Core Competencies

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1) Patient Care

Program Year 1: PGY-3

To provide compassionate, appropriate and effective patient care for the promotion of health, prevention of illness, treatment of neurological problems and care at the end of life
Make informed recommendations about preventive, diagnostic, and therapeutic options, and interventions that are based on clinical judgment, scientific evidence, and patient preferences
Be able to perform a thorough and accurate physical exam on children with common neurological problems.
Gather essential information from other sources such as medical records and radiology
Integrate the past and current clinical information to arrive at a problem oriented, prioritized, differential diagnosis
Be able to initiate a correct management plan for common neurological problems
Understand the indications, contraindications, and risks of commonly ordered medications, medical tests, and procedures in neurological patients
Able to perform technical neurological procedures adequately.
Be able to prioritize patients’ problems so that daily patient care duties can be completed in an accurate and timely manner
Understand appropriate monitoring and follow-up of patients, which includes laboratory data, test results, and medication use

Progressive patient care responsibilities

Program Year 2: PGY-4

All of the above and additionally:

Be able to obtain a precise, logical and efficient history
Be able to elicit subtle neurological findings on physical examination
Be able to use diagnostic procedures and therapies appropriately
Be able to interpret results of diagnostic tests and procedures properly
Be able to analyze clinical data to make informed decisions about patient management
Weigh alternatives for diagnosis and treatment giving consideration to patient preferences, risks, benefits, and cost
Counsel and educate patients about pertinent health issues, tests, and treatments
Manage multiple neurological and medical problems at once
Be able to choose an appropriate care location for inpatient conditions
Be able to perform neurological procedures without supervision

Program Year 3: PGY-5

All of the above and additionally:

Be competent in the care for children with the majority of neurological disorders with increasing independence
Consistently and thoroughly educate patients and their families
Demonstrate the ability to devote an appropriate amount of time to diagnostic reasoning and treatment as related to the complexity of the problem(s)
Reason well in ambiguous situations
Perform neurological procedures without supervision

2) Medical Knowledge

Residents are expected to:

Program Year 1: PGY-3

Demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and demonstrate the application of that knowledge to patient care and education of others
Apply an open-minded and analytical approach to acquiring new biomedical and clinical knowledge
Develop applicable knowledge of the basic clinical and neurobehavioral sciences that underlie the practice of neurology
Apply this knowledge in developing critical thinking, clinical problem-solving, and clinical decision-making skills in specific cases under their care
Access and critically evaluate current medical information and scientific evidence and modify knowledge base accordingly

Progressive responsibilities

Program Year 2: PGY-4

All of the above and additionally:

Demonstrate advancement in content knowledge and analytical thinking in order to develop well-formulated differential diagnoses for patients with uncommon diseases as well as patients with multiple problems
Demonstrate knowledge of epidemiology and social and behavioral science and be able to apply that knowledge to the care of the patient
Understand the indications, contraindications and risks of commonly used medications and procedures in child neurology
Demonstrate leadership and teaching skills in managing daily rounds and outpatient sessions
Attends and participates in conferences to continuously learn and reinforce medical knowledge and skills
Independently present up-to-date scientific evidence to support hypotheses
Develop knowledge of statistical principles such as sensitivity, specificity, predictive values, number needed to treat and odds ratios

Program Year 3: PGY-5

All of the above and additionally:

Regularly display self-initiative to stay current with new medical knowledge
Demonstrate continued advancement in neurological knowledge as appropriate for Board certification
Demonstrate an investigatory and analytic approach to clinical situations

3) Interpersonal and Communication Skills

The Resident demonstrates interpersonal and communication skills that result in effective information exchange and collaboration with patients, families and other health professionals. These skills include the ability to communicate across a broad range of socio-economic and cultural backgrounds and ability to communicate with physicians, health professionals, and health related agencies effectively. Resident is able to maintain comprehensive, timely and readable medical records. Resident can work effectively as a member or leader of a healthcare team and serve appropriately as a consultant to other physicians and health professionals. Resident is able to clearly lead daily work rounds, when appropriate.

