University of Alabama School of Medicine Goals and Objectives
for the Educational Program Leading to the MD Degree
Vision
The University of Alabama School of Medicine aspires to achieve national recognition
in medical student education comparable to that received for its research and
patient care for its ability to
produce physicians with the essential knowledge, skills, and professionalism
to successfully continue their professional education and pursue a variety of
careers to better serve Alabama and the nation through health promotion, medical
research, and disease prevention and treatment.
Mission
The mission of the University of Alabama School of Medicine is to produce
quality physicians who (1) possess all essential knowledge, skills, and professionalism
and who possess skills and the habit of life-long learning, (2) possess the ability
to work in and lead future health care systems, (3) will help meet the health
care and research needs of Alabama and the nation, and (4) reflect the population
and composition of Alabama.
UNDERGRADUATE MEDICAL EDUCATION GOALS AND OBJECTIVES
Professionalism and Communication
1. Each student will develop and cultivate personal and professional
qualities of ethics, commitment to patient well being, commitment derived from
the role accorded physicians in society, and an understanding of their own personal
strengths, weaknesses, obligations, and limitations.
a. Ethics:
Each student will...
- Understand, value, and practice basic ethical concepts, moral
reasoning, and patient, societal, and professional responsibility in the educational
and health care context.
- Exhibit personal qualities of honesty, integrity, reliability,
altruism, dependability, open-mindedness, and intellectual curiosity.
b. Commitment to patient well being:
Each student will...
- Understand, value, and practice compassionate treatment of
patients, including a respect for their privacy and dignity, a commitment to
advocate the interests of his/her patients over his/her own selfish interests,
a commitment to provide care irrespective of their ability to pay, advocacy for
the needs of individual patients and of patient groups, an understanding of the
roles of other health care professionals, and a commitment to collaboration with
other health care professionals as needed to achieve the best interests of the
patient.
c. Obligations derived from role of physicians in society:
Each student will...
- Understand and value the role given to physicians in society
and thereby practice personal lifelong learning as a means of achieving personal
and professional excellence in clinical care.
- Understand the need to place societal needs ahead of those
of any physician colleague whose performance is substandard and/or unethical.
- Recognize and value collaboration among health care disciplines,
between the physician and patient and his/her family, and among community and
governmental organizations, and industry for achievement of optimal care for
patients.
d. Understanding of self:
Each student will...
- Understand the importance of self-awareness as a means of
recognizing his/her own limitations in knowledge and clinical skills.
- Value and develop, through self-reflection, critical
self-appraisal, and openness to feedback, skills for continuous improvement as
a provider of health care.
2. Each student will understand and value the importance of honest
and effective communication with patients and their families, other health professionals,
and society.
a. Patients and their families:
Each student will...
- Understand, appreciate, and possess skill in educating
and counseling patients as a means of involving them meaningfully in decision-making
and thereby enabling and encouraging them to understand the importance of their
personal responsibility in their own health.
- Develop and practice interpersonal skills that facilitate
development of effective and empathetic relationships with patients and their
families and effective collaborations with other health care professionals.
- Develop and practice skills in producing and handling
in a confidential and appropriate manner oral and written communication with
patients and colleagues.
b. Other health professionals:
Each student will...
- Value the importance of and practice accurate, professional,
and productive communication with colleagues at all levels and in all locations
concerning each patient.
- Develop skills for using information technology to manage
information, access online medical information, and communicate with team members
in the interests of patients.
c. Society:
Each student will...
- Value the importance of physicians addressing health care
needs and problems at the societal level and, when possible, taking a leadership
role in the societal response to issues/problems that arise.
Biomedical Knowledge and Clinical Skills
1. Each student will acquire a fund of biomedical, psychological,
and social knowledge, develop the skill of obtaining information from the patient,
and assess the collected information in the light of the latest, critically evaluated
medical literature.
a. Foundation of knowledge:
Each student will...
- Understand the normal human structure and function of the
body and its major organ systems and the molecular, biochemical, and cellular
mechanisms that are important in maintaining the body's homeostasis.
