ACGME | Accreditation Council for Graduate Medical Education

Core Competencies

©2001 by Michael G. Stewart, MD, MPH
Director of Residency Education
The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences
Baylor College of Medicine

Residents will be regularly evaluated on the following six competencies, eventually achieving the expected level of a new practitioner. This will be completed partially through the regular evaluation processes already in place, and partially by regular review by the Program Director and Director of Residency Education; the pertinent information will be reviewed and compiled as part of the semi-annual review by the Program Director, and summarized on a checklist (attached). Achievement of satisfactory performance levels for all six competencies will be necessary for successful completion of the program.

Competency in patient care will be evaluated using a combination of direct observation of the resident during patient care - both as a primary physician (i.e. at public hospitals) and as an assisting physician (i.e. at private hospitals); the clinical outcomes of the patients under the resident's care; the resident's patient presentations to faculty and/or senior residents; direct observation during bedside rounds; and direct observation during Morning Report presentations. Surgical skill is an important aspect of patient care, and this is already evaluated as part of the regular quarterly evaluation. In addition, evaluations and reports from the responsible faculty members for each rotation will be reviewed and compiled. Residents are expected to increasingly function as independent practitioners, and demonstrate increasing responsibility, skill, and maturity in caring for their patients.

Competency in medical knowledge will be evaluated using a combination of their annual otolaryngology examination scores, scores on the Home Study Course self-tests, direct observation during patient care, and the results of direct questioning during clinical care and teaching experiences (such as case presentations or discussions at teaching conferences). The resident's knowledge base will be directly evaluated during their patient presentations to faculty and to senior residents during routine clinical care as well as during Morning Report presentations. Evaluation of competency in the cognate sciences (i.e. epidemiological and social-behavioral sciences) will be primarily evaluated during directed discussion in such forums as journal club, teaching and research conferences, or in patient-specific discussions as appropriate.

Competency in practice-based learning and improvement will be assessed by direct observation of improvement in the resident's clinical care as patient experience, knowledge and feedback grow, and through observation of improvements in surgical technique with repeated performance of procedures. In addition, the use of evidence-based medicine, evaluation of available evidence, and use of best-available evidence is stressed at the Morning Report meeting and during routine clinical care, and the resident's performance in this area can be directly evaluated in that setting.

Competency in interpersonal and communication skills will be assessed using direct observation of the resident during communications with other residents, with Otolaryngology attending physicians, with physicians from other services, with non-physician clinical staff, with non-physician non-clinical staff, and with patients and their families. These competencies in communication with physicians and non-physicians are already addressed on the existing quarterly evaluation form. Reporting back through the resident's mentor will serve as another mechanism for assessing competency in interpersonal and communication skills.

Competency in professionalism will be assessed by direct observation of the resident's responsibility in carrying out their professional duties - including continuity of care, responsiveness to changes in clinical situations, overall responsiveness and availability, and self-sacrifice, and their following of ethical principles in their dealings with patients, their families, and other physicians and health care workers. The resident's sensitivity to different patient populations will be evaluated by direct observation and comparison of the professionalism and responsibility demonstrated when caring for patients of different ethnic and economic backgrounds that are treated in the different hospitals within the Baylor-affiliated system.

Competency in systems-based practice will be assessed by direct observation of the resident's use of the entire health care system in caring for their patients, as well as their teamwork within the system. This will be addressed using both the regular quarterly evaluations, as well as through direct observation at the Morning Report meeting and during clinical care, as well as during discussions at clinical care conferences.

CORE COMPETENCIES

Resident _______________________

OTO year - ____

Date of completion ___ /___ / ___

Patient care (compassionate, appropriate, effective)

Evaluated through: direct observation, clinical outcomes, patient presentations, bedside rounds, Morning Report presentations.

Satisfactory ____

Unsatisfactory ____