HB_ MH_ _ME by lonyoo

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									Family Medicine Curriculum Goals and Objectives
Key
1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07

Human Behavior, Mental Health, and Medical Ethics
Competency Develop self-awareness as a person, a healer, and as a member of the community in which (s)he practices Develop sensitivity to, and knowledge of , the emotional aspects of organic illness Be able to diagnose and manage psychosocial issues common to family medicine Be able to effectively utilize modern behavioral and psychiatric approaches in dealing with the psychosocial issues of patients Develop interpersonal skills that promote and enhance the doctor/patient relationship and reflect sensitivity to gender, race, age, sexual orientation, and cultural differences Understand medical ethics as it applies to the treatment of behavioral issues Develop an awareness of when to seek outside consultative support Describe normal psychosocial growth and development in individuals and families Recognize, diagnose, manage, or refer patients with mental retardation Recognize, diagnose, manage, or refer patients with learning disorders Recognize, diagnose, manage, or refer patients with communication disorders Recognize, diagnose, manage, or refer patients with Attention Deficit Disorder Recognize, diagnose, manage, or refer patients with disruptive behavior disorders Recognize, diagnose, manage, or refer patients with feeding, eating, and elimination disorders Recognize, diagnose, manage, or refer patients with schizophrenia and other psychotic disorders Recognize, diagnose, manage, or refer patients with substance abuse disorders Recognize, diagnose, manage, or refer patients with mood disorders, to include: mania and hypomania, depression (transient and clinical), and bipolar disorders Recognize, diagnose, manage, or refer patients with anxiety disorders, to include: panic attacks, chronic anxiety, and Post Traumatic Stress Disorder Recognize, diagnose, manage, or refer patients with somatization Recognize, diagnose, manage, or refer patients with personality disorders, including dissociative disorders Recognize, diagnose, manage, or refer patients with eating disorders Recognize, diagnose, manage, or refer patients with sleep disorders Recognize, diagnose, manage, or refer patients with family violence, including: child abuse (physical, sexual, emotional), child neglect, spousal abuse, elder abuse and neglect Perform a mental status examination Perform family therapy or consultation Evaluate stress across the family life cycle Perform basic behavior modification techniques Assess sexual dysfunction Perform sexual counseling Perform crisis counseling Identify the various factors that affect patient compliance and behavior, and be able to develop a corresponding management plan Describe diagnostic indications and contraindications for psychopharmacologic agents Describe dosage, length of use, monitoring or response, side effects, and compliance with psychopharmacologic agents Identify drug interactions for psychopharmacologic agents Identify associated medical problems with psychopharmacologic agents Develop an awareness of residents’ own attitudes, values, and responses to stress which could influence their ability to treat patients Define patient autonomy Define beneficence Define nonmaleficence Define patient confidentiality Define informed consent Describe regulations regarding advanced directives, including: living wills, power of attorney, and guardianship Describe regulations regarding organ donation Describe regulations regarding identification, documentation, and legal issues around incompetent patients Describe regulations regarding human reproductive issues 5,6 1,5 1,2,4 1,2 4,5 1,4,5 1,3,5 2 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2 1,2,3 1,2 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4,6 2 1,2 1,2 1,2 1,4,5 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 PGY Level 1 1 3 3 1 1 1 2 1 1 2 1 2 3 3 1 1 1 2 2 1 1 3 1 2 3 3 3 3 2 1 2 2 2 2 1 2 3 3 1 1 2 1 1 1

Objectives

Goals

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6Systems-Based Practice Last reviewed 7/16/07

Family Medicine Curriculum Goals and Objectives

Adult Medicine
Competency Develop the ability to diagnose, treat and manage the non-surgical, undifferentiated adult patient 1,2 Understanding the pathophysiologic and psychosocial bases for non-surgical diagnostic and therapeutic techniques 1,2 Promote development of a disciplined, scientific, family centered approach to the practice of adult medicine 1,3,4,5 PGY Level 1 3 2

Goals

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07

Family Medicine Curriculum Goals and Objectives

Adult Medicine (Critical Care)
Competency PGY Level

Goals

To become familiar with the diagnostic strategies and medical care required for critically ill patients. Evaluate and initiate therapy for the undifferentiated critically ill patient. Evaluate and initiate therapy for paralysis Evaluate and initiate therapy for increased intracranial pressure Evaluate and initiate therapy for severe electrolyte disturbances Evaluate and initiate therapy for severe infections Evaluate and initiate therapy for respiratory failure Evaluate and initiate therapy for trauma Evaluate and initiate therapy for head injury Evaluate and initiate therapy for cardiovascular collapse Evaluate and initiate therapy for renal failure Evaluate and initiate therapy for liver failure Evaluate and initiate therapy for abdominal emergencies Understand the principles of mechanical ventilation Understand the principles of invasive monitoring Perform arterial line placement (site) Perform arterial puncture Perform arthrocentesis (site) Perform chest tube insertion and placement Perform endotracheal intubation

1,2,6 1,2 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2 1,2 1,2 1,2 1,2 1,2 1,2

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

Objectives

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Cardiology) Be able to diagnose and manage a variety of cardiovascular disorders Develop an awareness of the importance of the physician and patient working together to promote optimal cardiovascular health Be able to recognize the psychosocial and economic impact of cardiovascular disease on the individual and family

Family Medicine Curriculum Goals and Objectives

Competency 1,2,4,6 1,4,5,6 1,2,6

PGY Level 2 1 2

Goals

Describe normal cardiovascular anatomy and physiology, including changes with age and pregnancy Identify the risk factors for coronary artery disease, including: hyperlipidemia, cigarette smoking, genetic predisposition, sedentary life-style, hypertension, diabetes, excess weight, nutrition, and hormonal status Conduct a cardiovascular history and cardiac-centered physical examination and be able to interpret the following noninvasive examinations: electrocardiography, chest 1,2 radiography, stress testing, and ECG monitoring Understand the role, risks and benefits of the following invasive examinations: diagnostic cardiac catheterization and angiography, intracoronary and peripheral vascular intervention, diagnostic carotid and peripheral vascular angiography, 1,2 internal monitoring devices, and electrophysiologic studies 1,2 Perform cardiopulmonary resuscitation, both basic and advanced Describe the psychological issues associated with cardiovascular conditions, 1,2,4 including: sexual issues, depression, and family dynamics 1,2,4,6 Manage ambulatory rehabilitation after an invasive intervention Describe the physiology and be able to manage patients with coronary artery disease 1,2,6 1,2,6 Describe the physiology and be able to manage patients with syncope 1,2,6 Describe the physiology and be able to manage patients with arrhythmias 1,2,6 Describe the physiology and be able to manage patients with hypertension Describe the physiology and be able to manage patients with pulmonary heart 1,2,6 disease Describe the physiology and be able to manage patients with congestive heart failure 1,2,6 Describe the physiology and be able to manage patients with thromboembolic 1,2,6 disease Describe the physiology and be able to manage patients with valvular heart disease 1,2,6 Describe the physiology and be able to manage patients with congenital heart 1,2,6 disease Describe the physiology and be able to manage patients with a dissecting aneurysm 1,2,6 1,2,6 Describe the physiology and be able to manage patients with heart murmurs Describe the physiology and be able to manage patients with peripheral vascular 1,2,6 disease 1,2,6 Describe the physiology and be able to manage patients with cardiomyopathies 1,2,6 Describe the physiology and be able to manage patients with pericardial disease

2

2

2

1

2

1 1 2 2 1 2 2 1 2 1 2 3 3 2 2 1 2 2

Objectives

Family Medicine Curriculum Goals and Objectives
Key
1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Infectious Disease) Competency PGY Level 1

Goals

Be able to diagnose and treat patients who present with clinical, infectious disease syndromes that are commonly seen in the family medicine setting

1,2,4,6

Describe the physiology and be able to manage patients with infection related disease Diagnose, manage, and understand referral criteria for fever of unknown origin Diagnose, manage, and understand referral criteria for the acutely ill patient with fever and rash Diagnose, manage, and understand referral criteria for upper respiratory tract infections, including: cold, pharyngitis, laryngitis, croup, otitis, sinusitis, and epiglotitis Diagnose, manage, and understand referral criteria for pleuropulmonary and bronchial infections, including: bronchitis, bronchiolitis, pneumonia, empyema, lung abscess, and CF Diagnose, manage, and understand referral criteria for urinary tract infections Diagnose, manage, and understand referral criteria for peritonitis and other intraabdominal infections Diagnose, manage, and understand referral criteria for cardiovascular infections, including: endocarditis, prosthetic valves, myocarditis, and pericarditis Diagnose, manage, and understand referral criteria for skin and soft tissue infection, including: cellulitis, fasciitis, and lymphadenitis Diagnose, manage, and understand referral criteria for gastrointestinal infections and food poisoning, including: esophagitis, diarrheal disease, and food-borne disease Diagnose, manage, and understand referral criteria for bone and joint infection, including: septic arthritis, osteomyelitis, and infection of prosthesis Diagnose, manage, and understand referral criteria for sexually transmitted diseases, including: STDs of the skin and mucous membranes, urethritis, vulvovaginitis, cervicitis, prostatitis, orchitis, epididymitis, and PID Diagnose, manage, and understand referral criteria for eye infections, including: conjunctivitis, keratitis, endoopthalmitis, and periocular infection Diagnose, manage, and understand referral criteria for hepatitis, including: acute viral, chronic, and granulomatous Diagnose, manage, and understand referral criteria for HIV/AIDS, including: epidemiology, detection (to include types of tests, sensitivity and specificity, indications and regulations around testing, and pre and post test counseling), risk factors, clinical manifestations and diagnosis, psychosocial and ethical issues, financial and legal issues 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 2 1 1 1

