Unified Competency Objectives

In April 2005, EVMS adopted a revised set of "Unified Competency Objectives" to be attained by all M.D. students.

The civic and medical leaders who founded the Eastern Virginia Medical School envisioned an institution that would champion improving the health of the region. Decades later, the school celebrates its record of training physicians who are committed to knowledge and skill, and doubly committed to the service of others.

Distinctive characteristics of the institution have evolved over its lifetime:

• Education is central to its mission, not peripheral to the research and clinical enterprises.
• Principles of humanism in medicine and the biopsychosocial model of disease and health are emphasized, promoting the values of altruism and duty.
• An ethic of community service moves students beyond formalized educational settings.
• The learning atmosphere emphasizes cooperation among students, faculty, other health-care professionals, local and international care providers, and policy makers.
• Life-long learning and the practice of evidence-based medicine are accepted as professional responsibilities.
• The environment promotes collaboration, creativity, leadership, and service.

Within the context of this institutional philosophy and culture, the faculty have articulated the following Unified Competency Objectives as the goals and objectives of the curriculum.

1. The Foundations of Medicine
   1. Demonstrate an understanding of the basic science foundations of medical practice.
   2. Demonstrate facility with common medical terminology.
   3. Recognize the etiologies, pathogeneses, and clinical manifestations of diseases.
   4. Recognize pathophysiologic and behavioral precursors of health and illness.
   5. Demonstrate a basic understanding of how basic science and clinical research studies are designed, implemented, and evaluated.
   6. Recognize potential biases in clinical trials.
   7. Explain recent research findings appropriately to patients.
       
2. Overall Clinical Effectiveness
   8. Demonstrate appropriate clinical skills.
   9. Perform specified common procedures.
   10. In caring for patients, demonstrate ethical responsibility, moral integrity, caring, and compassion.
   11. Use information systems to optimize care delivery and improve outcomes.
   12. Provide appropriate care for chronically ill patients.
   13. Provide appropriate care for terminally ill patients.
   14. Recognize when a patient is in a specific at-risk group and provide appropriate treatment and preventive measures.
   15. Provide continuity of care to patients appropriate to the context.
   16. Recognize how one’s personal beliefs and feelings affect relationships with patients.
   17. Recognize and understand different cultural backgrounds and belief systems presented by patients and understand how these differences affect clinical care.
   18. Demonstrate an understanding of patients’ rights, including autonomy, privacy, and informed consent.
   19. Recognize one’s own limitations in knowledge and skills, and demonstrate a willingness to seek assistance when needed.
   20. Recognize one’s own risk factors for potential impairment.
   21. Show enthusiasm for patient care.
   22. Function effectively as a member of the health-care team, respecting the roles and skills of other team members, communicating appropriately, and working effectively within the team.
   23. Demonstrate a work ethic appropriate to the demands of the medical profession.
   24. Demonstrate a commitment to life-long learning — continually enhancing the knowledge, skills, and attitudes that contribute to professional effectiveness.
   25. Demonstrate a knowledge of patient safety issues and measures for preventing errors that may harm patients.
        
3. Gathering Information
   26. Conduct a medical interview with comprehensiveness appropriate to the patient’s presentation and the clinical setting.
   27. Use a patient-centered approach to elicit information from patients and family members.
   28. Perform a physical examination with comprehensiveness appropriate to the patient’s presentation and the clinical setting.
   29. Appropriately request and interpret common diagnostic entities (e.g., laboratory evaluations, imaging studies, and consultations), identifying their indications, contraindications, predictive values, and costs.
        
4. Communication Skills
   30. Develop rapport and a positive therapeutic relationship with patients, demonstrating appropriate sensitivity, empathy, and respect.
   31. Discuss medical information in language appropriate to the patient/family.
   32. Respond appropriately to emotional factors that can affect (a) patients' seeking of medical care, (b) the exacerbation or relief of medical disorders, and (c) treatment effectiveness.
   33. Provide information, including the availability of outside resources, to patients and families in a way that is appropriate to their educational and cultural backgrounds.
   34. Present to other health-care providers a concise, orderly, and coherent oral communication of the patient’s unique clinical presentation in a manner appropriate to the clinical context.
   35. Record a concise, orderly, and coherent written communication of the patient’s unique clinical presentation appropriate to the discipline.
        
5. Management and Decision-Making
   36. Demonstrate a rational, evidence-based, and cost-effective approach to clinical problems, which attends to patient values, family function, cultural background, and resources available to the patient.
   37. Develop an initial diagnostic and therapeutic plan for common presentations, using information from patients, prior health information, family members, health-care team members, and laboratory evaluations.
   38. Identify indications, contraindications, costs, and appropriate applications of biomedical, psychosocial, and combined therapies.
   39. For a given patient, use evidence-based medicine principles to select the best diagnostic and therapeutic plans.
   40. Compare available diagnostic and treatment modalities based on their demonstrated effectiveness with similar patients and problems (evidence-based medicine).
   41. Use appropriate strategies, including negotiation, in the discussion with the patient of diagnosis and management issues.
   42. Identify and recruit family or community resources and/or services of other members of the health care team for optimal patient care.
        
6. Prevention
   43. Assess a patient’s risk and resilience factors for illness.
   44. Develop a health promotion/disease prevention plan for a patient based on age, health status, willingness to pursue preventive strategies, and resources.
        
7. Health Care Environment
   45. Discuss the political and economic context of health care, including the potential effects of access, delivery, and reimbursement mechanisms on patient outcomes.
   46. Recognize the bases for disparities in health-care resource allocations and outcomes.
   47. Discuss the impact of public health issues (at the local, regional, national, and international levels) on the provision of health care.
   48. Identify health care needs that can be addressed by participating in community service activities.

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