|
Legend for Evaluation Methods for Residents |
|
|
AE
- Attending Evaluations DSP
– Directly Supervised Procedures IE
– In-service Exam MR – Morning Report |
PDR–Program
Director’s Review (twice annually) PR
– Peer Review SPE – Standardized patient evaluation |
FOR LBJ GENERAL HOSPITAL ROTATIONS
UNIVERSITY OF
DEPARTMENT OF INTERNAL MEDICINE RESIDENCY PROGRAM
June, 2006
Morning
Report (MR) – These
sessions are held five mornings each week (Monday through Friday) from 8:00am
to 9:00am. Monday, Thursday and Friday
general Morning Report is for interns, residents and students, and Tuesday and
Wednesday general Morning Report is for upper level ward residents. Interns, residents, and students meet with
the ACSs (CMRs) and faculty
members attending morning report to discuss two cases which are prepared by an
on- call resident. The on-call resident
presents the details of the case for discussion. The residents and faculty discuss the case to
arrive at a diagnosis, as well as any further learning learning
points from the case.
Attending
Rounds (AR) –
Daily, including weekends, usually from 9:00am to noon, patients are presented
to the attending physician. Post call
rounds usually start at 6:00 am. Bedside
teaching is regularly included in the rounds.
Occasionally specialty cases are presented for discussion depending upon
the interests of the attending physician. Learning activities include the physical exam,
a discussion of particular medical diseases, psychosocial and ethical themes,
and management issues.
Dr. Fred Rounds (DrFR) – Dr. Fred,
an attending physician and senior faculty member, conducts these rounds four
days a week, from 9:00am to 11:00am. Dr.
Fred has been named a Master of the
Faculty Supervision (FS) – This learning activity occurs when a faculty
member is directly responsible for teaching and supervising a resident, often
on a one-to-one basis and typically in a team setting. The resident is responsible for direct
patient care, but the faculty member serves as a resource. The faculty member meets with the resident
often to supervise patient care and to provide feedback.
Directly Supervised Procedures - (DSP) – Residents learn
procedures under the direct supervision of an attending or fellow during some
rotations. For
example, in the Medical Intensive Care Unit the Pulmonary /Critical Care
attending or fellow, or the MICU attending, observe the placement of central
venous and arterial lines. Specific procedures used in patient care varies by
rotation.
Direct
Patient Care (DPC) – In
this teaching activity, residents admit their own patients and are responsible
for the ongoing care including management and discharge. Patient management is supervised by the
attending physician.
Noon
Conferences (NC) –
The noon conferences focus on monthly themes of the
various specialty medicine topics for eleven months of the year,
i.e., Cardiology,
Gastroenterology, Hematology, etc.
Exceptions to this are Grand Rounds, held every Tuesday at noon
throughout the year, and Senior Seminar, where the topic is the selected by the
presenting resident. These are the same
noon conferences as the conference that occur at our other
primary teaching hospital. All residents
on inpatient floor teams, as well as those on ambulatory block rotations and
electives, are expected to attend noon conference. During the 12th month of the year, the noon
conferences are the Introductory Lecture Series.
Noon Conferences are comprised of
the following:
Introductory
Lecture Series (ILS) –
These lectures are held during the month of July in place of other noon
conferences, except for Grand Rounds, which continues to be held every Tuesday throughout
the year. Various introductory topics
are presented by subspecialty and general medicine faculty to introduce interns
to basic and essential topics in internal medicine.
Core
Curriculum (CC) –
This noon conference is held on a weekly basis, and is structured in a board
review context where faculty members discuss a core topic in their specialty
field of medicine. Faculty members
review possible board questions related to the core topic with residents. By the end of an academic year, residents
should have had a thorough review of all topics covered in the Core Curriculum
of the residency training program.
Clinicopatholigic Conference (CPC) – This noon conference is held once
a month, and consists of discussions of informative cases by clinicians,
radiologists, and pathologists. The case
is given to a discussant, an internist or a specialist depending on the case,
weeks ahead of the time of presentation.
