1. The New ACGME Competencies for Internal Medicine

2. The New Competencies for Internal Medicine ACGME Outcomes project Applies to all disciplines Implemented as of 7/1/02 New evaluation forms New Learning Objectives

3. The six general competencies: Patient Care Medical Knowledge Professionalism Systems-based Practice Practice-based Learning and Improvement Interpersonal and Communication Skills

4. Patient Care 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.

5. Medical Knowledge 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.

6. Practice-Based Learning and Improvement Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care

7. 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. EBM, literature searching, information technology, teaching

8. Interpersonal and Communication Skills Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals

9. 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.

10. Professionalism Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population

11. Professionalism Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession, and society.

12. Systems-Based Practice Systems-Based Practice, as manifested by actions that 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 care that is of optimal value

13. Systems-Based Practice 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.

14. Systems-Based Practice 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

15. Professionalism Increasing emphasis in licensure Like pornography- “easy to recognize but difficult to define” How physicians meet their responsibilities to individual patients and to communities

16. Professionalism ABIM- “comprises those attitudes and behaviors that sustain the interests of the patient above one’s own self interest…and entails altruism, accountability, commitment to excellence, duty and …respect for others.”

17. Medical Professionalism National focus on defining and measuring professionalism [Hundert]

18. Medical Professionalism: Physicians subordinate their own interests to the interests of others Physicians adhere to high moral and ethical standards Physicians respond to societal needs

19. Medical Professionalism: Physicians evidence core humanistic values, including honesty, integrity, caring and compassion, altruism and empathy, respect for others, and trustworthiness Physicians demonstrate accountability for themselves and their colleagues

20. Medical Professionalism: Physicians demonstrate a continuing commitment to excellence Physicians demonstrate a commitment so scholarship and to advancing their field Physicians reflect upon their actions and decisions

21. Medical Professionalism: Example of common pitfalls Inappropriate expressions of anger at patients, families or other health care professionals Publicly belittling patients, families or colleagues Disrespect for patients because or their disease, lifestyle or background Compromising care to “get out early”

22. Learning Medical Professionalism: The “Hidden Curriculum” Role models Life-long learning/ self reflection