Competency III - Using Science to Guide Diagnosis, Management, Therapeutics, and Prevention

Definitions / Levels of achievement / Assessment criteria

I. Definitions

• The competent graduate knows and can explain the scientific underpinnings, at the molecular, cellular, organ, whole body, and environmental levels for states of health and disease based upon current understanding and cutting-edge advances in contemporary basic science.

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• This information is used to diagnose, manage, and prevent the common health problems of individuals, families, and communities by collaborating with them.

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• Graduates develop problem lists and differential diagnoses, carry out additional investigations, implement interventions with consultation and referral as needed, determine outcome goals, recognize and utilize prevention opportunities, monitor progress, share information and educate, and adjust therapy and diagnosis according to results.

II. Levels of Achievement

A. Level One

This level of competence is expected of students before entering their clinical clerkships.

• Students demonstrate their knowledge of the relevant basic sciences through basic science course written examinations and by passing the USMLE Step 1.

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• Students will meet the Criteria for Assessment for diagnosis, management, and prevention of the most prominent and common conditions in situations that require more general knowledge rather than specific medical expertise (Ex: discussing prevention of sexually-transmitted diseases with a group of adolescents).

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• Students can identify general not specific approaches to management, and generally would not be expected to actually carry them out in real settings.

B. Level Two

This is the minimum level of achievement for graduating medical students.

• Students display their scientific knowledge of the relevant clinical sciences through clerkship examinations and by passing USMLE Step 2.

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• Students show a thorough understanding of health problems in real clinical contexts where specific medical expertise is needed.

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• They will determine and present diagnosis, management, and therapeutic plans encompassing the health problem in its entirety: its origin, points of pathogenesis, specific threats and consequences at the molecular, cellular, and physiologic levels.

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  Students can interpret standard diagnostic studies and history and physical examination (H&PE) data to decide the most likely diagnoses when faced with forthright presentations of common problems in major disciplines.

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• Students can carry out diagnostic and therapeutic management plans in relatively uncomplicated situations. They can evaluate the efficacy of chosen interventions in achieving therapeutic goals, recognizing when therapies need to be reevaluated.

C. Level Three

Students who have received additional specific training at an advanced level through elective experiences attain this level of achievement.

• Students are attuned to subtle cues and nuances and can ably treat situations that are less common, and more complex.
• They integrate their approach to the care of individuals in the context of their families and communities, taking advantage of opportunities for prevention and education, as well as the immediate physical cure.
• Students can explain a multi-system health problem via pathogenesis, mechanisms of intersystem exchanges and their complications; they can then present therapeutic goals and interventions to counteract the multiple pathophysiological forces in motion.
• They are able to teach others how to use science to guide diagnosis, management, and prevention.

II. Assessment Criteria

A. Explains the differences between good health and states of ill health, applying the anatomical, biochemical, microbiologic, and pathophysiologic bases for these states at the molecular, cellular, organ, whole body, and environmental levels.

 

B. Uses data from H&PEs and lab tests to formulate appropriate problem lists, and differential diagnoses.

 

C. Proposes a general approach to further data gathering and specific diagnostic steps.

 

D. Proposes a general therapeutic approach to a given disease or problem.

 

E. Integrates preventive interventions into the comprehensive health care of individuals.

 

F. Recognizes when particular situations may require use of special diagnostic skills, attitudes, and goals.

 

G. Elucidates the limits of the scientific underpinnings guiding diagnosis, management, and prevention.

 

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