The discussant is informed of everything about the case except the
diagnosis. The findings leading to the ultimate diagnosis are discussed by a
radiologist and pathologist at the end of the conference.
Grand
Rounds (GR) – The
Department of Medicine hosts Grand Rounds every Tuesday from noon to
1:00pm. Speakers from local, regional
and national medicine training programs, are invited
to present topics from the broad spectrum of internal medicine. All residents on inpatient floor teams, as
well as those on ambulatory block rotations and electives are expected to
attend. Grand Rounds is televised from
Memorial Hermann to LBJ on Tuesdays.
Senior
Seminar (SS) - Senior Seminar is held in a noon
conference format, most often at Memorial Hermann but occasionally at LBJ. Upper level residents present an
in-depth review of a medical topic as well as their own research. Residents are
formally critiqued by both the associate program director and their resident
colleagues.
Medical
Jeopardy (MJ) –
Medical Jeopardy is held once a month at noon. Residents form teams and compete
against each other for various prizes using a computerized medical game format.
Professionalism
Curriculum (PC) -
This is an organized series of recurring large and small group discussions
focusing upon current issues and dilemmas in medical professionalism and ethics
presented primarily by an associate program director. Lectures are usually presented in a noon
conference format.
Evidence
Based Medicine (EBM) – This is a series of noon monthly lectures
presented to allow residents to learn how to critically appraise journal
articles, stay current on statistics, etc.
The lectures are presented by an associate program director.
Med/Path Conference (MP) – This conference is presented once a month in a
noon conference format. A medicine
resident presents a case, and then the pathology resident discusses the
pathology finding including slides, involved in the case. There are four to five cases discussed per
meeting.
Med/Rad Conference (MR) – This conference is presented
once a month in a noon conference format.
Interesting cases are reviewed by a radiologist at this conference.
Pathology
for Clinicians Conference (PathCl) – This
conference is presented once a month at noon by pathologists to teach residents
how to use the lab appropriately and to the maximum benefit of the
patient. Pathologists explain how to
interpret CBCs and blood smears, how to interpret lab
data, how a lab test is performed, when it is appropriate to order what lab
tests, and what the lab test means to the patient.
|
Legend
for Learning Activities |
||
|
AR – Attending Rounds CPC–Clinicopathologic Conf. CC-Core
Curriculum DPC
– Direct Patient Care DSP –
Directly Supervised Procedures |
DrFR – Dr. Fred Rounds EBM-Evidence
Based Medicine FS –
Faculty Supervision GR –
Grand Rounds IL-Introductory
Lecture Series MJ
– Medical Jeopardy |
MP – Med-Path Conference MedRad –Med-Rad
Conf. MR – Morning Report NC – Noon Conferences PathCl-Pathology Clinicians PC–Professionalism Curriculum SS
– Senior Seminar |
|
Legend
for Evaluation Methods for Residents |
|
|
AE
- Attending Evaluations DSP
– Directly Supervised Procedures IE
– In-service Exam MR –
Morning Report |
PDR–Program
Director’s Review (twice annually) PR
– Peer Review SPE –
Standardized patient evaluation |
FOR M.D.
UNIVERSITY OF
DEPARTMENT OF INTERNAL MEDICINE
RESIDENCY PROGRAM
June, 2006
Morning Conference (MC) – This conference is held on Monday and Friday
mornings at 8:00 am. The conference
consists of didactic teaching and lectures regarding general medicine topics
and oncology issues, and is administered by the Oncology fellows.
Tuesday and Thursday Teaching Conferences (TTC) – Every Tuesday and Thursday at
12:00 noon a teaching conference occurs.
The Oncology Grand Rounds are conducted every Tuesday at 8:00am which is
comprised of didactic lectures about oncology issues.