- Understanding various causes (genetic, developmental, metabolic,
toxic, microbiologic, autoimmune, neoplastic, degenerative, traumatic, and behavioral)
of maladies and the ways in which they operate on the body.
- Know the rationale and application of the therapeutic options
relevant to the various mechanisms of disease.
- Understand and be able to apply the social and behavioral
sciences, epidemiology, and humanities to important non-biologic and cultural
factors that contribute to health or disease.
b. Information from patient:
Each student will...
- Develop an ability and skill for eliciting through an accurate
and comprehensive medical history and physical exam all information that is relevant.
- Develop an ability to organize the information from all sources,
including epidemiology.
- Understand appropriate tests and procedures to be ordered
on the basis of findings from the medical history and physical exam in the light
of epidemiological knowledge.
c. Comparison with literature:
Each student will...
- Develop an ability to access medical literature, critically
analyze this literature, understand how medical knowledge is generated, and assess
the literature's relevance to the clinical case under consideration.
2. Each student will demonstrate the ability to apply information
compiled from all sources into a coherent prioritized differential diagnosis
and make appropriate
clinical decisions.
Each student will...
- Demonstrate an ability to recognize a situation requiring
rapid intervention, take steps to implement appropriate emergency care, know
the pathophysiological rationale for particular management approaches, and explain
methods of
monitoring effectiveness of therapy and avoidance of complications.
- Demonstrate the ability to synthesize and integrate the pertinent
facts from the history, physical, and laboratory data, formulate a hypothesis,
and, if appropriate, order additional tests and procedures for confirmation,
relying on knowledge of the most frequent clinical, laboratory, radiologic, and
pathologic manifestations of common maladies..
- Understand the contribution to patient care provided by other
health professionals and when to obtain their consultation.
- Demonstrate the ability to integrate psychological and social
issues and apply them to clinical situations.
- Develop a diagnosis, establish causation, and formulate management
strategies.
3. Each student will demonstrate sound clinical judgment, solid technical
and procedural skills, and compassionate interpersonal skills.
Each student will...
- Understand the clinical problems (and their treatments) unique
to the various patient categories, including age, gender, and culture.
- Demonstrate skill in the evaluation of patients at various
levels of medical care, including impatient, ambulatory, home care, etc. and
the subsequent management appropriate for each level of care.
- Understand when to use medical and invasive procedures.
- Demonstrate skills in performing appropriate basic medical
and invasive procedures considered essential for entering any area of graduate
medical education.
- Understand the basic issues relating to the care of critically
ill patients.
- Understand the principles and application of fluid management,
pharmacologic management, and nutritional management.
- Understand common acute and chronic illnesses and their effect
on the patient, family, and society.
- Understand and value the importance of working collaboratively
with health care professionals, including those from other disciplines, to provide
patient focused
care.
- Know the role of prevention in health care and demonstrate
skills in providing health care services and health care information aimed at
maintaining health through recognition and reduction of risk factors that contribute
to major causes
of morbidity and mortality for individual patients and large populations across
the life span.
- Know the role of patient education as a means of involving
patients actively in their health care and demonstrate skill in patient counseling/educating
that makes the patient a part of the decision making process.
Social and Community Contexts of Health Care
The student will develop an understanding of the social, cultural,
and community factors that contribute to and affect patients' health status and
influence the health care system and patients' access to care.
The student will...
- Understand the epidemiological factors that place the individual
patient, as well as patient populations in general, at risk for disease or injury.
- Understand and value gender, ethnic, and cultural issues at
work in the physician-patient encounter and in the patient's response to disease,
treatment, and wellness.
- Understand the effects of chronic disease, trauma, violence,
alcohol and drug abuse, and tobacco use on the patient, family, society, and
community.
- Understand the importance of and develop skills in addressing
psychosocial, economic behavioral, and community factors when negotiating with
patients on
health-related lifestyle modification.
- Understand basic principles of health care economics.
- Understand the importance of advocating for quality in patient
care.