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

2 1 2 3 1 2 2

Objectives

1,2,4,6 1,2,4,6 1,2,4,6

1 3 2

1,2,4,6

3

Family Medicine Curriculum Goals and Objectives
Key
1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Neurology) Competency PGY Level Understand both the pathophysiological and biopsychosocial etiologies of neurological disorders 1,2 Be able to diagnose, treat, and manage patients who present with neurological disorders that are commonly seen in the family medicine setting 1,2,4,6

Goals

3 2

Objectives

Demonstrate the ability to gather the necessary historical information from the patient, including: history and physical, neurologic examination, and mental status examination Describe the indications, contraindications, risks and significance of ancillary tests Identify neurologic complications of systemic illness Describe the psychologic and rehabilitation aspects of neurological management, especially for chronic or long-term neurologic conditions Understand the neurologic disabilities of elderly patients and the importance of assessing, restoring, and maintaining their functional capacity Describe the role of a neurologic specialist in the diagnosis, treatment , and management of patients with neurological disorders Diagnose, treat, and manage headache, including migraine and non-migraine Diagnose, treat, and manage acute stroke Diagnose, treat, and manage TIA Diagnose, treat, and manage peripheral neuropathy Diagnose, treat, and manage low back pain Diagnose, treat, and manage nerve entrapment Diagnose, treat, and manage Parkinsonism Diagnose, treat, and manage seizure disorders Diagnose, treat, and manage dementia and Alzheimer’s disease Diagnose, treat, and manage multiple sclerosis Diagnose, treat, and manage peripheral nervous system disorders Diagnose, treat, and manage dizziness Diagnose, treat, and manage syncope

1,2,4 1,2,4,6 2 1,2,6 1,2,6 1,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

1 3 3 3 3 3 1 2 2 1 1 2 2 1 2 3 2 1 1

Family Medicine Curriculum Goals and Objectives
Key
1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Endocrinology) Competency Be able to diagnose and treat patients who present with endocrine disease syndromes that are commonly seen in the family medicine setting 1,2,4,6 PGY Level

Goals

1

Diagnose, manage, and understand referral criteria for diabetes mellitus Diagnose, manage, and understand referral criteria for hyperlipidemia Diagnose, manage, and understand referral criteria for obesity Diagnose, manage, and understand referral criteria for thyroid dysfunction

Objectives

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

1 1 1 1

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Pulmonary)

Family Medicine Curriculum Goals and Objectives

Competency

PGY Level

Goals

Be able to disgnose and treat patients who present with pulmonary disease syndromes that are commonly seen in the family medicine setting

1,2,4,6

Diagnose, manage, and understand referral criteria for asthma Diagnose, manage, and understand referral criteria for bronchitis Diagnose, manage, and understand referral criteria for COPD Diagnose, manage, and understand referral criteria for cough Diagnose, manage, and understand referral criteria for croup Diagnose, manage, and understand referral criteria for lung cancer Diagnose, manage, and understand referral criteria for pharyngitis Diagnose, manage, and understand referral criteria for pneumonia Diagnose, manage, and understand referral criteria for viral URI

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

1 1 1 1 1 2 1 1 1

Objectives

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Hematology/Oncology)

Family Medicine Curriculum Goals and Objectives

Competency

PGY Level

Goals

Be able to diagnose and treat patients who present with Hematologic/Oncologic sydromes that are commonly seen in the family medicine setting

1,2,4,6

2

Diagnose, manage, and understand referral criteria for anemia Diagnose, manage, and understand referral criteria for B-12 deficiency Diagnose, manage, and understand referral criteria for enlarged lymph nodes Diagnose, manage, and understand referral criteria for malignancies

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

1 1 2 3

Objectives

Family Medicine Curriculum Goals and Objectives
Key
1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Gastroenterology) Competency PGY Level Be able to diagnose and treat patients who present with Gastrointestinal disease syndromes that are commonly seen in the family medicine setting

Goals

1,2,4,6

3

Diagnose, manage, and understand referral criteria for bleeding per rectum Diagnose, manage, and understand referral criteria for cholecystitis Diagnose, manage, and understand referral criteria for cirrhosis Diagnose, manage, and understand referral criteria for colon cancer Diagnose, manage, and understand referral criteria for constipation Diagnose, manage, and understand referral criteria for diarrhea (acute or chronic) Diagnose, manage, and understand referral criteria for diverticular disease Diagnose, manage, and understand referral criteria for esophageal reflux Diagnose, manage, and understand referral criteria for gastritis Diagnose, manage, and understand referral criteria for infectious and non-infectious hepatitis Diagnose, manage, and understand referral criteria for hernia Diagnose, manage, and understand referral criteria for inflammatory bowel disease Diagnose, manage, and understand referral criteria for irritable bowel syndrome Diagnose, manage, and understand referral criteria for pancreatitis Diagnose, manage, and understand referral criteria for peptic ulcer disease

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

1 2 2 2 1 1 1 1 1 2 2 3 2 2 1

Objectives

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Rheumatology)

Family Medicine Curriculum Goals and Objectives

Competency

PGY Level 3

Goals

Be able to diagnose and treat patients who present with rheumatologic syndromes that are commonly seen in the family medicine setting

1,2,4,6

Diagnose, manage, and understand referral criteria for bursitis Diagnose, manage, and understand referral criteria for costrochondritis Diagnose, manage, and understand referral criteria for ganglion cyst Diagnose, manage, and understand referral criteria for gout Diagnose, manage, and understand referral criteria for low back pain Diagnose, manage, and understand referral criteria for osteoarthritis Diagnose, manage, and understand referral criteria for rheumatoid arthritis Diagnose, manage, and understand referral criteria for tendonitis Diagnose, manage, and understand referral criteria for TMJ

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

1 1 2 1 1 1 3 2 2

Objectives

Family Medicine Curriculum Goals and Objectives
Key
1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Nephrology) Competency PGY Level Be able to diagnose and treat patients who present with disease syndromes of the kidney that are commonly seen in the family medicine setting

Goals

1,2,4,6

3

Diagnose, manage, and understand referral criteria for hematuria 1,2,4,6 2 1 1 2 2

Objectives

Diagnose, manage, and understand referral criteria for proteinuria 1,2,4,6 Diagnose, manage, and understand referral criteria for 1,2,4,6 pyelonephritis Diagnose, manage, and understand referral criteria for renal stones 1,2,4,6 Diagnose, manage, and understand referral criteria for renal failure 1,2,4,6

Family Medicine Curriculum Goals and Objectives
Key 1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Adult Medicine (Allergy and Immunology) Competency PGY Level Be able to diagnose and treat patients who present with allergic and immunologic disease syndromes that are commonly seen in the family medicine setting

Goals

1,2,4,6

2

Objectives

Diagnose, manage, and understand referral criteria for allergic rhinitis Diagnose, manage, and understand referral criteria for asthma Diagnose, manage, and understand referral criteria for urticaria 1,2,4,6 1,2,4,6 1,2,4,6 1 1 2

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Women's Health

Family Medicine Curriculum Goals and Objectives

Competency Develop an understanding that women desire to be treated as competent participantsin their health care Develop an understanding that a woman's health is affected not only by medical factors, but also by family, life cycle, relationshsips, and the community Develop an appreciation of the role that women play in the health of the family by choosing a health care provider, making meal selections, and providing family care at home Gain an undestanding of the complex physiologic, hormonal, and psychosocial issues that affect women's health Develop gender specific expertise in providing comprehensive health care for women Describe normal female growth and development Conduct an appropriate history and physical examination for all age groups Provide gynecologic and maternity care for women, including breast health Educate patients about health promotion/disease prevention regarding nutritional needs Educate patients about health promotion/disease prevention regarding cancer screening, including: Papanicolaou test, breast exams and mammography, and pelvic axams Educate patients about health promotion/disease prevention regarding exercise Educate patients about health promotion/disease prevention regarding osteoporosis Educate patients about health promotion/disease prevention regarding smoking Educate patients about health promotion/disease prevention regarding coronary artery disease Educate patients about health promotion/disease prevention regarding motor vehicle safety Elicit information from patients to determine if domestic violence is present Elicit information from patients to determine if rape has occurred Elicit information from patients to determine if sexual harassment is present Elicit information from patients to determine if sexual abuse is present Elicit information from patients to determine if role strain and child care issues are present Elicit information from patients to determine if changing family structure and roles is occurring Elicit information from patients to determine if poverty is affecting the patient and/or her children Describe the sequelae and be able to administer basic counseling to patients related to sexual abuse Describe the sequelae and be able to administer basic counseling to patients related to depressive illnesses, including postpartum depression Describe the sequelae and be able to administer basic counseling to patients related to anxiety disorders Describe the sequelae and be able to administer basic counseling to patients related to problems with self-esteem Describe the sequelae and be able to administer basic counseling to patients related to eating disorders Describe the sequelae and be able to administer basic counseling to patients related to substance abuse Counsel patients regarding the emotional impact of abortion Identify issues affecting women’s access to health care Describe the epidemiology of HIV as it relates to women Describe the epidemiology of infant mortality Diagnose, treat, and mange (where appropriate) coronary artery disease Diagnose, treat, and mange (where appropriate) hypertension Diagnose, treat, and mange (where appropriate) thyroid disorders Diagnose, treat, and mange (where appropriate) connective tissue disease Diagnose, treat, and mange (where appropriate) headaches Diagnose, treat, and mange (where appropriate) lung cancer Diagnose, treat, and mange (where appropriate) urinary tract infections 1,3,4,5,6 1,3,4,5,6 1,3,4,5,6 1,2 1,3,4,5,6 2 1,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4,5,6

