General Policies & Procedures: Essential Capacities for Matriculation, Promotion & Graduation for U of M GME Programs

Essential Capacities for Matriculation, Promotion, and Graduation
University of Minnesota Medical School Graduate Medical Education Programs

I. General Issues

A. Overview

• Graduate Medical Education requires that the accumulation of scientific knowledge be accompanied by the simultaneous development of specific skills and competencies. Because our Medical School has a responsibility to society to graduate the best possible physicians, all resident physicians and fellows must meet both our academic standards and our technical standards to matriculate, to progress through the curriculum and to meet the requirements for graduation from University of Minnesota Medical School residency and fellowship programs.

Academic standards refer to acceptable demonstrations of mastery in various disciplines, before matriculation and after, as judged by faculty members, examinations, and other measurements of performance. Acceptable levels of mastery are required in six broad areas of competency once a student matriculates at the University of Minnesota Medical School. These six areas of competency are used by graduate medical education programs to evaluate their residents.

These six areas of competency are:

• Medical/scientific knowledge
• Clinical Skills/patient care
• Professionalism
• Communication/interpersonal skills
• Practice-based learning (engaging in self-assessment and utilizing appropriate resources to make improvements in one's learning and performance)
• Systems-based practice (understanding complex medical systems in order to effectively carry out responsibilities to optimize patient care)

The University of Minnesota Medical School residency and fellowship programs are committed to preparing our residents and fellows within the continuum of medical education.  Our academic and technical standards are based upon the goal of training capable, well-rounded future clinicians.

Academic standards are addressed in more detail in the curriculum. Any resident or fellow who has specific questions about performance requirements, should speak with the residency/fellowship program director.

Our technical standards are described in detail under item II.  Technical standards refer to the essential aptitudes and abilities that allow individuals to perform the duties required of resident physicians and fellows.  Additional technical standards may be added to meet the specific requirements of individual programs.

 Without the capability to meet our technical standards, residents and fellows cannot fulfill the requirements of residency/fellowship programs at the University of Minnesota Medical School.  Meeting the University of Minnesota Medical School technical standards (detailed below) is, therefore, required for 1) matriculation (insomuch as the abilities can reasonably be determined before matriculation), 2) subsequent promotion from year to year, and 3) successful completion of a residency/fellowship program from the University of Minnesota Medical School.

B. Residents and Fellows with Disabilities

It is our experience that a number of individuals with disabilities (as defined by Section 504 of the Rehabilitation Act and the Americans with Disabilities Act) are qualified to study and practice medicine with the use of reasonable accommodations. To be qualified for the study of medicine at the University of Minnesota Medical School, those individuals must be able to meet both our academic and technical standards, with or without reasonable accommodation.  Accommodation is viewed as a means of assisting individuals with disabilities to meet essential standards by providing them with an equal opportunity to participate in all aspects of the program.  (Reasonable accommodation is not intended to guarantee that residents/fellows will be successful in meeting the requirements of the course or program.)*

*Reasonable Accomodations May Not:

• fundamentally alter the nature of the training program
• compromise the essential elements of the program
• cause an undue financial or administrative burden
• Endanger the safety of patients, self or others

C. The Use of Auxiliary Aids and Intermediaries

Qualified residents/fellows with documented disabilities are provided with reasonable accommodations at the University of Minnesota Medical School, which may include involvement of an intermediary or an auxiliary aid.  No disability can be reasonably accommodated at the University of Minnesota Medical School with an intermediary that provides cognitive support or substitutes for essential clinical skills, or supplements clinical and ethical judgment. Thus, accommodations cannot eliminate essential program elements or fundamentally alter the residency/fellowship program curriculum.

II. The University of Minnesota Medical School Technical Standards

Residents and fellows at the University of Minnesota Medical School must meet the technical standards, with or without reasonable accommodations, which are grouped in five broad areas:

• Perception/observation
• Communication
• Motor/tactile function
• Cognition
• Professionalism

A. Perception/Observation

Residents and fellows must be able to perceive, by the use of senses and mental abilities, the presentation of information through:

• Small group discussions and presentations
• Large-group lectures
• One-on-one interactions
• Demonstrations
• Laboratory experiments
• Patient encounters (at a distance and close at hand)
• Diagnostic findings
• Procedures
• Written material
• Audiovisual materials
  

B. Communication

Residents and fellows must be able to skillfully (in English) communicate verbally and in written form with faculty members, other members of the healthcare team, patients, families, and other students, in order to:

• Elicit information
• Convey information
• Clarify information
• Create rapport
• Develop therapeutic relationships
• Demonstrate the Medical School and core competencies

C. Motor/tactile function

Residents and fellows must have sufficient motor function and tactile ability to meet the competencies required for graduation and to:

• Attend (and participate in) classes, groups, and activities which are part of the curriculum
• Communicate in a written format
• Examine patients (including observation, auscultation, palpation, percussion, and other diagnostic maneuvers)
• Do basic laboratory procedures and tests
• Perform diagnostic procedures
• Provide general and emergency patient care
• Function in outpatient, inpatient, and surgical venues
• Perform in a reasonably independent and competent way in sometimes chaotic clinical environments
• Demonstrate the Medical School and core competencies

D. Cognition

Residents and fellows must be able to demonstrate higher-level cognitive abilities, which include:

• Rational thought
• Measurement
• Calculation
• Visual-spatial comprehension
• Conceptualization
• Analysis
• Synthesis
• Organization
• Representation (oral, written, diagrammatic, three dimensional)
• Memory
• Application
• Clinical reasoning
• Ethical reasoning
• Sound judgment 

E. Professionalism:

Residents and fellows must be able to:

• Consistently display integrity, honesty, empathy, caring, fairness, respect for self and others, diligence, and dedication
• Promptly complete all assignments and responsibilities attendant to the diagnosis and care of patients (beginning with study in the first year)
• Develop mature, sensitive, and effective relationships, not only with patients but with all members of the medical school community and healthcare teams
• Tolerate physically, emotionally, and mentally demanding workloads
• Function effectively under stress, and proactively make use of available resources to help maintain both physical and mental health
• Adapt to changing environments, display flexibility, and be able to learn in the face of uncertainty
• Take responsibility for themselves and their behaviors

Any residency or fellowship applicant or resident/fellow who has a question about whether he or she can meet these standards due to the functional limitations from a disability, should contact Disability Services for a confidential discussion.

 A disability specialist is available to talk with any medical school applicant or resident/fellow about their concerns related to a physical, sensory, medical, learning, or psychiatric condition that may be a disability.