This clerkship will focus on the development of basic clinical competencies. A list of competencies appropriate for the third year medicine clerkship has been validated by national and local surveys of faculty. The consensus view resulted in this list:  

1. Data Collection (History and Physical Examination)

Taking a medical history, performing a physical exam, performance of admission workups, hospital follow-ups, focused outpatient work-ups, outpatient follow-ups.  Diagnostic Decision Making

Developing a problem list, formulating a differential diagnosis, principles of test interpretation (sensitivity, specificity, predictive value), interpretation of common diagnostic tests (CBC, peripheral blood smear, chemistry panels, ECG, chest X-ray, urinalysis, pulmonary function tests).  

2. Therapeutic Decision Making

Assessing risks, benefits, and costs of treatment options, involving patient in decision-making, selecting drugs, managing multiple problems simultaneously.  

3. Case Presentation and Documentation Skills

Recording an initial history and physical exam, preparing progress notes, oral presentation of new cases and follow-up cases.  

4. Communication and Relationships with Patients

Establishing rapport with patients, identifying hidden agendas, recognizing psychosocial issues, educating patients, compliance issues, demonstrating sensitivity to racial and cultural diversity; also bioethics of care, for example, advance directives, informed consent.  

5. Prevention

Risk assessment, risk factor modification, immunizations, promoting healthy lifestyles, periodic health screening.      

6. Self-Directed Learning

Self-assessment of current knowledge and knowledge needs, identification of learning issues, identification of learning resources, use of learning strategies, computer-based MEDLINE searching, self-monitoring of learning outcomes.

**Please take the time to read these goals carefully. Assess your current competence in each area and discuss your learning needs with your attending or preceptor. Review this list frequently and monitor your progress. Early in each rotation, ask your attending or preceptor to schedule a time to discuss these goals and your individual learning needs. Ask for feedback regularly! If your needs are not being met, or if you are not getting feedback, contact your campus coordinator (Dr. Hagan in Bismarck or Dr. Newman in Fargo, Dr. Hargreaves in Grand Forks) as early as possible. We often first learn of students' problems near the end or even after a rotation. If we learn of your difficulties early on, we may be able to intervene to help you.