PGY Level 1 1 1 1 3 1 1 2 3 1 1 1 2 1 1 2 3 2 2 1 1 2 2 2 2 2 2 2 1 2 2 1 1 1 1 2 1 2 1

Objectives

Goals

1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 2,6 2,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

Diagnose, treat, and mange (where appropriate) cholecystitis Diagnose, treat, and mange (where appropriate) weight disorders Diagnose, treat, and mange (where appropriate) diabetes Diagnose, treat, and mange (where appropriate) COPD Diagnose, treat, and mange (where appropriate) skin disorders

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

2 3 1 1 2

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Women's Health (GYN) Competency PGY Level 3

Family Medicine Curriculum Goals and Objectives

Goals

Develop the ability to provide quality medical care in the areas of the female reproductive system, maternity care, and labor/delivery

1,2,3,4,5,6

Educate patients about health promotion/disease prevention as it relates to gynecologic health, including: periodic health evaluation, diet and body weight, calcium and iron intake, exercise, safe sex, stress 1,2,4,6 reduction, cancer screening Describe the normal menstrual cycle, including: fluctuations in pituitary and ovarian hormones, ovarian follicle development, ovulation, corpus luteum development, endometrial histology, timing of fertility, premenstrual symptoms, dysmenorrhea, range of normal menstrual flow Describe normal and abnormal pubertal development 1,4 Elicit parents’ concerns about sexual identity, sexual behavior, and sexual responses Educate patients about sexual behavior and associated risks, including HIV testing, when appropriate 1,2,4,5 1,2,6 Given a case of abnormal uterine bleeding, construct a differential diagnosis and management plan Given a case of primary or secondary amenorrhea, derive a differential diagnosis and outline an 1,2,6 appropriate sequence of diagnostic tests and plan of management 1,2,4,5,6 Diagnose and treat trichomoniasis and treat the partner, if indicated 1,2,4,5,6 Diagnose and treat candidiasis 1,2,4,5,6 Diagnose and treat bacterial vaginosis 1,2,4,5,6 Diagnose and treat herpes simplex and treat the partner, if indicated 1,2,4,5,6 Diagnose and treat chlamydia and treat the partner, if indicated 1,2,4,5,6 Diagnose and treat gonorrhea and treat the partner, if indicated 1,2,4,5,6 Diagnose and treat syphilis and treat the partner, if indicated 1,2,4,5,6 Diagnose and treat condylomata/HPV Recognize the signs and symptoms of acute PID and prescribe appropriate diagnostic tests and 1,2,4,5,6 treatment Recognize lesions of the vulva and be able to outline an approach that will ensure their diagnosis, as well 1,2,4,5,6 as describe appropriate therapy Describe the natural history, signs, symptoms, diagnosis, and treatments for conditions which may cause pelvic pain: including leiomyomata, endometriosis, adenomyosis, adhesions Perform a PAP smear, interpret test results, and initiate a management plan for normal and abnormal 1,2,4,5,6 PAP smears Identify the indications and contraindications for cryotherapy of the cervix Describe the work-up and differential diagnosis of an adnexal mass 1,2 Perform an endometrial aspiration/biopsy and interpret results 1,2 Perform excision of Bartholin’s cyst Given a patient with hirsutism, demonstrate the ability to take an appropriate history, record partinent physical findings, outline the steps in diagnosis, interpret the results, and suggest management options 1,2,4,5,6 1,2,4,5,6 Recognize and initiate the work-up for infertility 1,2,4,5,6 Educate patients and their families about evaluating and treating infertility 1,2,4,5,6 Describe the assessment and treatments for female urinary incontinence and pelvic relaxation Describe the symptoms of menopause 1,2 Assess and manage changes in the pattern of menses 1,2,4 Counsel women about hormonal replacement therapy and prescribe therapy, where indicated 1,2,4,5,6 Educate women about the prevention of osteoporosis 1,2,4,5,6 Evaluate, treat, and manage osteoporosis 1,2,4,5,6 Counsel patients using natural family planning

1

2 2

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

Objectives

2

2 1 2 2 2 2

2 2

2

1 2 2 1 1 1 1 1 1 2

Objectives

Describe the indications, contraindications, effectiveness, cost, and potential side effects of periodic abstinence Describe the indications, contraindications, effectiveness, cost, and potential side effects of condoms Describe the indications, contraindications, effectiveness, cost, and potential side effects of spermicide Describe the indications, contraindications, effectiveness, cost, and potential side effects of the diaphragm Describe the indications, contraindications, effectiveness, cost, and potential side effects of the IUD Describe the indications, contraindications, effectiveness, cost, and potential side effects of oral contraceptives (combination or progesterone only) Describe the indications, contraindications, effectiveness, cost, and potential side effects of natural family planning Describe the indications, contraindications, effectiveness, cost, and potential side effects of DepoProvera

1,2,4,5,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6

2 1 1 1 1 1 1 1

Describe the indications, contraindications, effectiveness, cost, and potential side effects of sterilization (male and female) Describe the indications, contraindications, effectiveness, cost, and potential side effects of emergency postcoital contraception Describe the indications, contraindications, effectiveness, cost, and potential side effects of abortion Assist women and couples in choosing a good method of birth control for their situation, and provide the chosen method(s), either personally or by referral. Discuss the appropriate evaluation and treatment of a woman who has been sexually assaulted Perform a thorough breast examination Perform aspiration of breast cysts Formulate a timely plan, specific to each patient, for diagnosing and managing a palpable breast mass Formulate a timely plan, specific to each patient, for diagnosing and managing milky or clear nipple discharge Formulate a timely plan, specific to each patient, for diagnosing and managing bloody nipple discharge

1,2,6 1,2,6 1,2,6 1,2,4,5,6 1,2,6 1,5 1,4 1,2,6 1,2,6 1,2,6 1,2,6

1 1 1 1 2 1 2 1 1 1 1 2 2 2

Formulate a timely plan, specific to each patient, for diagnosing and managing the painful breast Formulate a timely plan, specific to each patient, for diagnosing and managing nonpalpable 1,2,6 mammographic abnormalities Formulate a timely plan, specific to each patient, for diagnosing and managing a family history of breast 1,2,6 cancer Formulate a timely plan, specific to each patient, for diagnosing and managing breast augmentation or 1,2,6 reduction

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Women's Health (Maternity)

Family Medicine Curriculum Goals and Objectives

Competency

PGY Level

Goals

Develop the ability to provide quality medical care in the areas of the female reproductive system, maternity care, and labor/delivery

1,2,3,4,5,6

3

Describe normal female growth and development Describe the biological and psychological impacts of pregnancy, delivery, and care of the newborn on a woman, her family, and significant others Conduct an initial assessment of a new obstetrical patient Perform pelvic examinations, clinical pelvimetry, and gestational dating Assess fetal growth and maternal-fetal wellbeing according to prenatal protocols Recognize and provide initial management of the high-risk prenatal patient, including consultation and referral Diagnose and mange medical and psychiatric conditions in pregnancy and be able to identify the more severe conditions that may require consultation, including: headache, vaginitis, UTI, STDs, respiratory infections, asthma, vomiting, diarrhea, abdominal and musculoskeletal pain, anemia, depression, abuse Help patients prepare for labor, birth, and infant care Diagnose labor and/or ruptured membranes Assess dilation, effacement, station, and fetal position Labor induction (Misoprastil) Labor induction (PG) Labor induction (Pitocin) Intrauterine pressure catheter placement Describe indications and contraindications for amnioinfusion. Describe the prevention of neonatal GBS disease Supervise and provide support for normal delivery Manage the third stage of labor Examine the vagina, cervix, and uterus postpartum Perform an episiotomy and related repair Demonstrate knowledge of techniques for pain relief during labor and postpartum Perform pudendal block Recognize and participate in the management of abnormal fetal presentations and multiple gestations Participate in the diagnosis and management of antepartum complications including: postdatism, intrauterine growth retardation, Class A gestational diabetes, vaginal bleeding, and preeclampsia Identify and manage intrapartum complications such as dysfunctional labor and fetal distress Perform an amniotomy Describe indications and methods for vacuum extractions Perform vaginal delivery (vacuum assisted) Perform vaginal delivery (spontaneous) Manage shoulder dystocia Manage postpartum hemorrhage Perform manual removal of the placenta, when indicated Repair first and second degree perineal lacerations Assist in Cesarean sections Manage infants with meconium-stained amniotic fluid

2 1,2,6 1,2,4,5,6 1,2,5 1,2,4,5,6 1,2,4,6

1 2 1 1 1 1

Objectives

1,2,4,5,6 1,2,4,5,6 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2

1,2 1,2 1,2 1,2

3 3 1 1 1 1 1 1 1 1 1 1 1 1 1 3 1

Objectives

1,2 1,2 1,2 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2 1,2,4,6 1,2,4,6