Educational Objectives
APGO Medical Student Educational
Objectives 8th Edition
This edition is designed to provide an organized and understandable set of
objectives for all medical students, regardless of future specialty plans. The
knowledge, skills and attitudes are intended to be both a resource for course
design for faculty and clerkship directors, and a useful study guide for
medical students. Each educational objective is linked to the level
of competence a student should be expected to achieve, the best
methods of evaluation and the representative general competency as
defined by the ACGME.
At a minimum, we expect all of our students to master Priority 1 objectives
(the essential elements are listed below) and be exposed to the majority of Priority
2 objectives and skills. These essential objectives and skills have been adapted
from APGO and are summarized below:
- Clinical skills in the medical interview and physical exam
with attention to OB Gyn history and genitourinary examination.
- Collect and interpret cervical cytology results
- Understand and be able to counsel women on modern contraceptive
technology
- Differential diagnosis of the “acute abdomen” – pelvic
infection, ectopic pregnancy, adnexal torsion, appendicitis, diverticulitis,
renal calculi
- Physiologic adjustments that accompany normal gestation, including
effects on lab test results
- Social and health policy aspect of women’s health, ethical
issues, sterilization, abortion, domestic violence, adolescent pregnancy, access
to health care, etc.
- Menstrual cycle, normal and abnormal function, including menopause
- Infertility
- Intrapartum care and common problems in obstetrics
- Breast health, including breastfeeding
- Vaginal and vulvar disorders
- Screening for reproductive cancers
Minimum Requirements for the Performance of OB Gyn Procedures
The OB Gyn clerkship directors from all three UA SOM campuses met, developed,
and quantitated a list of OB Gyn procedures that all students must meet as minimum
requirements during the 8 week clerkship rotation. These
minimum requirements were developed using the Priority 1 Objectives from the
APGO Medical Student Educational Objectives 8th Edition document as a guide.
The procedures have been identified by APGO as requiring a "show how" or "do" competency
level and the quantity selected was based on prior experiences from all 3 campuses.
The goal is for students to gain as much clinical experience as possible and
not be limited by these minimum guidelines.
MINIMUM REQUIREMENTS: Minimum requirements were set for each,
as noted in ( ):
- Inpatient Obstetrics –
• Evaluate OB patients presenting to Labor and Delivery Triage Unit.(5)
• Follow patients intrapartum (during labor). (5)
- Outpatient Obstetrics - Perform prenatal
evaluations in the OB Clinics. (5)
- Inpatient Gynecology – Follow and manage
postoperative Gyn patients. (5)
- Outpatient Gynecology - Evaluate patients
with gynecologic problems. (5)
- Conferences –Must attend at least 80%
of scheduled student conferences.
- Procedures –
• Perform a breast exam and counsel patient on self-examination (5)
• Perform a patient-centered pelvic examination (5).
• Perform an adequate Pap smear and obtain specimens to detect STDs (5).
• Assess gestational age via physical exam of the pregnant woman (5)
• Describe/demonstrate or perform a vaginal delivery (5)
• Perform fetal auscultation and interpret electronic fetal monitoring (5)
• Counsel patients on contraception (5)
• Diagnose and manage patient with vulvovaginal symptoms (5)
• Interpret a wet mount microscopic examination (5)
Click Here to
print these minimum requirements in a Check List format.
Core Clinical Competencies
The members of the Medical Education Committee University of Alabama School
of Medicine developed the Core Clinical Competencies. These are a compilation
of the professional behavior, clinical skills, medical knowledge and issues regarding
family and societal influences in health care that each graduate of the UASOM
must have acquired prior to graduation. The following objectives will be stressed
during the Ob-Gyn clerkship.
I. Professional Behavior
All areas of this section will be addressed during clinical interactions with
patients, staff, faculty and peers.
- Enhancing communication skills through interpersonal skills
- Professionally and compassionately relating news of serious
acute or chronic illness or congenital abnormality to patients and family.
- Identifying, organizing, and recording accurately in the patient
record the information needed to appropriately address the patient’s problem/condition
- Self education by utilizing key information sources, literature
searches, decision support systems, and assessing the quality of this information/studies
and application to clinical practice.
