The curriculum in each program must
contain overall goals for the program, competency-based goals and objectives for
each assignment at each educational level, regular didactic sessions and
delineation of resident responsibilities for patient care, progressive
responsibility for patient management, and supervision of residents over the
continuum of the program.
Council for Graduate Medical Education (ACGME) specifies that each "residency
program must require that its residents obtain competence in the six areas
listed below to the level of a new practitioner. Programs must define the
specific knowledge, skills, and behaviors required and provide
educational experiences as needed in order for their residents to demonstrate
1. Residents must
be able to provide Patient Care
that is compassionate, appropriate, and effective for the treatment of health
problems and the promotion of health. (Patient Care)
2. Residents must demonstrate knowledge of established and evolving
biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care.
3. Residents must demonstrate the ability to investigate and evaluate their
care of patients, appraise and
assimilate scientific evidence, and to continuously improve
patient care based on constant self-evaluation and life-long learning. (Practice-based learning
4. Residents must demonstrate interpersonal and communication
skills that result
in the effective exchange of information and collaboration with patients, their
families, and other health professionals. (Interpersonal and communication skills)
5. Residents must demonstrate a commitment to carrying out
professional responsibilities and an adherence to ethical principles. (Professionalism)
6. Residents must demonstrate an awareness of and responsiveness to the larger context and
system of health care, as well as the ability to effectively call on other resources
in the system to
provide optimal health care. (Systems-based practice)
Residents must also be educated to recognize the signs of fatigue
and sleep deprivation; and have an educational program regarding impairment
including substance abuse. The curriculum must advance residents'
knowledge of the basic principles of research, including how research is
conducted, evaluated, explained to patients and applied to patient care. Each
program has defined specific goals and objectives to
meet these requirements. These are usually included in the resident
handbook and/or the description of the clinical rotations.
development speakers are listed on the Faculty Affairs web page at
||Grants and Scientific
||Science and Research
||Social and Cultural Issues
Research and Publishing
An excellent resource for ethics education is the text book, Introduction
to Clinical Ethics by Fletcher et. al., which is located in
each departmental library. Several departments and residency
programs have a systematic ethics
instruction and assessment using a variety of formats.
Medical/legal and risk management
Mr. Kemal Kutait, Director of the MCPG Risk Management
Department, provides a session on risk management and prevention
at Housestaff Orientation/Registration each year. In addition, he will
provide a workshop
on risk management to departments on an individual basis upon request.
Sexual Harassment workshop
A 2-hour workshop by LJ Perrot, MD, JD, a licensed attorney and board-certified
anatomic/forensic pathologist, is designed to present the legal basis of SH,
dispel common myths, and suggest strategies for preventing and confronting SH.
Teaching methods include a didactic presentation, case studies, and small group
The workshop will enable participants to:
gain knowledge of sexual harassment issues
protect oneself and one's medical practice against sexual
develop strategies to confront sexual harassment
Contact information: LJ Perrot,
MD, JD, 686-8646, firstname.lastname@example.org
How to Break Bad News a 6-step
protocol by Robert Buckman, Johns Hopkins University
When the news is painful, you must prepare to have a conversation. Be
prepared to listen. Health-care providers talk too much, usually because
they feel uncomfortable and don't know other ways to maintain their control and
1) When you introduce the topic, do so in a private environment. Sit down,
introduce yourself and tell the patient/family what you do. If family
members or friends are present, get the patient's permission for them to
listen. Don't put a desk between you and the patient.
2) Look at your body language - be seated, use a handshake and make eye
contact. Talk slowly; when the news is a its worst, talk even
slower. If the patient looks away, stop talking and wait.
3) Learn the extent of the patient's knowledge. Ask what he or she has
been told so far. Having this information is extremely important for the
health-care provider because it enables "alignment". Don't
overreact to the patient who claims he or she was never told. Ask the
patient how much he or she wants to know. Ask the patient if there's
someone to whom he or she would rather you speak. If the patient doesn't
want to know, document that fact and proceed to the treatment plan and the
4) If the patient wants to know, there is no easy, magical way of breaking the
bad news. Don't anticipate what the patient will say or how he or she will
react to the news. Fire a warning shot, such as "I'm afraid the
situation is serious". Or "This is difficult for me to
say." Stop frequently; this gives the listener permission to
talk. Ask, "Is this making sense?" or "Do you see what I
mean?" Validate the patient's questions by saying, "That's
an excellent question." or "You raise an important point."
Sometimes, the best you can do is absorb the patient's feelings or
projections. Don't look away unless the patient is crying.
5) Respond to the patient's feelings and reactions. Remember that,
primarily, the patient wants to believe that you understand what is happening to
him or her.
6) Devise a plan based on the patient's priorities, and explain it to him or
her. Identify other sources of support.
Presented at University Hospital
Consortium's Patient Safety Program, October 2001.
A three-part module of biostatistics produced by Dr. Dan
Wilson from the University of Kansas Medical School is provided
to all housestaff and program directors. These are used through
self-study programs or as part of journal clubs within the
here to access module.
This topic is introduced in a session
during Housestaff Orientation/Registration which occurs each June. The
topic is covered more in-depth during the Morbidity and Mortality and/or QA
conferences within the training programs.
this topic is introduced in a session during Housestaff Orientation/Registration
which occurs each June. Individual departments have additional education
through Grand Rounds or didactic sessions. Click here to access information from lectures
by Drs. Frederick G. Guggenheim, Forrest B. Miller,
and James Waldron, members of the Physician Health Committee. GME Committee
on Physician Impairment, Drug Testing and Drug Abuse Intervention.
The UH Compliance Office provides a course upon request.
In addition, multiple internet resources are available:
Overview of the Medicare Program
Evaluation of residents: Each residency program must have an
effective plan for assessing residents' performance throughout the program and
for utilizing results to improve resident performance. Each program
director has developed a plan which includes use of dependable measures to
assess residents' competence in the areas of the six competencies noted above,
mechanisms for providing regular and timely feedback to residents, and a process
of using results to achieve progressive improvement in residents' competence and
The program director with the teaching faculty has developed a plan to use
resident performance and outcome assessment results in evaluating how effective
the program is educating residents and improving the residency program.
Back to the Table of Contents