LSUHSC-New Orleans School of Medicine

Educational Program Objectives and Institutional Competencies

Medical Knowledge

1. Students must understand and apply the principles of the basic sciences, particularly core areas of anatomy, physiology, biochemistry, microbiology, pharmacology, and genetics.
2. Students must demonstrate knowledge of the basic disease processes encountered in the clinical sciences, particularly the fields of internal medicine, surgery, obstetrics and gynecology, psychiatry, family medicine, neurology, and pediatrics.
3. Students must be able to identify and apply principles of medical ethics and attributes of professionalism in both patient care and research.  These include the core ethical principles of beneficence, nonmaleficence, autonomy and justice, and core professional values such as confidentiality, informed consent, disclosing errors, duty to treat, access and limits to care, life saving support and withdrawal:
   • Students must understand the fiduciary nature of the doctor-patient relationship and recognize the difference between paternalistic, patient-centered, and shared-decision models of care.
   • Students must be able to understand and apply the core duty to maintain confidentiality and the legal exceptions to that duty in patient care and human research.
   • Students must understand the importance of and methods of disclosing errors to patients.
   • Students must be able to identify and apply the ethical principles pertinent to end of life care, including: providing beneficial therapies and support, controlling pain, discontinuing futile care, and respecting patient’s dignity.
   • Students must be able to identify and apply the elements of obtaining informed consent, including information, capacity, and voluntariness. 
   • Students must exhibit an awareness of state and federal laws that provide the foundation for policies and practices that affect patient care and should know how to access these laws and regulations.
4. Students must participate regularly in learning activities that maintain and advance their competence and performance:
   • Students must maintain up-to-date skills by completing appropriate training before undertaking new procedures or practices. 

Patient Care

5. Students must demonstrate the ability to gather accurate information from patients via history taking and physical examination:
   • Students must take an appropriate history, including the history of present illness, social history, and psychological factors.
   • Students must examine patients as thoroughly as necessary, while providing for the patients’ comfort and safety.
6. Students must demonstrate the ability to manage patients’ health by making diagnoses and planning treatment:
   • Students must identify the patients’ most significant problems and diagnoses based on all available evidence.
   • Students must consider treatment and recommend management plans only after obtaining adequate knowledge of the patient’s health, lifestyle, capacity for cooperation, and preference.
7. Students must demonstrate knowledge of healthcare services that are aimed at preventing health problems and maintaining health.
8. Students must possess the knowledge necessary to provide effective patient care with respect to patient diversity and cultural beliefs:
   • Students must understand the need to adapt care of patients with consideration of their age, ethnicity, gender, and cultural and health beliefs.
   • Students must understand the importance and means of overcoming literacy, linguistic, or other cultural barriers to effective doctor-patient communication.
9. Students must demonstrate the knowledge required to manage unique or challenging aspects of patients’ health:
   • Students must understand the principles of pain assessment and management.
   • Students must understand the components and attributes of effective and compassionate end-of-life care.
10. Students must collaborate and communicate effectively in order to provide care:
    • Students must consult and take advice from colleagues when appropriate.
    • Students must perform agreed upon roles and responsibilities as members of healthcare teams.
    • Students must keep clear, complete, accurate, timely, and legible records.
    • Students must accurately report the relevant clinical findings to team members using case presentations.

Practice Based Learning and Improvement

11. Students must demonstrate the ability to review current sources of medical information:
    • Students must seek timely answers to questions that arise at the time of care using appropriate information sources and databases.
    • Students must assimilate evidence from practice guidelines and scientific studies related to their patients’ health problems, evaluate the quality of evidence, assess its relevance to patients’ needs, and integrate the information into patient care.
12. Students must know how to appraise evidence in order to enhance knowledge:
    • Students must use critical thinking skills when evaluating information.
    • Students must apply knowledge of study and statistical methods to the appraisal of clinical studies and other medical information.
13. Students must strive to evaluate and improve patient care practices:
    • Students must regularly seek useful assessment and feedback from others.
    • Students must implement changes in their performance and improvements in practice that incorporate feedback from patients and colleagues.
    • Students must apply best practice and available benchmarks to their patient care.

