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The Federated Council of Internal Medicine's Resource Guide for Residency Education: An Instrument for Curricular Change

Jack Ende, MD; Mark Kelley, MD; and Harold Sox, MD
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From the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. (Sox) For members of the Federated Council of Internal Medicine Task Force on Graduate Medical Education, see Appendix. Grant Support: In part by the American College of Physicians. Acknowledgment: The authors acknowledge the support of the organizations of the Federated Council of Internal Medicine: the American Board of Internal Medicine, the American College of Physicians, the American Society of Internal Medicine, the Association of Professors of Medicine, the Association of Program Directors in Internal Medicine, the Association of Subspecialty Professors, and the Society of General Internal Medicine. More specific acknowledgments are found in the resource guide. Requests for Reprints: Jack Ende, MD, Department of Medicine, Presbyterian Medical Center, University of Pennsylvania Health System, 39th and Market Streets, Philadelphia, PA 19104-2699. Current Author Addresses: Dr. Ende: Department of Medicine, Presbyterian Medical Center, University of Pennsylvania Health System, 39th and Market Streets, Philadelphia, PA 19104-2699.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;127(6):454-457. doi:10.7326/0003-4819-127-6-199709150-00007
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The Federated Council of Internal Medicine has developed a resource guide to help internal medicine residency programs produce internists who are prepared for today's practice of internal medicine and the challenges of practice in the future.The guide situates general internal medicine as the primary care profession that focuses on preventive, short-term, and long-term care of adult patients. It assumes that a single pathway is sufficient for educating general internists and subspecialty-bound trainees. It identifies the learning experiences that should be part of general internal medicine residency training, lists the clinical competencies that are important for primary care practice, and describes the role of the integrative disciplines that should inform the care of every patient. It also describes a process that program directors and local program committees can use to develop competency-based curricula.


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Figure 1.
Sample grid for assigning clinical competencies to specific training venues.

Worksheets allow program directors and local curriculum committees to endorse or revise the competencies identified by the Federated Council of Internal Medicine (FCIM) Task Force for each clinical area and to prioritize them. Priority 1 indicates that a condition should be learned through direct responsibility for patients; priority 2 indicates that other forms of patient-based learning, such as learning in groups, are appropriate; and priority 3 indicates that the condition is important but may be learned in other ways, such as through conferences or assigned reading. The worksheets then allow the program director or local committee to check off the site at which each competency is most likely to be encountered and to decide whether and how that competency should be addressed in the program's didactic (non-patient-based) learning experiences.

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