1 1 1 1 1 1 1 1 1 1 1 1

Objective

Assist in tubal ligations Provide initial stabilization of the newborn

1,2,4,6 1,2,4

1 1

Educate the mother regarding breastfeeding Provide postpartum contraception counseling Provide postpartum care to for mothers and their infants Perform newborn circumcision Provide genetic counseling to patients and their families

1,2,4,5 1,2,4,5 1,2,4,5,6 1,2 1,2,4,5,6

1 1 1 1 3

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Care of the Surgical Patient and Surgical Subspecialties

Family Medicine Curriculum Goals and Objectives

Competency Be able to diagnose and manage surgical disorders and emergencies common to the family medicine setting Know when to provide appropriate and timely referral of surgical cases for specialized care Be able to appreciate various surgical treatments and the potential risks associated with them Be able to provide proper surgical advice, explanation, and emotional support to patients and their families Be able to recognize conditions that are preferably managed on an elective basis Have a knowledge of preoperative care and care of medical conditions perioperatively Be able to work collaboratively with the surgical health care team 1,2,4,6 1,2 2 2,4,5 1,2 2 4,5

PGY Level 3 3 3 3 3 2 2

General Surgery Develop a differential diagnosis for patients presenting with abdominal pain Develop a differential diagnosis for patients presenting with hematemesis Develop a differential diagnosis for patients presenting with intractable nausea and vomiting Develop a differential diagnosis for patients presenting with jaundice Develop a differential diagnosis for patients presenting with melena Develop a differential diagnosis for patients presenting with shock Develop a differential diagnosis for patients presenting with traumatic injuries Educate patients about abdominal exploration Educate patients about appendectomy Educate patients about cholecystectomy Educate patients about colostomy Educate patients about herniorrhaphy Perform burn treatment Perform sterile technique Perform suturing of laceration (not scalp) Perform suturing of laceration (scalp) Suture skin, sub-cut, muscle Perform ulcer care Perform universal precautions Perform wound care Assess preoperative risk to assure a favorable risk/benefit ratio Manage small bowel obstruction Manage acute pancreatitis Manage antibiotic prophylaxis perioperatively Manage congestive heart failure perioperatively Manage diabetes mellitus perioperatively Manage fever perioperatively Manage fluid balance perioperatively Manage infection perioperatively Manage nutrition perioperatively Manage pulmonary embolus/DVT prevention perioperatively 2 2 2 2 2 2 2 2,4,5 2,4,5 2,4,5 2,4,5 2,4,5 1,2,4,5 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,3,6 1,2,3,6 1,2,3,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 2 2 2 2 2 2 2 2 2 2 2 2 3 1 1 1 2 1 1 1 3 2 2 2 2 2 2 2 2 2 2

Objectives

Goals

Manage renal insufficiency perioperatively Manage surgical wound care perioperatively Perform incision and drainage Perform laceration repair Perform removal of skin lesions, including shave biopsy and incisional biopsy Perform excision of sebacious cyst Perform techniques for local anesthesia and regional block Perform toenail removal Perform excision of lateral nail Perform I & O catheterization Manage fluid and electrolyte balance Manipulate drug therapy before and after surgery Know how to use and transfuse blood products Manage postoperative consequences and complications of urinary retention Manage postoperative consequences and complications of anemia Manage postoperative consequences and complications of fever Manage postoperative consequences and complications of obstruction and ileus Manage postoperative consequences and complications of pain management Manage postoperative consequences and complications of infection Manage postoperative consequences and complications of respiratory care Take an appropriate history, perform a physical exam, and order appropriate labs for the undifferentiated surgical patient Describe and implement informed consent Describe and implement procedure documentation Work collaboratively with a health care team, possibly including: anesthetists, nurses, occupational and physical therapists, social workers, home health nurses, surgical consultants, nutritionists, pharmacists, physician assistants, and nurse practitioners Educate patients prior to surgery and demonstrate an ability to understand patients’ needs and expectations before and after surgery

1,2,4,5,6 1,2,4,5,6 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,4,5 1,2

2 2 2 1 2 1 3 1 1 1 2 1 1 2 2 2 2 2 2 2 3 1 1

Objectives

3,4,5,6 1,2,4

2 2

Orthopedics Competency Describe normal musculoskeletal anatomy, physiology, growth, and development Conduct a musculoskeletal history and physical exam Identify the indications, contraindications, and interpretation of x-rays Identify the indications, contraindications, and interpretation of MRIs, CTs, and bone scanning Describe the pathogenesis, pathophysiology, and be able to recognize joint pain, swelling, and erythema Describe the pathogenesis, pathophysiology, and be able to recognize muscular pain, swelling, and injury Describe the pathogenesis, pathophysiology, and be able to recognize musculoskeletal trauma Describe the pathogenesis, pathophysiology, and be able to recognize fractures Describe the pathogenesis, pathophysiology, and be able to recognize dislocations Describe the pathogenesis, pathophysiology, and be able to recognize tendon injuries Describe the pathogenesis, pathophysiology, and be able to recognize nerve injury Describe the pathogenesis, pathophysiology, and be able to recognize bone and joint deformity 2 1,2,4,5 2 2 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2 Describe the pathogenesis, pathophysiology, and be able to recognize bone and joint infection 1,2 Describe the pathogenesis, pathophysiology, and be able to recognize metabolic bone disease 1,2 2 2 PGY Level 2 2 3 3 2 2 2 2 2 2 2 2

Objectives

Objectives
Describe the pathogenesis, pathophysiology, and be able to recognize musculoskeletal congenital abnormalities Describe the pathogenesis, pathophysiology, and be able to recognize musculoskeletal birth injury Describe the pathogenesis, pathophysiology, and be able to recognize child battering Describe the pathogenesis, pathophysiology, and be able to recognize compartment syndrome Describe the pathogenesis, pathophysiology, and be able to recognize avascular necrosis Diagnose pediatric hip displasia Diagnose pediatric Legg Calve-Perthes disease Diagnose pediatric Osgood-Schlatter’s disease Diagnose pediatric slipped capitofemoral epyphysis Diagnose pediatric “clubfoot” (talipes) Diagnose pediatric intoeing (metatarsus adductus, tibial torsion, femoral anteversion) Diagnose pediatric “bow leg” (genu varum) and “knock knee” (genu valgum) Diagnose pediatric epiphyseal injury according to the Salter-Harris classification Outline a plan for orthopedic conditions Educate patients regarding acute and chronic orthopedic problems Recommend appropriate pharmacologic treatment, including: salicylates, nonsteroidal antiinflammatories, steroids (oral and injectable), musce relaxants, and antibiotics Identify and implement the use of supportive and corrective devices, including braces and corrective shoes Manage orthopedic rehabilitation, including: physical therapy, occupational therapy, disability, and psychosocial issues Identify potential need for orthopedic surgery Basic treatment and management of fractures Treatment and management of sprains and strains Basic treatment and management of costochondritis Basic treatment and management of bursitis/ tendinitis/ tenosynovitis Basic treatment and management of the elbow (“tennis,” “nursemaid,” “little league”) Basic treatment and management of entrapment syndromes Basic treatment and management of a Baker’s cyst Basic treatment and management of chondromalacia patellae Basic treatment and management of Osgood- Schlatter disease Basic treatment and management of osteochondroses/aseptic necrosis Basic treatment and management of osteoarthritis Basic treatment and management of metabolic bone disease Basic treatment and management of acute and chronic low back pain Perform joint aspiration Perform joint and musculoskeletal injection, including local anesthesia and steroid (joint and bursa) Perform wrapping and taping, including: elasticized bandage, ankle taping, clavicular figure-ofeight bandage, and soft cervical collar Perform splinting, both upper and lower extremity Perform plaster and fiberglass casting, including: short and long leg (with and without walker), short and long arm, and case wedging Perform dislocation reduction, including: simple anterior shoulder, radial head, phalanges, patella

1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2,6 1,2,4,5,6 1,2,4 1,2,4,6 1,2,4,6 1,2 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,6 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4

2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

Urology Competency PGY Level

Objectives

Perform a routine physical examination of the genitourinary tract Demonstrate an understanding of office cystometrics Interpret radiologic studies of the urinary tract Diagnose and manage urinary obstruction Diagnose and manage vesicoureteral reflux Diagnose and manage infections of the GU tract Diagnose and manage urinary stone disease Diagnose and evaluate disorders of the testes and scrotum Diagnose and evaluate cancers of the GU system Evaluate hematuria Evaluate and manage urinary incontinence and impotence