Wednesday Afternoon Conference (WC)
– This conference is held on Wednesday afternoons with Dr. Daniel
Karp. It is an informal discussion of
general medicine and oncology topics relating to the resident’s patients.
Attending
Rounds (AR) – Patients are presented to the attending on a daily
basis during Attending Rounds. Bedside
teaching is regularly included in the rounds.
Learning activities include the physical exam, a discussion of oncology
and management issues, and psychosocial and ethical themes.
Directly Supervised Procedures - (DSP) – Residents learn
procedures under the direct supervision of an attending or fellow during some
rotations. For
example, in the Medical Intensive Care Unit the Pulmonary /Critical Care
attending or fellow, or the MICU attending, observe the placement of central
venous and arterial lines. Specific procedures used in patient care varies by
rotation.
Direct Patient Care (DPC) – In this teaching activity, residents
admit their own patients and are responsible for the ongoing care including
management and discharge. Patient
management is supervised by the attending physician
Core Curriculum Conference (CC) – This conference is held at
Hermann on various days at noon. The
conference is structured in a board review context where faculty members
discuss a topic for an hour. Faculty
members then go over board review questions related to that topic with
residents for an additional one-half hour.
If a conference is not being held at noon at M.D. Anderson, residents on
rotation at MD Anderson are required to attend Core Curriculum if the
conference is being held that day at
|
Legend
for Learning Activities |
|
|
MC
– Morning Conference TTC
– Tuesday/Thursday Conferences WC
– Wednesday Conference DPC
– Direct Patient Care |
DSP
– Directly Supervised Procedures CC
– Core Curriculum (Hermann) AR
– Attending Rounds |
|
Legend
for Evaluation Methods for Residents |
|
|
AE
- Attending Evaluations IE
– In-service Exam PDR–Program
Director’s Review (twice annually) |
PR
– Peer Review SPE –
Standardized patient evaluation |
DEPARTMENT OF INTERNAL MEDICINE
RESIDENTS
June, 2006
Morning Report (MR) – These sessions are held every
weekday from 9:00 to 10:00am. The Chief Resident at St. Luke’s conducts and
directs the sessions. The resident and
intern on call present a prepared case. Seven or eight faculty members attend
the reports, and the patient is discussed in terms of diagnosis and management
issues.
Saturday Morning Report (SMR) - These sessions are held on Saturday morning at 8:00am, and
are conducted by Dr. Barry Zeluff, Associate Chief
and Program Director, Education,
Internal Medicine Service, St. Luke’s Episcopal Hospital, or the Chief
Medical Resident at St. Luke’s. The
sessions are held in Dr. Zeluff’s office, and are
informal. Residents and interns review
their patients which were admitted overnight.
Dr. Zeluff asks if there are any issues, and
if so these problems are addressed.
Noon Conferences (NC) – These conferences are held daily from 12:00noon to 1:00pm
and the topics are not specifically scheduled but vary. The exception to this
is on Thursdays, when Baylor College of Medicine Grand Rounds serves as the
noon conference.
Teaching Rounds (TR) – Teaching Rounds are
held daily at St. Luke’s. They are similar to Attending Rounds at
Direct Patient Care (DPC) – In this teaching activity, residents
learn by caring for the patients they are treating. Patient management is supervised by the
attending physician.
Directly Supervised Procedures - (DSP) – Residents learn
procedures under the direct supervision of an attending or fellow during some
rotations. Specific procedures used in patient care vary
by rotation.
