PGY1 Expected Inpatient Skills/Competencies*

Patient Care

• resident and attending are recognized as supervisors 
• involves family members in discussions about care and keeps them updated
• can admit a routine patient in less than an hour
• can present a new patient in less than 10 minutes
• creates management plans for common inpatient conditions  
• starting to determine the appropriateness of admission/discharge 

Medical Knowledge

• creates a differential diagnosis and thorough problem list without prompting
• determines which basic studies are needed for work-up
• interprets basic test results but may need help with more complex ones 

Communication

• accurately elicits history from patient 
• routinely ascertains if patient understands and agrees with the plan of care 
• uses correct protocols for signing patients out efficiently
• shows active listening with patients through eye contact, paraphrasing and reflection
• redirects talkative patients to move ahead with important agenda items
• avoids jargon when talking to patients
• establishes boundaries with a challenging patient
• can communicate with a challenging patient, nurse or consultant

Professionalism

• arrives to morning report on time and with a professional appearance
• greets patients well, and introduces self and other team members
• recognizes when an interpreter is necessary
• completes assigned tasks and helps with other team needs when able
• acknowledges errors and is able to say “I don’t know”
• notifies chief or attending when s/he needs support
• adheres to duty hour rules by planning ahead and transitioning work to others

Practice-Based Learning and Improvement

• investigates learning opportunities without prompting and shares learning with the team
• asks the question “what is the evidence for this intervention?”
• recognizes deficits in knowledge and notifies supervisors of learning needs/goals
• asks for and provides feedback to the chief/attending
• reviews the steps of a procedure prior to doing it

System-Based Practice

• coordinates with other resources (team members, RN, SW, financial, PT/OT) to meet patient needs
• reviews medication list, fluids, IV access, need for catheters and telemetry
• addresses prevention of adverse outcomes in the hospital: IS, VTE prophylaxis, fall risk, EtOH w/d
• routinely seeks out nurses to get input and communicate plan
• submits progress notes by 12:30
• completes discharge summary at the time of patient discharge
• works with chief to effectively manage assigned teamwork
• thinks about system issues that led to hospitalization and what may complicate outpatient care
• attempts to provide cost-efficient care
• fills out PSNs when appropriate   

*This reference lists the expected competencies of a intern midway through the year. This document is meant to guide feedback, it is NOT a checklist.

PGY1 Overarching Competencies/Learning Objectives

Inpatient Wards PGY1

COMPETENCIES- At the completion of residency training, Family Medicine residents should be able to (AAFP):

• Be able to perform standardized comprehensive critical care assessments and develop acute treatment plans (Patient Care, Medical Knowledge)
• Be able to optimize treatment plans using a systematic approach to medical decision making and patient care, combining scientific evidence and clinical judgment with patient values and preferences. Knowledge should be evidence based and derived from nationally recognized resources. (Systems-based Practice, Practice-based Learning and Improvement)
• Coordinate admissions, inpatient care, and throughput within the hospital system (Systems-based Practice)
• Demonstrate the ability to communicate in multiple modalities with patients, families, other health care providers, and administrators. Effective communication is central to the role of the family physician to promote efficient, safe, and high-quality care. (Interpersonal and Communication Skills, Professionalism)
• Recognize self-limitations with regard to practice and seek consultation with other health care providers to provide optimal care. Assess medical information to support self-directed learning. (Medical Knowledge, Practice-based Learning and Improvement)
• Demonstrate compassion, empathy, and sensitivity to hospitalized patients and appreciate that informed adults with decision-making capacity may refuse recommended medical treatment (Professionalism)
• Synthesize an appropriate diagnosis and treatment plan for common pediatric conditions in both the outpatient and inpatient settings (Patient Care, Medical Knowledge)
• Demonstrate the ability to communicate effectively with the patient, as well as the patient’s family and caregivers, to ensure the development and clear understanding of an appropriate, acceptable diagnosis and treatment plan (Interpersonal and Communications Skills)
• Recognize his or her own practice limitations and seek consultation with other health care professionals and resources when necessary to provide optimal patient care (Professionalism, Systems-based Practice)
• Demonstrate the ability to communicate effectively with the surgeon supervisor/consultant about the patient’s symptoms, physical findings, test results, and proposed plan of care (Interpersonal and Communication Skills, Professionalism)