1,2,4,5 2 2 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6

3 3 3 3 3 3 3 3 3 3 3

Ophthalmology Competency Conduct an organized and effective eye examination, including: visual acuity, external exam, and ophthalmoscopic exam Describe the normal anatomy, physiology, and development of the eye Describe the effects of drugs/toxins on ocular function and disease Describe the effects of ocular drugs on systemic function Describe ocular complications of systemic disease Diagnose, manage, and understand referral criteria for inflammation, infection, and allergic conditions, including: conjunctivitis, blepharitis, hordeolum, chalazion, uveitis, and corneal abrasion Diagnose, manage, and understand referral criteria for motor alterations, including strabismus and amblyopia Diagnose, manage, and understand referral criteria for retinal disease, including: diabetic retinopathy, macular degeneration, retinal detachment, and retinal vascular occlusion Diagnose, manage, and understand referral criteria for cataract Diagnose, manage, and understand referral criteria for glaucoma Diagnose, manage, and understand referral criteria for CNS conditions affecting the eye, including papilledema and pupillary abnormalities Diagnose, manage, and understand referral criteria for trauma of the eye Diagnose, manage, and understand referral criteria for corneal abrasions Diagnose, manage, and understand referral criteria for contact lens complications Educate patients about the prevention of eye injury Demonstrate a special understanding of the ocular disability of elderly patients and the importance of regular assessment and maintenance of functional capacity Perform and interpret tests of visual acuity, including: direct ophthalmoscopy, flourescein staining of the cornea, and tonometry Develop a supportive and compassionate approach to the care of the patient with ocular disease, especially in the case of someone with deteriorating vision Demonstrate and understanding of the ways in which independence in daily living is affected by loss of visual function Identify and describe the various support systems available to patients with ocular disease 1,2,4 2 2 2 2 PGY Level 3 3 3 3 3

Objectives

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2 1,2,4,5,6 2 3,6

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

Otolaryngology EARS Evaluate and treat hearing loss, including audiogram interpretation and utility of hearing aides Evaluate and treat otitis externa Evaluate and treat otitis media and identify indications for referral Evaluate and treat vertigo/vestibular dysfunction Evaluate and treat tinnitis Competency 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 PGY Level 3 3 3 3 3

Objectives

Objectives

Objectives

Use and interpret tympanograms Treat tympanic membrane perforation, with special emphasis on determining which form of management is appropriate, conservative or surgical Diagnose cholesteatoma Diagnose and treat cerumen impaction

1,2 1,2,4,5,6 1,2 1,2,4

2 3 3 2

NOSE

Objectives

Evaluate and treat rhinitis, including allergic and vasomotor and know when to refer Evaluate and treat epistaxix (anterior and posterior bleeds) and know when to refer Evaluate and treat sleep apnea/snoring and know when to refer Evaluate and treat sinusitis and know when to refer

1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6

3 3 3 3

THROAT Evaluate and treat hoarseness Evaluate and treat salivary gland disorders and lymphadenopathy and know the indications for referral Treat recurrent pharyngitis and tonsillitis and know the indications for referral Diagnose peritonsilar abscess/eiglotitis and know the indications for referral Conduct an ENT exam, including indirect laryngoscopy Evaluate and treat allergic disorders Evaluate head and neck trauma and ENT emergencies and know the indications for referral Diagnose head and neck cancer 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 3 3 3 3 3 3 3 3

Objectives

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6Systems-Based Practice Last reviewed 7/16/07 Sports Medicine

Family Medicine Curriculum Goals and Objectives

Competency PGY Level Be able to provide pre-participation assessment appropriate to the age of the athlete 1,2,4,5,6 Be able to care for the injured athlete 1,2,4,5,6 Be able to serve as a health advisor and motivator in the arena of physical activity for persons of all ages 2,4,5 Understand the relationship of exercise to optimal functioning of organ systems 2 Understand the impact of exercise on the well-being of the individual and the family 2 Describe the interrelationship between exercise and nutrition; exercise and fluids and electrolytes Educate patients about injury prevention, including: proper equipment, taping techniques, and environmental issues Educate patients about conditioning and training techniques Provide appropriate exercise prescription along the following dimensions: agerelated, patients with chronic illness, the physically challenged athlete, and cardiac rehabilitation Understand the special exercise considerations for the following groups: prepubescent, female, geriatric, physically challenged, recreational, professional, and athletes with chronic disease or a physiologic condition Describe the effects of exercise in pregnancy Identify community exercise programs and facilities Provide medical management of an athletic event, including: assessment and care of the acutely injured athlete, including issues around transportation Provide medical management of the acutely ill athlete Provide medical management of sports specific injuries Provide medical management regarding the use of medical equipment and supplies, including taping and strapping, immobilization techniques, and bracing techniques Describe the various uses of exercise as treatment for physical and psychologic problems Describe the various problems associated with exercise, to include: exercise addiction, steroid abuse, pressures on athletes to perform with injuries, “weekend” athletes, chemical use and exercise, eating disorders, and exercise induced asthma

Goals

2 2 3 2 2

2 1,2,4 1,2,4

2 2 2

1,2,4,6

2

Objectives

2 2 6 1,2,4,5,6 1,2,4,6 1,2,4,6

2 2 2 2 2 2

1,2,4,6 2

2 2

2

2

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Emergency Care

Family Medicine Curriculum Goals and Objectives

Competency PGY Level Be able to conduct prompt assessment and intervention in acute emergent conditions for patients of all ages Develop an appreciation of the value of rapid and simultaneous assessments in emergency services Develop an appreciation of Medicolegal issues when providing emergency services Develop and understanding of when to seek consultative services Learn to serve as a member of a team in the care of emergency patients Be able to assure that adequate attention and emotional support is given to the patient and family members Communicate effectively and compassionately with patients and families Work effectively and collaboratively with other health care professionals Demonstrate a capacity to work quickly and efficiently to assess the patient according to the urgency of the patient’s problem Demonstrate time management skills in the treatment of emergencies, including: prioritization and triage, stabilization for transport, simultaneous triage of multiple patients, and efficient resource utilization Assess and manage trauma Assess and manage neurologic emergencies Assess and manage psychiatric emergencies Assess and manage burns Assess and manage violent patients Assess and manage obstetric and gynecologic emergencies Assess and manage victims of violence Recognize, treat, and refer (when appropriate) patients with acute respiratory problems, including airway management Recognize, treat, and refer (when appropriate) patients with life-threatening arrhythmias Recognize, treat, and refer (when appropriate) patients with cardiac arrest Recognize, treat, and refer (when appropriate) patients with ischemic heart disease, including acute myocardial infarction, cardiogenic shock, and unstable angina Recognize, treat, and refer (when appropriate) patients with cardiovascular crises, including thoracic or abdominal aneurysm Recognize, treat, and refer (when appropriate) patients with acid/base imbalance Recognize, treat, and refer (when appropriate) patients with shock, including: hypovolemic, restrictive, neurogenic, cardiogenic, and septic Recognize, treat, and refer (when appropriate) patients with infectious disease emergencies, including meningitis Recognize, treat, and refer (when appropriate) patients with environmental exposures, including: bites and stings, poisonous plants, inhalations, hypersensitivity reactions/anaphylaxis Recognize, treat, and refer (when appropriate) patients with toxicologic emergencies Perform airway management, including endotracheal intubation 1,2,3,4,5,6 5,6 2,5,6 2,5,6 4,5,6 1,4,5,6 4,5 3,4,5,6 1,2,4,5,6 1 1 1 1 1 1 1 1 1

Goals

1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6 1,2,4,5,6

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

Objectives

1,2,4,5,6 1,2,4,5,6 1,2

1 1 1

Objectives

Perform initiation of vascular access, including: intraosseous infusion, central lines (<2 years, >2 years), arterial cannulation, and venous cutdown Perform artificial circulation, including: advanced cardiac life support for any age group, defibrillation/cardioversion, intracardiac injections, pericardiocentesis, emergency cardiac pacing Perform invasive assessment techniques, including: peritoneal tap and lavage, spinal tap Perform anesthesia techniques, including: regional and local blocks, intravenous sedation and analgesia Perform reduction, immobilization and traction techniques in fractures and dislocations Repair skin lacerations Treat poisoning and overdoses

Objectives

1,2

1

1,2,4,5,6 1,2 1,2 1,2,6 1,2,4 1,2,4,6 2,3,6 3,6 3,6 3,6 3,6 3,6 3,6 3,6 3,6

1 1 1 1 1 1 3 3 3 3 3 3 3 3 3

Medico/legal

Describe HIPPA and effects on medical care/systems Describe negative outcome and causation Describe negligence and standard of care Describe patient competence Describe informed consent Describe brain recoverability Describe withholding/termination of cardiopulmonary resuscitation Describe chain of evidence Describe appropriate documentation methods

Objectives

Family Medicine Curriculum Goals and Objectives
Key
1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Care of Neonates, Infants, Children, and Adolescents Develop an understanding and appreciation of the longitudinal nature of general pediatric care, including aspects of physical and emotional growth and development, health promotion/disease prevention, management of chronic and acute medical conditions, and family and environmental impact on health Be able to recognize and manage behavioral, medical, and surgical problems of neonates, infants, children, and adolescents in home, school, ambulatory, and hospital settings Competency PGY Level

Goals

1,2,3,4,5,6

3

1,2,3,4,5,6

3

Describe the anatomic and physiologic characteristics of the newborn infant and fetus Describe the effects of labor and delivery on the infant and fetus Perform a complete physical examination of the newborn infant, including neurological exam Assess 1 and 5 minute APGAR scores of the newborn infant Describe the newborn’s respiratory, cardiovascular, metabolic, and temperature adaptations to extra-uterine life Describe the special requirements of the newborn in the areas of: water, calories, electrolytes, protein, fat, and the physical environment Describe the contents of breast milk and formula in terms of calories, fluid, and electrolytes Define normal neonatal laboratory values of CBC, electrolytes, blood gases/pH, and bilirubin Describe the physical signs of gestational age Describe and assess the behaviors of the mother and infant as they relate to the maternal-infant bonding process Describe the pharmacokinetics in the newborn and its effect on commonly used drugs Describe the etiology, physical exam findings, and management of common nevi Describe the etiology, physical exam findings, and management of diaper dermatitis Describe the etiology, physical exam findings, and management of Epstein’s Pearls Describe the etiology, physical exam findings, and management of erythema toxicum Describe the etiology, physical exam findings, and management of hemangiomata Describe the etiology, physical exam findings, and management of milia Describe the etiology, physical exam findings, and management of mongolian spot Describe the etiology, physical exam findings, and management of sebaceous gland hyperplasia Describe the etiology, physical exam findings, and management of supernumery nipples