Core Curriculum Conference (CC) – This conference is held at
|
Legend for Learning Activities |
||
|
DPC
– Direct Patient Care DSP
– Directly Supervised Procedures MR
– Morning Report CC
- Core Curriculum Conf at MHH |
NC
– Noon Conferences SMR
– Saturday Morning Report TR
– Teaching Rounds |
|
|
Legend
for Evaluation Methods for Residents |
|
|
AE
- Attending Evaluations IE –
In-service Exam |
PDR–Program
Director’s Review (twice annually) PR – Peer
Review |
The University of Texas-Houston Health Science Center
Internal
Medicine Residency Program Curriculum
December
2, 2002
The Continuity Clinic rotation
occurs one-half day each week throughout residency at the
Patients seen in the Continuity Clinic rotation include
patients referred to the resident’s Panel Clinic after discharge from
|
Legend for Learning Activities |
||
|
ACS – Ambulatory Care Series CC-Core Curriculum DPC – Direct Patient Care |
FS –
Faculty Supervision GR –
Grand Rounds IL-Introductory
Lecture Series MJ – Medical Jeopardy |
NC – Noon Conferences PC–Professionalism Curriculum SS – Senior Seminar |
|
Legend
for Evaluation Methods for Residents |
|
|
FE
- Faculty Evaluations IE
– In-service Exam PDR–Program
Director’s Review (twice annually) |
PR
– Peer Review SPE –
Standardized patient evaluation |
*Evaluations
of residents on the Continuity Clinic rotation occur once every six months rather
than usual monthly evaluations.
Principal Educational Goals by Relevant Competency
The principal educational goals for residents on this
rotation are indicated for each of the six ACGME competencies in the tables
below and numbered in the first column.
The second column of the table lists the goal, the third column lists
the most relevant learning activities for that goal, and the fourth column
indicates the correlating evaluation methods for that goal. A detailed
description of the on-going learning activities at Memorial Hermann and
PG-1 and PG-2/3/4 (Goals are
for all levels unless indicated)
A. Patient Care
|
|
Principal
Educational Goals |
Learning
Activities |
Evaluation Methods
|
|
1. |
Ability
to take a complete medical history and perform a careful and accurate
physical examination. |
DPC
|
FE,
SPE |
|
2. |
Ability to write concise, accurate and
informative histories, physical examinations and progress notes. |
DPC |
FE |
|
3. |
Define and prioritize patients’ medical
problems and generate appropriate differential diagnoses. |
DPC,
ACS |
FE |
|
4. |
Develop rational, evidence-based management
strategies. |
DPC, SS |
FE |
|
5.
|
PG-1 - Ability to make basic interpretation
of chest and abdominal x-rays and electrocardiograms. PG-2/3/4
– Develop and demonstrate proficiency in above. |
DPC |
FE, IE FE, IE |
|
6. |
PG-1
- Ability to perform pelvic examination under supervision. PG – 2/3/4
– Ability to perform pelvic examination. |
DPC, ACS DPC, ACS |
FE FE |
|
7. |
Ability to recognize the physical
findings of important medical illnesses. |
DPC |
FE |
|
8. |
Willingness and ability to help patients engage in
strategies of disease prevention. |
DPC |
FE, SPE |
B. Medical Knowledge
|
|
Principal
Educational Goals |
Learning
Activities |
Evaluation
Methods |
|
1.
|
Expand
clinically applicable knowledge base of the basic and clinical sciences
underlying the care of medical patients. |
|
FE,
IE |
|
2.
|
Access
and critically evaluate current medical information and scientific evidence
relevant to patient care. |
DPC,
CC, SS |
FE,
IE |
|
3.
|
PG-1-Understand basic pathophysiology, clinical manifestations, diagnosis and
management of medical illnesses seen by a general internist in the ambulatory
setting. PG-
2/3/4 - Develop
and demonstrate in-depth knowledge of above. |
DPC,
CC DPC,
CC |
FE,
IE FE,
IE |
|
4.
|
PG-1-
Recognize the
indications for and basic interpretation of chest and abdominal X-rays,
electrocardiograms, and pulmonary function tests. PG-2/3/4 – Develop and demonstrate
in-depth knowledge of above. |
DPC,
CC DPC,
CC |
FE,
IE FE,
IE |
|
5.
