Competency-Based Curriculum

The Nine Abilities constitute a competency-based curriculum that defines the knowledge, skills and personal and professional values we expect of all of our graduates. In the last decade, faculty and students have translated each of the nine abilities into observable behaviors that students must demonstrate over the course of their medical education.

A competency-based curriculum rests on sound practical, time-tested principles of good educational practice. In 1996, the Association of American Medical Colleges (AAMC) endorsed this approach and encouraged all medical schools to follow suit. In 2003, the Accreditation Council for Graduate Medical Education (ACGME) adopted six competencies as outcomes for their residency training that are similar to our Nine Abilities. A brief description of these abilities follow.

Ability I Effective Communication The competent graduate demonstrates effective verbal, nonverbal and written communication skills in a wide range of activities, including patient care, consultation and teaching.	Ability II Basic Clinical Skills The competent graduate develops the skills to obtain a comprehensive history, conduct a thorough physical examination, perform basic clinical tests and interpret data in a spectrum of patient care settings.
Ability III Using Basic Science in the Practice of Medicine The competent graduate logically applies basic scientific principles and concepts in evaluating, identifying, treating and preventing illness.	Ability IV Diagnosis, Prevention and Treatment The competent graduate is able to diagnose, manage and prevent a spectrum of health problems.
Ability V Lifelong Learning The competent graduate understands the need to continually expand and enhance one’s knowledge and abilities to best serve patients, demonstrating intellectual inquisitiveness and competence.	Ability VI Professionalism The competent graduate displays a deep and ongoing commitment to the care of patients while ably attending to professional and personal responsibilities
Ability VII Community Health Promotion and Advocacy The graduate advocates for the patient’s well-being and works with community partners to identify and address factors and policies that alter opportunities to be healthy.	Ability VIII Moral Reasoning and Clinical Ethics The competent graduate recognizes the ethical dimensions of medicine and health policy.
Ability IX Clinical Decision Making The competent graduate demonstrates an understanding of and reflects on the complex processes involved in the evaluation and treatment of a patient. The graduate can incorporate the previous eight competencies into a holistic approach to medical care.

How are students evaluated?

Students are evaluated in the Nine Abilities by multiple methods of assessment: Written exams and participation in Problem-Based Learning small-group sessions are the principal assessment methods in preclinical basic science courses. National standardized subject-based exams are also used in a number of core clerkships to assess student’s clinical knowledge base.

In Doctoring and all of the core clerkships performance-based methods of assessment are employed such as Objective Structured Clinical Examinations (OSCEs). Students are also directly observed by attendings, residents, and nurses, interviewing patients or completing a physical examination in the clinical setting. Students’ oral skills are assessed in presenting the patient to a physician and on their write ups of patient encounters in the clinic setting in both Doctoring and the core clerkships.

Table 1: Where the abilities are addressed and assessed.

	IMS	Doctoring	Core Clerkships	Clinical Electives	Scholarly Concentration
Effective Communication		x	x	x	x
Basic Clinical Skills		x	x	x	x
Using Basic Science in the Practice of Medicine	x		x	x	x
Diagnosis, Prevention, and Treatment	x	x	x	x	x
Lifelong Learing	x	x	x	x	x
Professionalism	x	x	x	x	x
Community Health Advocacy and Promotion		x	x	x	x
Medical Ethics and Moral Reasoning		x	x	x	x
Clinical Decision Making	x	x	x	x	x