2 2 1,2 1,2 2 2 2 2 2 2 2 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1,2,4,6 Describe the etiology, physical exam findings, and management of umbilical cord 1,2,4,6 granuloma Describe the etiology, physical exam findings, and management of caput succedaneum 1,2,4,6

Describe the etiology, physical exam findings, and management of cephalohematoma Describe the etiology, physical exam findings, and management of fractured clavicle Describe the etiology, physical exam findings, and management of molding Describe the etiology, physical exam findings, and management of subconjunctival hemorrhage Develop a plan of anticipatory guidance for the newborn infant and mother which includes: feeding techniques, breast and bottle feeding, fluid and calorie requirements, bathing, umbilical cord care, circumcision care, sleep patterns, crying, vaginal bleeding, stool patterns, diapering, pacifiers and sucking, home equipment and safety, father’s role, temperament, and time for parents Describe the etiology, exam findings, and develop a management plan for cephalohematoma Describe the etiology, exam findings, and develop a management plan for clinodactyly and other minor anomalies Describe the etiology, exam findings, and develop a management plan for colic Describe the etiology, exam findings, and develop a management plan for constipation Describe the etiology, exam findings, and develop a management plan for feeding problems and regurgitation Describe the etiology, exam findings, and develop a management plan for hydrocele Describe the etiology, exam findings, and develop a management plan for natal teeth 1,2,4,6 Describe the etiology, exam findings, and develop a management plan for umbilical hernia Describe the etiology, exam findings, and develop a management plan for undescended testes Diagnose, evaluate, and manage anemia Diagnose, evaluate, and manage hyperbilirubinemia/jaundice Diagnose, evaluate, and manage hypocalcemia Diagnose, evaluate, and manage hypoglycemia Diagnose, evaluate, and manage newborn withdrawal syndrome Diagnose, evaluate, and manage neonatal seizures Diagnose, evaluate, and manage polycythemia Perform endotracheal intubation of neonates Perform lumbar puncture of neonates Perform phlebotomy of neonates Perform umbilical arterial catheterization of neonates Perform suprapubic bladder aspiration Perform umbilical veinous catheterization of neonates Develop a differential diagnosis for the infant in respiratory distress, to include: hyaline membrane disease, meconium aspiration, pneumonia, pneumothorax, sepsis, transient tachypnea of the newborn Perform cardiopulmonary resuscitation appropriate to APGAR status and clinical status, to include administration of oxygen and use of AMBU bag, entotracheal intubation Develop a management plan for normal term newborn Develop a management plan for well, small for gestational age infant Develop a management plan for well, large for gestational age infant 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1 1 1 1

1,2,3,4,5,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6

2 1 1 1 1 1 1

Objectives

1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4

1,2,3,4,5,6

1

1,2,4,5,6 1,2,3,6 1,2,3,6 1,2,3,6

1 1 1 1

Develop a management plan for well, pre-term infant, greater than 34 weeks gestational age Develop a management plan for infant of a diabetic mother Develop a management plan for infant of a mother carrying Group B strep Develop a plan for the assessment, management and referral of the infant with unexplained cyanosis Discuss the etiology, signs, and symptoms of a hypospadias and ambiguous genitalia Interpret and manage results of neonatal screening for hypothyroidism, PKU, and other conditions Describe normal and abnormal child behavior and development across the following dimensions: cognitive, language, motor, social, emotional Screen for childhood problems related to growth Screen for childhood problems related to development Screen for childhood problems related to hearing Screen for childhood problems related to vision Screen for childhood problems related to metabolic factors, including: phenylketonuria, galactosemia, hypothyroidism Screen for childhood problems related to anemia, including sickle cell and iron deficiency Screen for childhood problems related to dental Screen for childhood problems related to lead Screen for childhood problems related to glucose 6-phosphate dehydrogenase deficiency Screen for childhood problems related to communicable infectious disease Screen for childhood problems related to hypertension Resuscitate children who exhibit airway management problems, respiratory failure, shock states, and cardiopulmonary failure and arrest Develop interpersonal and communication skills that are vital to interaction with pediatric patients, families, and health care professionals Identify and treat issues of child neglect and maltreatment, including: physical abuse, sexual abuse, and emotional/nutritional neglect Perform pediatric arterial puncture Perform pediatric bladder catheterization Perform pediatric intraosseous line placement Perform pediatric lumbar puncture Perform pediatric peripheral intravenous line placement Perform pediatric suprapubic bladder aspiration Manage pediatric wounds involving incision and drainage of subcutaneous abscesses

1,2,3,6 1,2,3,6 1,2,3,6 1,2,4,6 2 1,2,4,6 2 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6 1,2,4,5,6 4,5,6 1,2,4,5,6 1,2 1,2 1,2 1,2 1,2 1,2

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 2 2 2

Objectives

1,2,4, 1,2,4, Manage pediatric wounds involving nail trephination 1,2,4, Manage pediatric wounds involving suturing of lacerations Conduct initial evaluations and stabilize isolated minor orthopedic problems, including the splinting of nondisplaced fractures and the reduction of certain extremity dislocations 1,2,4, 1,2,4,6 Evaluate and mange pediatric ingestions of toxic substances Perform initial evaluation of new admissions and transfers to the in-patient service and develop an assessment and plan which includes in-patient care and post-hospitalization 1,2,3,4,5,6 care Manage well-children to include monitoring normal growth and development, including: neurodevelopmental exam, speech and hearing assessment, psychoeducational 1,2,3,4,6 assessment, and assessing other developmental disabilities

2 2

2

2

Manage well-children to include administration of routine immunizations Manage well-children to include routine screening procedures Manage well-children to include anticipatory guidance Diagnose and manage upper respiratory infections, including pharyngitis and otitis media Diagnose and manage gastrointestinal problems, including diarrhea and vomiting Diagnose and manage common skin problems, including eczema and impetigo Diagnose and manage common behavioral problems, including enuresis and ADHD Take a detailed psychosocial history from a teen patient Conduct a physical exam of external genitalia of a male teen patient Conduct a physical exam of external genitalia of a female teen patient Conduct a pelvic exam of a teen patient Screen teen patients for substance abuse and related problems Conduct a sports physical examination Provide education to adolescents and their families regarding sexuality Provide education to adolescents and their families regarding reproductive health Provide education to adolescents and their families regarding normal adolescent development Provide education to adolescents and their families regarding safe driving Provide education to adolescents and their families regarding substance abuse Provide education to adolescents and their families regarding violence in the home and community Recognize, evaluate, and treat disordered eating, including obesity, and refer (as needed)

1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,4,5 1,4,5 1,4,5 1,4,5 1,4,5 1,2,4,6 1,2,4,5 1,2,4,5 1,2,4,5 1,2,4,5 1,2,4,5 1,2,4,5 1,2,4,5,6

2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6Systems-Based Practice Last reviewed 7/16/07 Community Medicine Be able to assess and understand the important health needs of a community Develop sensitivity to the sociocultural differences in practice populations Develop an understanding of the availability and scope of community health resources for patients and their families Develop an understanding of the various issues in occupational medicine, including disability assessment, employee health, and job-related injury and illness Be able to apply principles of health promotion and disease prevention to individuals and communities

Family Medicine Curriculum Goals and Objectives

Competency 2,3,6 4,5 1,2,3,4,5,6

PGY Level 3 2 3

Goals

1,2,6 1,2,3,4,5,6

3 3

Objectives

Develop a description of a community, including: population demographics, economic features, physical characteristics, available health and medical services/resources, community health statistics Be able to assign priority ranks to community health problems according to: magnitude of the problem, seriousness of the consequences, feasibility of correcting the problems Develop a community health plan Conduct a pre-employment history and physical of a patient, with an emphasis on job specific issues of health, safety, and productivity Conduct a complete job-specific physical examination including, if appropriate, mechanics and interpretation of basic pulmonary function testing Conduct a complete job-specific physical examination including, if appropriate, mechanics and interpretation of basic ECGs Conduct a complete job-specific physical examination including, if appropriate, mechanics and interpretation of routine x-rays Conduct a complete job-specific physical examination including, if appropriate, mechanics and interpretation of routine audiometric and visual tests Conduct a complete job-specific physical examination including, if appropriate, appropriate allergy testing techniques Diagnose general occupational-related lung disease, including reaction to irritants and immune mediated reactions Diagnose general occupational-related renal disease Diagnose general occupational-related skin disease, including: primary irritant dermatitis, allergic sensitizers, and photosensitizers Diagnose general occupational-related liver disease Diagnose general occupational-related carcinogens and mutagens Diagnose general occupational-related hemopoietic illness Diagnose general occupational-related CNS related illness Diagnose general occupational-related reproductive and genetic concepts Diagnose general occupational-related trauma, acute and repetitive Diagnose general occupational-related burns Diagnose general occupational-related stress