|
PG-1-Learn indications for and basic
interpretation of standard laboratory tests, including blood counts,
coagulation students, blood chemistry tests, urinalysis, body fluid analyses,
and microbiologic tests. PG-2/3/4 – Develop and demonstrate
in-depth knowledge of above. |
DPC,CC DPC,
CC |
FE
FE
|
|
6. |
PG-1 -
Familiarity with basic principles of disease prevention, including adult
immunizations, cardiovascular risk assessment, prevention of cardiovascular
disease, screening for cancer, prevention of osteoporosis and cessation of
use of tobacco. PG-2/3/4 –
Develop and demonstrate in-depth knowledge of above. |
DPC,
ACS DPC,
ACS |
FE,
SPE FE,
SPE |
|
7. |
Appreciation of the evolution of chronic
conditions over time. |
DPC,
ACS, CC |
FE,
SPE |
|
8.
|
PG –1 Basic
familiarity with pathophysiology, clinical
manifestations and non-operative management of common musculoskeletal
conditions, including occupational and sports-related injuries. PG-2/3/4
– Develop and demonstrate in-depth knowledge of above. |
DPC,
ACS, CC DPC,
ACS |
FE FE |
|
9. |
PG-1 - Basic
familiarity with pathophysiology, clinical
manifestations and medical management of common gynecological conditions,
including acute salpingitis, vaginitis,
dysmenorrhea, irregular menses and menopausal
symptoms. PG-2/3/4
– Develop and demonstrate in-depth knowledge of above. |
DPC,
ACS DPC,
ACS |
FE FE |
|
10.
|
PG-1 - Basic
familiarity with pathophysiology, clinical
manifestations and medical management of common otolaryngological
conditions, including acute and chronic sinusitis and allergic rhinitis. PG-2/3/4
– Develop and demonstrate in-depth knowledge of above. |
DPC,
ACS DPC,
ACS |
FE FE |
|
11. |
PG-1 - Basic
familiarity with pathophysiology, clinical
manifestations and management of common ophthalmologic conditions, including
minor ocular injuries and conjunctivitis. PG-2/3/4
– Develop and demonstrate in-depth knowledge of above. |
DPC,
ACS DPC,
ACS |
FE FE |
|
12. |
Familiarity
with special features of diagnosis, interpretation of tests and management of
illnesses in a geriatric population. |
DPC,
SL |
FE,
IE |
C. Interpersonal
Skills and Communication
|
|
Principal Educational
Goals |
Learning Activities |
Evaluation Methods |
|
1. |
Communicate effectively with
patients and families. |
DPC, PC |
FE, SPE |
|
2. |
Communicate effectively with
physician colleagues at all levels. |
DPC, PC |
FE, PR |
|
3. |
Present information on patients
concisely and clearly, both verbally and in writing. |
DPC |
FE, PR |
D. Professionalism
|
|
Principal Educational Goals |
Learning Activities |
Evaluation Methods |
|
1. |
Interact professionally toward towards patients, families,
colleagues, and all members of the health care team. |
DPC, PC |
FE |
|
2. |
Acceptance
of professional responsibility as the primary care physician for patients
under his/her care. |
DPC, PC |
FE |
|
3. |
Appreciation of the social context of illness. |
DPC, PC |
FE, SPE |
|
4. |
Understand ethical concepts of confidentiality, consent,
autonomy and justice in the outpatient setting. |
DPC, PC |
FE |
|
5. |
Understand professionalism concepts of integrity, altruism
and conflict of interest in the outpatient setting. |
DPC, PC |
FE |
E. Practice-Based
Learning and Improvement
|
|
Principal
Educational Goals |
Learning
Activities |
Evaluation Methods |
|
1. |
Identify
and acknowledge gaps in personal knowledge and skills in the care of
ambulatory patients. |
DPC |
FE |
|
2. |
Develop
and implement strategies for filling gaps in knowledge and skills. |
DPC |
FE,
IE, PDR |
|
3. |
Commitment
to professional scholarship, including systematic and critical perusal of
relevant print and electronic literature, with emphases on integration of
basic science with clinical medicine, and evaluation of information in light
of the principles of evidence-based medicine related to the outpatient world. |
DPC,
SS |
FE |
F. Systems-Based
Practice
|
|
Principal Educational Goals |
Learning Activities |
Evaluation Methods |
|
1. |
Understand and utilize the multidisciplinary resources
necessary to care optimally for clinic patients. |
DPC |
FE |
|
2. |
Collaborate with other members of the health care team to
assure comprehensive patient care. |
DPC |
FE |
|
3. |
Use evidence-based, cost-conscious strategies in the care
of outpatients. |
DPC, SS |
FE |
|
4. |
Effective
collaboration with other members of the health care team, including nurses,
clinical pharmacists, occupational therapists, physical therapists, nutrition
specialists, patient educators, speech pathologists, respiratory therapists, enterostomy nurses, social workers, and providers of home
health services. |
DPC |
FE |
|
5. |
Knowing when and how
to request medical consultation, and how best to utilize the advice provided.
