Educational Competencies

I. Purpose

This manual defines the current Einstein Educational Program Objectives (EPOs) for the MD Program and the process used to generate and vet the new EPOs. This manual relates to LCME Accreditation (v. 2021) Standard/Element 6.1 (Program and Learning Objectives). See Definitions for more information about the purpose of EPOs.

II. Scope

This manual applies to all educational committees and subcommittees that report to the Dean of the College of Medicine for the MD program, as well as all students, faculty, and staff who teach in the MD program.

III. Procedure

The Competency Based Medical Education (CBME) Subcommittee has primary authority for revisions to the Einstein Educational Program Objectives (EPOs). Reviews are conducted alongside overall curriculum reviews done on a standing basis every 5 years. More frequent reviews may occur if a gap/redundancy is identified or based on accreditation review and feedback. Any adjustments to Einstein EPOs must be reviewed and approved by the Executive Committee.

Reviews have been conducted as follows:

In 2018, the CBME Subcommittee commenced a comprehensive review and revision of the prior version of Einstein’s EPOs. This review was completed at the end of 2020. The new draft version of the EPOs was distributed to the Program Evaluation and Curriculum Improvement Subcommittee (PECIS) for editorial revisions with a particular focus on whether the EPOs submitted were written such that they could be assessed. Simultaneously, a working group of the Einstein Diversity and Inclusion Council, collaborating with a small group of Bronx community members, also reviewed and made editorial suggestions/revisions to the draft document. Feedback from both groups was reviewed and incorporated into a new draft by a working group of the CBME Subcommittee and this version was approved by the full CBME subcommittee in February 2021. The revised Einstein EPOs were presented and approved by the Executive Committee in April 2021.

In 2023, the Liaison Committee on Medical Education (LCME) cited Element 6.1 as Satisfactory with Need for Monitoring. This led to another comprehensive review of the Einstein EPOs, this time with the added benefit of having mapping data to analyze. There were many EPOs that were identified as being aspirational and that were, at this time, not assessable in the curriculum or only partially assessable. As such, the CBME recommended revisions/deletions to the Einstein EPOs with a plan to return to any modified elements over the next 5 years to determine if new assessments were needed and where in the curriculum those assessments might fit. CBME approved the revised EPOs in October 2023. The revised Einstein EPOs were presented and approved by the Executive Committee in October 2023.