2,3,6

1

2,3,6 2,3,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6 1,2,3,4,6

2 3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

Objectives

Identify specific occupational-related pulmonary disease, including pneumoconioses Identify specific occupational-related dermatoses Identify specific occupational-related noise exposure Identify specific occupational-related musculoskeletal problems, including: postural, positional, and other orthopedic problems Identify specific occupational-related radiation exposure Identify specific occupational-related heavy metal poisoning Identify specific occupational-related solvent and noxious gas exposure Identify specific occupational-related vibration injuries Identify specific occupational-related eye injuries Identify specific occupational-related pesticide and herbicide exposure Identify specific occupational-related heat and cold stress Identify specific occupational-related barotrauma 1,2,4,6 Identify and manage stress in the workplace Identify and manage substance abuse in the workplace, including alcoholism and 1,2,4,6 drugs 1,2,4,6 Identify and manage mental illness in the workplace Identify and describe medico-legal issues related to OSHA Identify and describe medico-legal issues related to NIOSH Identify and describe medico-legal issues related to worker’s compensation Identify and describe medico-legal issues related to disability Implement appropriate preventive techniques to include immunizations Implement appropriate preventive techniques to include medications, e.g. fluoride, calcium, aspirin, prophylactic antibiotics, prenatal vitamins, etc. Implement appropriate preventive techniques to include social supports, e.g. family education and community resources Implement appropriate preventive techniques to include adherence/compliance factors, e.g. recall systems, longitudinal plans, and patient education Identify institutional resources for preventive services (environmental and health) 3,6 1,2,4,6 1,2,4,6 1,2,4,6

2 2 2 2 2 2 2 2 2 2 2 2

2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 2 2 2

6 6 6 6

1,2,4,6

2 1

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6Systems-Based Practice Last reviewed 7/16/07 Care of the Older Patient

Family Medicine Curriculum Goals and Objectives

Competency Develop a philosophy of continuing care that recognizes the impact of lifestyle and health care patterns on health in later years 1,2,3,6 Be able to communicate with patients about changes they will experience as they age 2,4,5 Help elderly persons function independently with self-respect and dignity through self-care and self-determination 1,2,3,4,5,6 Understand the psychosocial, economic, spritual, and ethical factors that affect the aging patient and the patient's family, particularly issues with care of the dying Incorporate a basic working knowledge of aging physiology and pharmacology to evaluate and manage syndromes or diseases unique to or more common in older persons Be able to take a sensitive and focused history and physical examination in older patients, and learn how to use the observations of patients' families and significant others in patient care and management Be able to work collaboratively with an interdisciplinary health care team Understand medico-legal issues as they apply to the elderly Understand one's own attitudes to aging, disability, and death Incorporate components of comprehensive geriatric assessment into the evaluation and care of an elderly patient Be able to differentiate changes due to normal aging from changes due to illness

PGY Level 2 2 2

2,6

2

Goals

1,2,3,6

2

1,2,4,5 3,4,5,6 2,6 3,5 1,2,6 1,2

2 2 2 2 2 2

Describe normal physiologic aging in regard to cardiovascular system Describe normal physiologic aging in regard to cognitive changes Describe normal physiologic aging in regard to hematologic system Describe normal physiologic aging in regard to immunology Describe normal physiologic aging in regard to metabolic changes, including changes in weight Describe normal physiologic aging in regard to musculoskeletal changes Describe normal physiologic aging in regard to neurologic changes Describe normal physiologic aging in regard to pulmonary system Describe normal physiologic aging in regard to sleep patterns Describe normal physiologic aging in regard to urogenital function Describe normal psychological, social, and environmental changes of aging, including: reactions to common stresses and changes (retirement), bereavement, relocation and ill health, physical living arrangements, increased risk of iatrogenic illness, changes in family relationships that affect health care of the elderly Describe the impact of immobilization and its consequences on the health care of the elderly Describe the impact of dependency or long-term institutionalization on the health care of the elderly Describe the impact of access to health care on the health care of the elderly

2 2 2 2 2 2 2 2 2 2

2 2 2 2 2 2 2 2 2 2

2 2 2 2,6

2 2 2 2

Describe the unique modes of presentation of elderly patients for care, including: altered and nonspecific presentation of specific diseases, e.g. dementia, instability and falls, incontinence, and delirium Perform a comprehensive functional status examination of the elderly patient, including being able to utilize selected instruments that assess activities of daily living (ADL), independent activities of daily living (IADL), cognition, affect, and gait Perform a comprehensive physical examination in the office, hospital, and nursing home settings, mindful of the patient’s modesty and mobility while balancing the need for full examination Obtain a patient history from other caregivers Describe issues pertinent to health maintenance and screening of the elderly Develop health maintenance plans for elderly patients Recognize and describe the altered presentations of the acute abdomen Recognize and describe the altered presentations of adverse drug reactions and drug intoxication Recognize and describe the altered presentations of carcinomas Recognize and describe the altered presentations of congestive heart failure Recognize and describe the altered presentations of hypo and hyperthyroidism Recognize and describe the altered presentations of infections such as pneumonia, urinary tract infections, and sepsis Recognize and describe the altered presentations of myocardial infarction Recognize and describe the altered presentations of pulmonary embolus Perform appropriate screening for hearing impairment, incorporate this into their routine care of older patients, and be able to work with other health care professionals to develop a treatment plan for the following hearing and speech deficiencies in the elderly patient: aphasia, noise-induced loss, ostosclerosis, presbycusis Perform appropriate screening for visual impairment, incorporate this into their routine care of the elderly patient, and be able to work with other health care professionals to develop a treatment plan for the following ophthalmologic problems of the elderly patient: blepharitis, cataracts, glaucoma, senile macular degeneration, sicca syndrome Describe the natural history, differential diagnosis, and treatment of alcoholism and problem drinking in the elderly Describe the natural history, differential diagnosis, and treatment of anxiety in the elderly Describe the natural history, differential diagnosis, and treatment of depression in the elderly Describe the natural history, differential diagnosis, and treatment of grief reaction in the elderly Describe the natural history, differential diagnosis, and treatment of life cycle transitions in the elderly Describe the natural history, differential diagnosis, and treatment of paranoia in the elderly Recognize and manage caregiver stress Describe the natural history, differential diagnosis, and derive a management plan for atrial fibrillation in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for B12 deficiency in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for dementia, especially Alzheimer’s dementia Describe the natural history, differential diagnosis, and derive a management plan for delirium in the elderly patient

2

2

1,2,4,5,6

2

1,2,4,5,6 1,2,4,5 2,3,6 1,2,3,6 1,2 1,2 1,2 1,2 1,2 1,2 1,2 1,2

2 2 2 2 2 2 2 2 2 2 2 2

1,2,3,4,5,6

2

1,2,3,4,5,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 2,4,5,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6

2 2 2 2 2 2 2 2 2 2 2 2

Objectives

Describe the natural history, differential diagnosis, and derive a management plan for falls of the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for gait impairment of the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for Parkinson’s disease in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for osteoporosis in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for osteomalacia in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for basal cell and squamous cell carcinomas in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for osteoarthritis in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for polymyalgia rheumatica and temporal arteritis in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for herpes zoster in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for fecal impaction and constipation in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for arterial and venous stasis and ulcers in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for pressure ulcers in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for cerebrovascular insufficiency and stroke in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for hyperosmolar coma in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for prostate carcinoma, breast carcinoma, and colon carcinoma in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for urinary incontinence and retention, including indications for and management of catheterization in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for atrophic vaginitis in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for vulvar dystrophy in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for malnutrition and failure to thrive in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for common oral and dental problems in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for benign prostatic hypertrophy in the elderly patient Describe the natural history, differential diagnosis, and derive a management plan for common soft tissue syndromes leading to functional impairment, including shoulder syndromes and greater trochanteric bursitis in the elderly patient

1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6

2 2 2 2 2 2 2 2 2 2 2 2 2 2

Objectives

1,2,3,6

2

1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6

2 2 2 2 2 2

1,2,3,6 Describe the natural history, differential diagnosis, and derive a management plan 1,2,3,6 for common foot problems in the elderly Discuss the principles of drug therapy in the elderly as they relate to drug 1,2,3,6 interaction/ iatrogenesis Discuss the principles of drug therapy in the elderly as they relate to altered 1,2,3,6 pharmacodynamics and pharmacokinetics

2 2 2 2

Discuss the principles of drug therapy in the elderly as they relate to adherence/compliance Discuss the principles of drug therapy in the elderly as they relate to frequently misused medications Discuss the principles of drug therapy in the elderly as they relate to dangers of polypharmacy Explain the unique nutritional requirements of the elderly patient with regard to the following: calcium/vitamin D, protein/calorie malnutrition, special needs Discuss the risks and benefits of restraint use in the elderly including institutional policies Discuss the management strategies to avoid restraint use Identify the range of services available to promote rehabilitation or maintenance of an independent lifestyle for elderly people Identify the various types of long-term care facilities and alternative housings available to the elderly and the benefits and drawbacks to each Identify the different roles and responsibilities of the members of an interdisciplinary team, including: visiting nurse, geriatric nurse practitioner, nursing home professionals, occupational therapists, and physical therapists Describe the various healthcare payment systems as they apply to the elderly and the ways they influence health care patterns and decisions, including: Medicare, Medicaid, managed care programs, private health insurance (including long-term care insurance) Define and identify the purpose of advanced directives Communicate effectively with patients and their families about end-of-life issues Distinguish between “durable power of attorney” and “guardianship” and understand how they direct care for the elderly Distinguish between “do not resuscitate” orders and limitation of care Distinguish between “competence” and “decision- making capacity” Assess the decision-making capacity of an elderly patient Discuss the relationship between the structure and process of care in in-patient and outpatient settings in the delivery of appropriate care to elderly patients