|
DPC |
FE |
|
6. |
Consideration of the
cost-effectiveness of outpatient diagnostic and treatment strategies. |
DPC, SS |
FE |
|
7. |
Knowing when to refer
patients to specialists in orthopedics, gynecology, otolaryngology and
ophthalmology. |
DPC, ACS |
FE |
|
8. |
Knowing when to
consult or refer a patient to a medical subspecialist. |
DPC, ACS |
FE |
|
9. |
PG-2/3/4
– Willingness and ability to teach medical students and PG-1 residents. |
DPC, PC |
FE, PR |
The University of Texas-Houston Health Science Center
Internal
Medicine Residency Program Curriculum
June,
2006
MEMORIAL HERMANN/LBJ AMBULATORY
BLOCK ROTATION
Residents participate in the
|
Legend
for Learning Activities |
||
|
AR – Attending Rounds Au – Autopsy Report CR – Chairman’s Rounds CPC–Clinicopathologic Conf. CC-Core
Curriculum DPC –
Direct Patient Care |
DSP –
Directly Supervised Procedures EBM - Evidence
Based Med FS –
Faculty Supervision GR –
Grand Rounds IL-Introductory
Lecture Series JC – Journal Club MJ
– Medical Jeopardy |
M&M-Morbidity & Mortality MP – Med/Path Conference MR – Morning Report NC – Noon Conferences PathCl- Path for Clinicians PC–Professionalism Curriculum SS
– Senior Seminar |
|
Legend
for Evaluation Methods for Residents |
|
|
FE
- Faculty Evaluations DSP
– Directly Supervised Procedures IE
– In-service Exam PDR–Program
Director’s Review (twice annually) |
PR
– Peer Review SPE –
Standardized patient evaluation |
Principal Educational Goals by Relevant Competency
The
principal educational goals for residents on this rotation are indicated for
each of the six ACGME competencies in the tables below and numbered in the first
column. The second column of the table
lists the goal, the third column lists the most relevant learning activities
for that goal, and the fourth column indicates the correlating evaluation
methods for that goal. A detailed description of the on-going learning
activities at Memorial Hermann and
PG-1 and PG-2/3/4 (Goals are for all
levels unless indicated)
A. Patient Care
|
|
Principal Educational Goals |
Learning Activities |
Evaluation Methods |
|
1. |
Ability to take a good medical
history and perform a careful and accurate physical examination. |
DPC |
FE |
|
2. |
Ability
to write concise, accurate and informative histories, physical examinations
and progress notes. |
DPC |
FE |
|
3. |
Maintain focus and timeliness in
the evaluation and management of ambulatory problems. |
DPC |
FE |
|
4. |
Understand and implement
appropriate strategies for disease prevention and health promotion. |
DPC, ACS |
FE |
|
5. |
Develop strategies to efficiently
evaluate and manage common ambulatory medical problems. |
DPC, ACS |
FE |
|
6. |
Ability
to formulate comprehensive and accurate problem lists, differential diagnoses
and plans of management. |
DPC |
FE |
|
7. |
PG-1
- Ability to make basic interpretation of chest and abdominal x-rays. PG–2/3/4
- Develop and demonstrate proficiency in above. |
DPC, CC DPC, CC |
FE, IE FE, IE |
|
8. |
PG-1
- Ability to
make basic interpretation of electrocardiograms. PG-2/3/4
- Develop and demonstrate proficiency in above. |
DPC, CC, IL DPC, CC, IL |
FE, IE FE, IE |
|
9. |
PG-1
- Ability to perform pelvic examination under supervision. PG-2/3/4
- Ability to perform pelvic examination. |
DPC, ACS DPC, ACS |
FE FE |
|
10. |
Willingness and ability to help
patients engage in strategies of disease prevention. |
DPC |
FE, IE |
B.