- Developing a productive interaction with patients, encouraging
patient autonomy, maintaining confidentiality and maintaining continuing personal
responsibility for the patient’s health care.
- Describing the professional and ethical issues facing physicians
when encountering and treating the economically disadvantaged.
- Identifying and presenting in an unbiased manner potentially
controversial health care issues, including reproductive choice, maternal-fetal
conflicts and religious conflicts with the provider
- Professional dress and manner in patient care areas.
II. Clinical Skills
Interviewing, History and Physical Examination
- Sexual, menstrual and obstetrical history
- Family history as it relates to risk factors for disease and
possible congenital anomalies/risks
Exam: Abdominal, genito-urinary-rectal, and breast
Diagnostic Skills: Indications and interpretation of the
results for the following tests:
- Pap smear (cytology results)
- Pathology of the genital tract-cervix, endometruim, uterus,
ovaries
- Pregnancy tests - urine & serum
- Cultures for sexually transmitted diseases
- Hormonal assays
Screening and Health Maintenance:
- Risk factors for common chronic illnesses and gynecologic
disease
- Indications and interpretation of periodic screening tests
including the impact of age, ethnicity and other risk factors in women
- Routine prenatal care and deviations from the routine course
- The impact of life style choices on health and disease
Pharmacology and Therapeutics
- Identify pharmacokinetics and volume distribution of medication
in the pregnant woman, utilize the pregnancy classification system in the PDR
to select drugs
Patient Education
- Prevention/Health Screening: self breast exam, mammograms,
pap smears, safe sex, osteoporosis
- Hospital discharge education: postpartum care, breastfeeding,
wound care, use of medication, activity restrictions.
Technical Skills
- Pelvic and breast examination
- Place and remove skin staples
- Demonstrate surgical scrub and sterile techniques
- Perform a vaginal delivery
- Obtain a pap smear and cervical cultures
- Episiotomy repair
- Assist with common surgical procedures: hysterectomy, cesarean
section, laparoscopy
Emergency Situations
- Recognize hemorrhagic and septic shock, either obstetrical
or surgical
- Recognize an acute abdomen
Critical/Perioperative Care
- Complications of labor and delivery including pre-eclampsia,
preterm labor, premature rupture of membranes, hemorrhages, abruption, fetal
distress, and dysfunctional labor and shoulder dystocia.
- Pre-surgical evaluation of surgical risks factors, indication
for surgery, principles of informed consent
III. Medical Content Knowledge
Ambulatory Problems (female reproductive)
- Pre-conceptive counseling for women with chronic common medical
conditions affecting the prenatal course and delivery
- Common causes of acute and chronic pelvic pain
- Common breast complaints
- Common causes of abnormal vaginal bleeding patterns including
complications of pregnancy
- Primary and secondary amenorrhea
- Vaginitis
- Common causes of urinary problems: UTI, urinary incontinence
- Management of estrogen deficiency
- Contraceptive counseling and management
Inpatient Problems
- Labor, delivery and postpartum
- Pyelonephritis
- Pregnancy complications such as hypertension
Infectious Conditions
- HIV infection
- STD
- Post operative/post-delivery infections
- Infectious agents as they pertain to pregnancy
Neoplastic Conditions
- Cancer of uterus, ovaries, cervix
- Benign neoplasms of uterus, ovaries, cervix and breast
Genetics
- Identify those diseases/conditions for which screening is
appropriate preconceptively or during pregnancy
Age-Related Issues
- Normal life cycle physiology and how it impacts on the pathology
with particular emphasis on menstrual cycle, puberty and menopause
- Anticipation of female reproductive life cycle changes including
physiologic factors and provide education to the patient to help maximize the
acceptance of and adaptation to these normal life stages.
- Physiological, emotional, and societal influences of sexuality
throughout life stages and their relationship to illness and health in traditional
and alternative expression of sexuality.
Gender, Ethnic, Cultural Issues
- Respect for the individual’s values, goals and concerns
regarding reproductive choices, infertility, safe sex, and contraception
- Effects of family relationships on health and illness
- Complex behavioral change and other factors involved in patient
compliance with medical plan
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