Narrative - V.A.3.a

 

Sinai-Grace Hospital

Detroit Medical Center/Wayne State University2

 

Competency Based Promotional Criteria

 

PGY-1 RESIDENT

Patient Care

Gathers essential/accurate information via interviews and physical exams and reviews.

Monitors and follows up patients appropriately

Capable of recognizing medical emergencies and initiating management.

Prioritizes a patient's problems

Prioritizes a day of work

Knows indications, contraindications, & risks of some invasive procedures

Competently performs some invasive procedures.

Provides services aimed at preventing or maintaining health in ambulatory practice

Works with all health care professionals to provide patient-focused care.

Asks for help when needed

 

Medical Knowledge

Demonstrates knowledge of basic and clinical sciences.

Applies knowledge for clinical decision making and determining therapy.

Understands patho-physiology of disease 

Uses written and electronic reference and literature sources to learn about patients' diseases

Understands his or her limitations of knowledge and clarifies information with senior residents.

 

Practice Based Learning

Has an understanding of basic clinical epidemiology and study design.

Has a basic understanding of the use of statistics in medicine.

Is motivated to acquire knowledge by self directed problem based learning.

Uses PUBMED, Ovid and other computerized sources of results and information to enhance patient care

Accepts feedback and develops self-improvement plans.

 

Interpersonal and Communication Skills

Demonstrates caring and respectful behaviors with patients and families.

Writes pertinent and organized notes

Has timely and legible medical records

Uses effective listening, narrative and non-verbal skills to elicit and provide information.

Works effectively as a member  of the health care team.

 

 

 

Professionalism

Establishes trust with patients and staff

Is honest, reliable, cooperative and accepts responsibility

Shows regard for opinions and skills of colleagues

Is free from substance abuse or satisfactorily undergoing rehabilitation

Demonstrates respect, compassion and integrity.

Is responsive to the needs of patients and society, which supercede self-interest.

 

Systems-Based Practice

Understands the need for managing cost and judicious use of resources.

Has a basic understanding of how medical care is funded in the United States.

Is a patient advocate

Has constructive skepticism

Advocates for high quality patient care and assists patients in dealing with system complexity.

Makes a effort to avoid prescribing and other medical errors.

Practices within institutional policies and guidelines to ensure safe and effective patients care.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PGY-2 RESIDENT

 

In addition to the knowledge and skills of an R1, the expectations from a R2 resident includes:

 

Patient Care

Capable of reviewing history and physical examination findings of R1’s and students and elicit subtle clinical findings.

Understands and weighs alternatives for diagnosis and treatment

Capable of independently managing most common diseases admitted to the medicine service.

Capable of managing most medical emergencies effectively.

Uses diagnostic procedures and therapies appropriately

Interprets results of procedures properly

Is able to manage multiple problems at once

Makes informed decisions about diagnosis and therapy after analyzing clinical data.

Develops and carries out management plans.

Considers patient preferences when making medical decisions.

Triages patients to appropriate location

Capable of training and supervising R1’s and students on common procedures on medical service.

 

Medical Knowledge

Demonstrate a greater depth of knowledge of most medical conditions admitted to the medical service. Familiar with unusual presentation of common conditions and  other rare conditions that should be considered in the differential diagnosis.

Is aware of indications, contraindications and risks of commonly used medications and procedures

Demonstrates knowledge of epidemiologic and social-behavioral sciences.

Applies the basic, clinical, epidemiologic and social behavioral science knowledge to the care of the patient

 

Practice Based Learning

Undertakes self-evaluation with insight and initiative.

Capable of identifying gaps in knowledge and using information resources to find the most current answers to such questions.

Meets current guidelines of professional societies in caring for conditions where widely accepted guidelines are available.

Facilitates the learning of students and other health care professionals.

Identifies opportunities to demonstrate clinical pearls on rounds and assigns topics to trainees to review using concepts of evidence based medicine.

Capable of reviewing journal articles and presenting critique at journal club.

 

 

 

 

Interpersonal and Communication Skills

Works effectively as a member or leader of the health care team.

Creates and sustains therapeutic and ethically sound relationships with patients and families.

Provides education and counseling to patients, families and colleagues.

Is able to discuss end of life care with patient/families.

Responsive to needs of nurses, pharmacist and other health care providers.

 

Professionalism

Displays initiative and leadership

Is able to delegate responsibility to others

Demonstrates commitment to on-going professional development.

Demonstrates commitment to ethical principles pertaining to the provision or withholding of care, patient   confidentiality, informed consent and business practices.

Demonstrates sensitivity to patient culture, gender, age, preferences and disabilities.

 

Systems-Based Practice

Advocates for high quality patient care and assists patients in dealing with system complexity.

Applies knowledge of how to partner with health care providers to assess, coordinate and improve patient care

Uses systematic approaches to reduce errors.

Participates in developing ways to improve systems of practice and health management.

Acknowledges errors and works to minimize them.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PGY-3 RESIDENT

 

In addition to the knowledge and skills of an R1 and R2, expectations of a R3 resident includes:

 

Patient Care

Reasons well in ambiguous situations

Spends time appropriate to the complexity of the problem

Capable of evaluation and triage of multiple complex patients

Is effective as a consultant

Capable of assisting R1 and R2s in more technically difficult procedures

 

Medical Knowledge

Has developed a knowledge base in internal medicine adequate to pass the ABIM certifying examination.

Demonstrate greater confidence and precision in developing differential diagnoses to reflect increased clinical experience.

Demonstrates an investigatory and analytic approach to clinical situations

More active in teaching and promoting the academic mission of the department.

 

 

Interpersonal and Communication Skills

Works effectively as a leader of the health care team.

More effective in conflict resolution.

Is perceived as a role-model for junior house-staff.

Available to mentor and help junior house-staff.

 

Professionalism

More active as a representative of the department of medicine.

More involved in volunteering and community service.

Advocates for change and reform as an internist to improve patient care.

Recognized as a committed physician who is dependable.

 

Systems-Based Practice

Demonstrates ability to adapt to change 

Provides cost effective care

Understands how individual practices affect other health care professionals, organizations and society.

Demonstrates knowledge of types of medical practice and delivery systems.

Practices effective allocation of health care resources that does not compromise the quality of care.

 

 

Practice Based Learning

Analyzes personal practice patterns systematically, and looks to improve.

Compares personal practice patterns to larger populations.

Locates, appraises and assimilates scientific literature appropriate to specialty.

Applies knowledge of study design and statistics.

Capable of mentoring R1 and R2 residents in research projects and developing presentations.

Active in developing scholarly projects.