1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6 1,2,3,6

2 2 2 2 2 2 2 2

1,2,3,6

2

1,2,3,6 1,2,3,6 3,4,5,6 2,6 2,6 2,6 1,2,4 1,2,3,6

2 2 2 2 2 2 2 2

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6Systems-Based Practice Last reviewed 7/16/07 Care of Skin and Associated Organs

Family Medicine Curriculum Goals and Objectives

Competency PGY Level Become proficient in the prevention, diagnosis, and treatment of patients with dermatologic problems Develop an understanding of the impact of skin problems on the patient and family Develop an understanding of when it is approriate to seek consultation from a dermatologist Be able to actively engage in the co-management of a paitent with a dermatologist 1,2,3,4,5,6 1,2,5 1,2,3,6 1,2,3,4,5,6 3 3 2 2

Goals

Objectives

Describe normal anatomy, development, and physiology of the skin Describe risk factors for developing skin diseases/ conditions , including: congenital, acquired, and aging Educate patients about prevention strategies for skin cancer Demonstrate an understanding of the implications of dermatologic diseases on the family Diagnose, treat, and manage eczema and dermatitis Diagnose, treat, and manage benign and malignant neoplasms of the skin Diagnose, treat, and manage stasis dermatitis and ulcers Diagnose, treat, and manage infections of the skin, including: bacterial, fungal, and viral Diagnose, treat, and manage pediatric rashes Diagnose, treat, and manage papulosquamous eruptions Diagnose, treat, and manage localized or generalized pruritis Diagnose, treat, and manage acne Diagnose, treat, and manage urticaria Diagnose, treat, and manage cutaneous manifestations of systemic diseases Diagnose, treat, and manage psoriasis Diagnose, treat, and manage hair and nail problems Identify connective tissue disease Identify vesiculobullous disease Identify pigment disorders Identify, utilize, and interpret appropriate diagnostic techniques, including: biopsy, culture, and scraping Perform cauterization of skin lesions, including: acid cautery, electrocautery, and electrodesiccation and curettage Perform cryosurgery Perform punch/shave biopsy Perform excision of skin lesions Perform intralesional injection of corticosteroids Perform incision and drainages Perform treatment of ingrown toenails Perform unna boot application

2 2 1,2,4 2,5,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2,4,6 1,2 1,2 1,2 1,2 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4 1,2,4

2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4-Interpersonal and Communication Skills, 5-Professionalism, 6Systems-Based Practice Last reviewed 7/16/07 Diagnostic Imaging and Nuclear Medicine

Family Medicine Curriculum Goals and Objectives

Competency Obtain the knowledge necessary to order appopriate radiological or nuclear medicine tests for family medicine or emergency medicine patients Develop the skills necessary to provide an initial assessment of commonly used radiologic examinations Learn how to consult radiologists for appropriate tests Give preliminary reading on chest x-rays Give preliminary reading on KUB Give preliminary reading on abdominal films: flat, upright, decubitus Give preliminary reading on films of ribs and long bones Give preliminary reading on vertebral column Identify the principles, indications and findings for MRI studies Identify the principles, indications and findings for CT scans Identify the principles, indications and findings for lung scans Identify the principles, indications and findings for bone scans Identify the principles, indications and findings for thyroid scans Identify the principles, indications and findings for ultrasound of the abdomen, pelvis, pregnant woman and fetus Identify the principles, indications and findings for mammography Identify and describe the therapies used in interventional radiology

PGY Level 1 2 1 1 1 1 1 1 1 2 1 1 2 2 1 2 3

Goals

2,3,4,6

5,6 2,3 2,3 2,3 2,3 2,3 2,3 2,3 2,3 2,3 2,3 2,3 2,3 2,3

Objectives

Family Medicine Curriculum Goals and Objectives
Key
1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Research and Scholarly Activities Competency Understand the fundamental principles of evidence -based family medicine to include: assessing study outcomes; assessing medical information; research design/epidemiological concepts; assessing articles dealing with diagnosis, treatment, and prognosis; and decision analysis Be able to utilize various strategies for gathering medical information 2,3,6 Have the opportunity to participate in research or other scholarly activities 2,6 Define and apply the components of the “usefulness equation,” including information validity, relevance, and work Define and distinguish between POEMs and DOEs Frame evidence-based questions, to include: population, intervention, and expected outcome Describe the following research study designs in terms of their strengths and limitation: case-control, cohort, and randomized clinical trial Define and give an example of the following: a-priori hypothesis, regression to the mean, age/period/cohort effects, and “N of 1” studies Describe a research study in terms of the following dimensions: objective, time frame, and investigator’s action Describe and calculate (where appropriate) the following concepts related to diagnosis and use them to assess the medical literature: sensitivity, specificity, prevalence, positive predictive value, negative predictive value, likelihood ratios, pre-test probability, and posttest probability Describe and calculate (where appropriate) the following concepts related to treatment and use them to assess the medical literature: p-values, significance, power, Type I error, Type II error, relative risk reduction, absolute risk reduction, number needed to treat, bias, and confounding variables Assess the validity of prognosis articles from the medical literature based on: assembly of an “inception cohort,” adequacy of the inclusion criteria, allocation concealment, adequacy of subject follow-up, and outcomes for blinding and objectivity Define the following components of decision analysis: DA strategy, DA utilities, sensitivity analysis, quality-adjusted life years, and Markov Process (application?) Define and distinguish between the information gathering modes of: hunting, foraging, retracing, sporting Demonstrate ability to use the following sources to locate medical information: e-mail, listservs, discussion groups, internet/WWW, CD-ROM databases, and on line/CD-ROM textbooks Conduct a “hunting” specific search {Optional} Conduct a research project as part of a resident research program {Optional} Write a review article for the Journal of Family Practice POEMs section Create a CARE path for the Department of Family Medicine to include: identifying the problem that is commonly encountered by family medicine physicians but is controversial in terms of diagnosis, treatment or both; conducting a comprehensive literature search on the topic; developing an analysis of how to manage the health problem; conducting a baseline chart review within the Department of FM; presenting the CARE path to the Department of FM faculty, staff, and residents; conducting a post implementation chart review 6-12 months post implementation PGY Level

Goals

2

2 3 3

2,6 2,6 2,6 2,6 2,6 2,6

2 2 2 2 2 2

2,6

2

Objectives

2,6

2

2,6 2,6 2,6

2 2 2

2,6 1,2,3,6 2,6 2,6

2 2 3 3

2,3,4,6

2,3

Key

1-Patient Care, 2-Medical Knowledge, 3-Practice-Based Learning and Improvement, 4Interpersonal and Communication Skills, 5-Professionalism, 6-Systems-Based Practice Last reviewed 7/16/07 Practice Management

Family Medicine Curriculum Goals and Objectives

Understand the current available practice settings Be able to adapt to different health care environments through a knowledge of practice management issues Understand external regulatory agencies and accreditation requirements, including: state, DEA, hospital, Medicare, Medicaid, and others Understand practice elements that include: organization, administration, communication, and marketing Enable residents to make informed personal choices about their careers Help guide residents through their job search process Help residents to understand their ethical responsibility to advocate for the highest standards in the delivery of patient care Identify personal and professional goals Identify and effectively utilize various resources for job opportunities Prepare a curriculum vita Assess various practice opportunities according to: location/community; mode of practice; practice configuration; parameters of employment/ contracts, including: compensation and benefits, workload and performance expectations, professional liability coverage, legal provisions, etc. Describe practice facilities according to location, design, financing, rent/lease/own, laboratories and government regulations, radiology and ultrasonography, special officebased procedures Describe office organization according to the following: chain of command, schedules, number and type of support staff, computer systems, supply and inventory management

Competency 2,6 1,2,3,6 2,6 3,6 3,5,6 4,5,6 3,5,6 5 5 5

PGY Level 3 3 3 3 3 3 3 3 3 3

Goals

6

3

6

3

6 Describe practice operations according to: patient flow and scheduling, medical records and chart organization, written office policies and procedures, front desk duties, insurance and other third-party billing, management of pharmaceutical representatives and samples, management of phone calls, telephone and paging systems, chart and filling options, retention of records, consultation referrals, management of patient education, clinical 3,6 tracking systems Identify the following office and business monitoring procedures: financial reports, cash flow and controls, lines of credit, accounting systems, billing and collection policies, accounts receivable, financing and capital, overhead management Describe the various common health plans, including, but not limited to Medicare and Medicaid Describe the basic principles of personal financial planning, including: budgeting, debt, and retirement Describe staff and personnel policies, including: employee relations (salaries and benefits, motivation, recruitment and retention, terminations, evaluation, accountability, job descriptions), labor laws, personnel records Describe basic medico-legal issues around the following: informed consent, patient confidentiality, liability, negligence, duty to exercise care, standards of care, failure to diagnose or treat, statute of limitations, statutory immunity, and the doctor/patient relationship Describe professional liability insurance, to include: policy types, policy limits, obligations, types of insurance providers, abandonment 3,6 Identify the components of a complete and thorough medical record

3

Objectives

3

6 6 6

3 3 3

6

3

6 6

3 3 3


								
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