Medical Knowledge
|
|
Principal
Educational Goals |
Learning
Activities* |
Evaluation Methods |
|
1. |
Expand
clinically applicable knowledge base of the basic and clinical sciences
underlying the care of ambulatory patients. |
DPC,IL, CC |
FE, IE |
|
2. |
Access
and critically evaluate current medical information and scientific evidence
relevant to ambulatory patient care. |
DPC, SS |
FE, IE |
|
3. |
PG-1
- Understanding the basic pathophysiology, clinical
manifestations, diagnosis and management of medical illnesses commonly seen
by a general internist in the ambulatory setting. PG-2/3/4
- Develop and demonstrate proficiency in above. |
DPC, CC DPC, CC |
FE, IE FE, IE |
|
4. |
Understanding
the clinical manifestations, diagnosis and management of problems commonly
seen in adolescents. |
DPC, SL |
FE |
|
5. |
Familiarity
with indications for and interpretation of chest and abdominal X-ray,
electrocardiograms, and pulmonary function tests. |
DPC, CC |
FE, IE |
|
6. |
Familiarity
with indications for and interpretation of standard laboratory tests,
including blood counts, coagulation studies, blood chemistry tests,
urinalysis, body fluid analyses, and microbiologic tests. |
DPC, CC |
FE, IE |
|
7. |
PG-1- Familiarity
with basic principles of disease prevention, including adult immunizations,
cardiovascular risk assessment, prevention of cardiovascular disease,
screening for cancer, prevention of osteoporosis and cessation of use of
tobacco. PG-2/3/4
- Develop and demonstrate proficiency in above.
|
DPC, CC, ACS DPC, ACS, CC |
FE FE, IE |
|
8. |
PG-1- Basic
familiarity with pathophysiology, clinical
manifestations and non-operative management of common musculoskeletal
conditions, including occupational and sports-related injuries. PG-2/3/4
- Develop and demonstrate proficiency in above.
|
DPC, ACS, GR DPC, ACS, GR |
FE FE |
|
9. |
PG-1-Basic
familiarity with pathophysiology, clinical
manifestations and medical management of common gynecological conditions,
including acute salpingitis, vaginitis,
dysmenorrhea, irregular menses and menopausal
symptoms. PG-2/3/4
- Develop and demonstrate proficiency in above.
|
DPC, ACS, GR DPC, ACS, GR |
FE FE |
|
10. |
PG-1 - Basic
familiarity with pathophysiology, clinical
manifestations and medical management of common otolaryngological
conditions, including acute and chronic sinusitis and allergic rhinitis. PG-2/3/4
- Develop and demonstrate proficiency in above.
