ACGME Requirements

Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Fellows are expected to:

• Learn the practice of health promotion, disease prevention, diagnosis, care, and treatment of men and women from adolescence to old age, during health and all stages of illness.
• Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families.
• Gather essential and accurate information about their patients.
• Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
• Develop and carry out patient management plans.
• Counsel and educate patients and their families.
• Use information technology to support patient care decisions and patient education.
• Perform competently all medical and invasive procedures considered essential for the area of practice.
• Provide health care services aimed at preventing health problems or maintaining health.
• Work with healthcare professionals, including those from other disciplines, to provide patient-focused care.

Fellows 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. Fellows are expected to:

• Demonstrate an investigatory and analytic thinking approach to clinical situations.
• Know and apply the basic and clinically supportive sciences which are appropriate to their discipline.
• Are expected to learn the scientific method of problem solving, evidence-based decision making, a commitment to lifelong learning, and an attitude of caring that is derived from humanistic and professional values.

Fellows must be able to investigate and evaluate their patient care practices, appraise, and assimilate scientific evidence, and to continuously improve their patient care practices based on constant self-evaluation and life-long training. Fellows are expected to develop skills and habits to be able to meet the following goals:

• Identify strengths, deficiencies, and limits in one’s knowledge and expertise.
• Set learning and improvement goals.
• Identify and perform appropriate learning activities.
• Systematically analyze practice using quality improvement methods and implement changes with the goal of practice improvement.
• Incorporate formative evaluation feedback into daily practice.
• Locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems.
• Use information technology to optimize learning, access online medical information; and support their own education.
• Participate in the education of patients, families, students, Fellows, and other health professions.
• Analyze practice experience and perform practice-based improvement activities using a systematic methodology.
• Obtain and use information about their own population of patients and the larger population from which their patients are drawn.
• Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.

Fellows must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients’ families, and professional associates. Fellows are expected to:

• Create and sustain a therapeutic and ethically sound relationship with patients.
• Use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills.
• Work effectively with others as a member or leader of a healthcare team or other professional group.
• Communicate effectively with physicians, other health professionals, and health-related agencies.
• Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds.
• Act in a consultative role to other physicians and health professionals.
• Maintain comprehensive, timely, and legible medical records, if applicable.

Fellows must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. Fellows are expected to:

• Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and ongoing professional development.
• Demonstrate a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices.
• Demonstrate sensitivity and responsiveness to patients regardless of their culture, age, gender, and disabilities.

Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. Fellows are expected to:

• Understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice.
• Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources.
• Practice cost-effective health care and resource allocation that does not compromise the quality of care.
• Advocate for quality patient care and assist patients in dealing with system complexities.
• Know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance.
• Work in inter-professional teams to enhance patients’ safety and improve patient care quality.
• Participate in identifying system errors and implementing potential systems solutions.