IV. EPOs

IV.A. Competency A: Physician as Healer
COMPETENCY
Students will demonstrate effective clinical, diagnostic, and communication skills, cultural sensitivity, and empathy, in accordance with each patient’s needs and in partnership with each patient. Students will recognize that professional development in this area requires becoming comfortable with uncertainty and cultivating humility (including cultural and structural humility) in light of the vast breadth of human experience they will encounter.
A1 Gather essential and accurate information about patients and their conditions through history-taking.
A2 Gather essential and accurate information about patients and their conditions through physical examination.
A3 Gather and analyze information about patients and their conditions through medical chart review, laboratory findings, and results of imaging and other studies.
A4 Recognize and respond effectively to patients’ verbal, non-verbal, and contextual cues.
A5 Use and articulate a systematic approach to clinical diagnosis; initiate and adjust an appropriate diagnostic plan.
A6 Use and articulate a systematic approach to create an evidence-based management/treatment plan.
A7 Develop a patient-centered plan that incorporates a patient’s unique personal circumstances (e.g., health beliefs, economics, disability, culture, faith, spirituality) and addresses the impact of structural factors (e.g., racism, social determinants, social history, public policy) on health outcomes.
A8 Demonstrate empathy and build trust to provide comfort and support to patients and, when applicable, their families, caregivers, and/or surrogate decision makers.
IV.B. Competency B: Physician as Scientist
COMPETENCY
Students will acquire, appraise, and apply knowledge of biomedical, clinical, psychosocial, epidemiological, and population health sciences as the foundation for all their endeavors. Students will understand the critical role of research in these domains in enhancing the health of individuals and populations. By participating in a scholarly investigation regarding patients of all races, ethnicities, biological sex, gender identities, abilities, and backgrounds, students will work to advance scientific knowledge and master principles that can be used to improve health and health care.
B1 Demonstrate knowledge of the range of normal structures and functions of the body and its organ systems, and the underlying molecular, genetic, biochemical, and cellular mechanisms of homeostasis.
B2 Demonstrate knowledge of congenital and acquired causes of disease, dysfunction, and disability, and the underlying pathophysiology.
B3 Recognize that race is a social, not biological, construct and that racism, rather than race, causes both individual and population-level health disparities.
B4 Analyze the impact of behavioral, social, and structural factors (e.g., racism, racial inequity, poverty, environment, nutrition, public policy) on the health status of diverse patient populations, recognizing the impact of historical oppression and exploitation.
B5 Apply knowledge of science and the scientific method to characterize the quality of evidence, and critically evaluate scientific and medical literature.
B6 Analyze how scientific and medical discoveries can be translated and applied to improve the health of individuals and diverse populations, including local and underserved communities.
IV.C. Competency C: Physician as Advocate
COMPETENCY
Through knowledge of the health care system, skill development, hands-on service, and leadership experiences, students will demonstrate the knowledge and skills to advocate for health care that is high-quality, safe, efficient, just, and equitable for individual patients and diverse populations, especially those that are marginalized, oppressed, and/or underserved. Students will recognize the need for continued efforts toward greater social and racial justice in the healthcare system.
C1 Analyze present, and when applicable, past, health care policies, economics, and financing and discuss their implications on individual patients, communities, and populations, recognizing the ways these policies have adversely affected the health of marginalized communities.
C2 Advocate for the broad range of their patients’ healthcare needs, including those stemming from social and structural determinants of health.
C3 Apply knowledge of the principles of patient safety, quality improvement, and systems science to ensure quality care for all patients.
C4 Identify and partner with relevant stakeholders within communities to understand their healthcare needs and how to best serve those needs, utilizing effective communication strategies.
IV.D. Competency D: Physician as Educator
COMPETENCY
Students will apply educational principles to facilitate effective learning and promote well-being among patients, families, and communities. Students will demonstrate the ability to effectively teach their peers, colleagues, and other health professionals in clinical practice, basic science, and translational medicine.
D1 Employ appropriate methods, including patient-centered and culturally responsive communication skills and techniques, to educate patients, and when applicable, families, caregivers, and/or other surrogate decision-makers to adopt and sustain healthy behaviors.
D2 Contribute to a supportive, inclusive, and stimulating learning environment.
D3 Utilize effective teaching techniques, including professional presentation skills, tailored to the number and type of learners, the setting and context, and the educational objectives.
D4 Provide effective and constructive feedback to learners, peers, colleagues, and teachers.
IV.E. Competency E: Physician as Colleague
COMPETENCY
Students will work collaboratively as members of medical, scientific, and educational communities.
E1 Demonstrate a recognition of, and respect for, the roles and contributions of the various members of the interdisciplinary and/or interprofessional health care team.
E2 Demonstrate the interpersonal and leadership skills to work collaboratively and inclusively with individuals and teams across classroom, clinical, community, and/or research settings.
E3 Demonstrate effective written communication skills.
E4 Demonstrate effective oral communication skills.
E5 Consider and acknowledge diverse perspectives in appraising alternative approaches to problem-solving and collaborative decision-making.
IV.F. Competency F: Physician as Role Model
COMPETENCY
Students will act in accordance with the highest levels of ethics and professionalism in all realms, including clinical care, research endeavors, advocacy, education, and general behavior as a member of society. Students will serve as role models for individual patients, colleagues, and society at large. Students will demonstrate dedication to their personal and professional development, including ongoing self-care, self-awareness, and self-reflection to sustain their commitment to core humanistic principles and service.
F1 Consistently attend required educational activities, notifying the appropriate supervisor if you are unable to attend.
F2 Consistently complete instructor and course/clerkship/acting internship evaluations to aid in the improvement of the educational program at Einstein.
F3 Treat all patients, colleagues, and community members equitably and respectfully no matter how they self-identify or how others may perceive them (e.g., age, race, ethnicity, country of origin, disabilities, sexual and gender identification, religion, political perspective, economic background, physical appearance, and/or legal status).
F4 Apply ethical principles in all aspects of patient care, research, and education.
IV.G. Competency G: Physician as Life-Long Learner
COMPETENCY
Students will recognize that learning is a life-long endeavor. Not only does scientific knowledge continually advance, but the methodologies, modalities, and technologies available to learners are ever-changing. Students must learn to critically assess new research and clinical innovations, as well as apply evidence-based and structurally competent recommendations. Effective lifelong learning requires that students engage in ongoing self-assessment and receive comprehensive feedback from external sources to identify personal knowledge gaps and maintain an enduring commitment to best practices.
G1 Identify gaps in understanding, knowledge, clinical skills, and/or reasoning.
G2 Conduct a literature search, review available evidence, and apply new knowledge, skills, and reasoning to patient care and/or research.
G3 Identify and correct gaps in knowledge, skills, and performance through self-reflection and feedback from others.
G4 Identify professional interests, strengths, options, and opportunities to guide career planning and development.

V. Definitions

Educational Program Objectives (EPOs): statement of objectives, in outcome-based terms, that allow for the assessment of medical students’ progress in developing the competencies that the profession and public expect of a physician. The Einstein EPOs are divided into seven competencies and 35 sub-competencies.

VI. Effective Date

Effective as of October 24, 2023

VII. Policy Management and Responsibilities

Einstein’s Office of Medical Education (OME) is the Responsible Office under this Policy. Einstein’s Executive Dean is the Responsible Executive for this Policy. Einstein’s Senior Associate Dean for Medical Education is the Responsible Officer for the management of this Policy.

 

Last approved by the Executive Committee of Einstein’s Medical Education Council in October 2023.