Interpersonal Relationships and Communication

14. Students must demonstrate effective communication with patients:
    • Students must use active listening skills when interviewing patients.
    • Students must effectively counsel and educate patients and families, providing information in a form that can be readily understood.
15. Students must demonstrate knowledge of how to effectively communicate with patients in challenging situations:
    • Students must understand the importance of taking responsibility for medical errors.
    • Students must know the appropriate approaches to delivering information about a life-threatening diagnosis or grave prognosis.
    • Students must know that circumstances may arise that make it necessary to end a professional relationship with a patient, although a complaint from a patient does not necessitate such action.
    • Students must know that when a relationship is ended, the decision must be fair, the patient must be informed, and appropriate alternative care must be ensured.
16. Students must demonstrate effective communication with team member:
    • Students must communicate effectively with colleagues when presenting patient information.
    • Students must ensure effective communication when transferring patient care responsibilities to other team members.

Systems Based Practice

17. Students must demonstrate an understanding of the healthcare system as a whole, including untilization of resources:
    • Students must know how various types of medical practice, delivery systems, and payment methods within different practice environments vary from one another.
    • Students must understand the various roles of other health care providers.
    • Students must know the importance of advocating for safe, accessible, quality patient care and the use of systems to reduce errors and improve safety.
18. Students must recognize how their patient care decisions and professional behavior affect the healthcare and educational systems in which they work:
    • Students must be committed to the efficient and effective use of resources to avoid unnecessary services.
    • When involved in teaching, students must exhibit attitudes and practices necessary to provide effective role modeling, competency training and evaluation.

Professional Behavior

19. Students must maintain integrity and personal responsibility:
    • Students must be honest and trustworthy when writing reports and completing or signing forms or other documents.
    • Students must treat patients even though their medical conditions may put the students at risk, and they must take appropriate steps to minimize risk or seek treatment in the event that patient poses a risk to their safety.
    • Students must act with honesty and integrity to ensure that their conduct justifies the trust the patients place in them and the profession.
    • Students must not pursue improper relationships with patients.
    • Students must refrain from expressing personal beliefs in ways that are likely to exploit patients’ vulnerability.
    • Students must adhere to the codes, laws, and regulations of practice relevant to their work.
20. Students must demonstrate an understanding of their responsibilities to others (patients, colleagues, the profession, and society):
    • Students must respect their patient’s right to seek another opinion.
    • Students must understand and support their patient’s emotional state.
    • Students must treat their colleagues fairly and with respect.
    • Students must not provide medical services if their performance is affected by alcohol or other substances.
    • Students must act in their patient’s best interest when making referrals and providing care.
    • Students must maintain honesty when assessing the performance of any colleagues.
    • Students must take appropriate steps without delay if concerns arise that a colleague displays unprofessional behavior.
    • Students must do their best to ensure fair access to healthcare services for all patients.
    • Students must provide medical care in the best interest of the patient that is not compromised by collaboration with industry or any outside influence.  
    • When engaged in research, students must comply with established standards and protect the interests of research subjects as a first priority.
21. Students must understand their own limits and ensure their own competence:
    • Student must take personal responsibility for maintaining up-to-date knowledge of basic science and clinical medicine.
    • Students must be aware of the boundaries of their knowledge and skills.
    • Students must always state their qualifications, skills, and experience truthfully.

Program objectives and their components were originally drafted and adopted in 2008 using Good Medical Practice-USA [Version 0.1 August 15, 2007] as a guideline for medical student competencies. The Curriculum Oversight Committee revised the objectives in the Spring 2009. The revisions were adopted at the August 5, 2009 meeting of the general faculty.