|
DPC, ACS, GR DPC, ACS, GR |
FE FE |
|
11. |
PG-1 - Basic
familiarity with pathophysiology, clinical
manifestations and management of common ophthalmologic conditions, including
minor ocular injuries and conjunctivitis. PG-2/3/4 - Develop and demonstrate
proficiency in above. |
DPC DPC |
FE FE |
C. Interpersonal
Skills and Communication
|
|
Principal
Educational Goals |
Learning
Activities* |
Evaluation Methods |
|
1. |
Communicate
effectively with patients and families across a broad range of socioeconomic
and ethnic backgrounds. |
DPC, PC |
FE |
|
2. |
Communicate
effectively with physician colleagues and members of other health care
professions to assure comprehensive patient care. |
DPC, PC |
FE |
D. Professionalism
|
|
Principal
Educational Goals |
Learning
Activities* |
Evaluation Methods |
|
|
1. |
Interact
professionally towards patients, families, colleagues, and all members of the
health care team. |
DPC,
PC |
FE
|
|
|
2. |
Appreciation
of the social context of illness. |
DPC,
PC |
FE
|
|
E. Practice-Based Learning and Improvement
|
|
Principal
Educational Goals |
Learning
Activities |
Evaluation Methods |
|
1. |
Identify
and acknowledge gaps in personal knowledge and skills in the care of
ambulatory patients. |
DPC |
FE |
|
2. |
Develop
real-time strategies for filling knowledge gaps that will benefit patients in
a busy practice setting. |
DPC |
FE |
|
3. |
Commitment
to professional scholarship, including systematic and critical perusal of
relevant print and electronic literature, with emphases on integration of
basic science with clinical medicine, and evaluation of information in light
of the principles of evidence-based medicine. |
DPC,
CC, SS |
FE,
IE |
F.
Systems-Based Practice
|
|
Principal Educational Goals |
Learning Activities |
Evaluation Methods |
|
1. |
Understand and utilize the multidisciplinary resources
necessary to care optimally for ambulatory patients. |
DPC |
FE |
|
2. |
Collaborate with other members of the health care team to
assure comprehensive ambulatory patient care. |
DPC |
FE |
|
3. |
Use evidence-based, cost-conscious strategies in the care
of ambulatory patients. |
DPC, SS |
FE |
|
4. |
Begin to understand the business aspects of practice
management in a variety of settings. |
|
FE |
|
5. |
Knowing when to
consult or refer a patient to a medical subspecialist. |
DPC |
FE |
|
6. |
Knowing when to refer
patients to specialists in orthopedics, gynecology, otolaryngology and
ophthalmology. |
DPC |
FE |
|
7. |
Effective utilization
of medical consultants, including knowing when and how to request consultation,
and how best to utilize the advice provided. |
DPC |
FE |
|
8. |
Consideration of the
cost-effectiveness of diagnostic and treatment strategies. |
SS, GR |
FE |
The University of Texas-Houston Health Science Center
Internal
Medicine Residency Program Curriculum
December
2, 2002
LBJ
NON-MEDICAL SUBSPECIALTIES CLINIC ROTATION
The Non-Medical Subspecialties Rotation at
|
Legend
for Learning Activities |
||
|
ACS
– Ambulatory Care Series CC-Core
Curriculum DPC –
Direct Patient Care FS
– Faculty Supervision |
GR
– Ground Rounds IL-Introductory Lecture Series JC – Journal Club NC
– Noon Conferences |
PC–Professionalism Curriculum RC – Research Conference SL
– Subspecialty Lectures SS
– Senior Seminar |
|
Legend
for Evaluation Methods for Residents |
|
|
FE
- Faculty Evaluations IE
– In-service Exam PDR–Program
Director’s Review (twice annually) |
PR
– Peer Review SPE –
Standardized patient evaluation |
Principal Educational Goals by Relevant Competency
The principal educational goals for residents on this
rotation are indicated for each of the six ACGME competencies in the tables
below and numbered in the first column.
The second column of the table lists the goal, the third column lists
the most relevant learning activities for that goal, and the fourth column
indicates the correlating evaluation methods for that goal. A detailed
description of the on-going learning activities at
PG-2/3/4
(Goals are for upper level residents only):
A. Patient Care
|
|
Principal Educational Goals |
Learning Activities |
Evaluation Methods |
|
1. |
Perform and document a comprehensive
medical history and examination. |
DPC |