Residents are expected to:

Program Year 1: PGY-3

Be able to perform an accurate, thorough yet concise oral presentations regarding patient care
Use effective listening, narrative, and non-verbal skills to elicit information from patients
Be able to use medical terminology appropriately
Prepare written notes (admission notes, transfer notes, progress notes, discharge summaries, etc.), which are legible and timely
Establish rapport with patients from a variety of backgrounds
Demonstrate proficiency in use of verbal and nonverbal skills in interactions with colleagues, nursing, and ancillary staff
Be able to effectively communicate uncomplicated diagnostic and therapeutic plans to patients and their parents
Be able to work as team members with medical students, senior residents, and attending physicians as well as with other members of the healthcare team
When working with medical students, be able to observe students, demonstrate skills and give constructive feedback

Progressive responsibilities

Program Year 2: PGY-4

All of the above and additionally:

Progressively assume a leadership role, facilitating interactions between team members, including establishing expectations, and overseeing patient care
Be able to engage patients in shared decision-making or ambiguous or controversial scenarios
Effectively discuss informed consent, resuscitation status, and death and dying with patients and families
Should be able to negotiate most "difficult" patient encounters including the irate patient
Provide effective education and counseling to patients and families regarding health and illness
Demonstrate an effective working relationship with other members of the healthcare team including nurses and ancillary staff

Program Year 3: PGY-5

All of the above and additionally:

Be able to successfully negotiate nearly all difficult patient encounters with minimal direction
Be able to function as team leaders with decreasing reliance on attending physicians
Be able to function as a consultant, including completion of appropriate documentation and verbal communication with the requesting physician.
Be able to demonstrate the development of long term professional relationships with patients followed since early in the PGY-3 year

4) Professionalism

Committed to carrying out professional responsibilities and adhering to ethical principles. Resident demonstrates respect for patient privacy and autonomy and is accountable to patient, society and the medical profession for actions. Resident demonstrates compassion, integrity and respect for others as well as responsiveness to patient needs that supersede self-interest. The Resident demonstrates sensitivity and responsiveness to a broad patient population including diversity in gender, age, culture, race, religion, disability, and sexual orientation. Resident demonstrates the ability to manage personal stress effectively. Answer pages or messages in a timely fashion. Resident understands how to maintain appropriate professional boundaries, and demonstrates integrity, honesty and compassion. Resident completes assigned tasks in a timely fashion.

Residents are expected to:

Program Year 1: PGY-3

Demonstrate respect and compassion in interactions patients and their families, colleagues, and other members of the health care team
Demonstrate respect, compassion, integrity, and honesty
Be responsible for the safety and wellbeing of patients, colleagues and staff
Appropriately maintain patient confidentiality
Responding in a timely manner to staff needs including pages and abnormal lab tests
Follow directions
Complete tasks assigned
Maintain a professional appearance
Be punctual
Show responsibility for meeting program requirements

Progressive responsibilities

Program Year 2: PGY-4

All of the above and additionally:

Display initiative and leadership in his/her daily role as a resident physician
Demonstrate commitment to ethical principles including but not limited to patient confidentiality, informed consent, and business practices
Demonstrate sensitivity to children and their parent’s culture, gender, age, preferences, and child’s disabilities
Demonstrate progress in meeting some or most program requirements including starting scholarly projects
Display initiative in career planning after the completion of residency
Exhibit concern for the educational development of fellow residents and students
Provide leadership
Be willing to help colleagues

Program Year 3: PGY-5

All of the above and additionally:

Be able to act appropriately in the role as a medical consultant
Demonstrate progress in meeting all program requirements
Function as team leaders with decreasing reliance on attending physicians
Be a self-directed learner
Function as a role model
Complete scholarly project by graduation

5) Practice-Based Learning and Improvement

Resident is able to critically evaluate the care of their patients, appraise and assimilate scientific evidence, and continuously improve patient care delivered on the basis of ongoing self-evaluation and learning. The resident uses knowledge to educate patient families, team members, pediatric and neurology residents, medical students, allied health personnel, peers, and other health professionals as appropriate. Resident is capable of self-identifying strengths, deficiencies, and the limits of their knowledge and expertise. The Resident is receptive to constructive criticism (formative evaluation feedback) regarding the care of patients and physician performance. Resident is able to set learning and improvement goals, and identify and perform activities appropriate to meeting those goals.

Residents are expected to:

Program Year 1: PGY-3

Be self-motivated
Be able to formulate clinical questions in the day-to-day care of patients
Be able to locate scientific literature to assist in medical decision-making
Be able to identify ones’ limitations of knowledge and skills and seek help when needed
Accept feedback and develop self-improvement plans when appropriate
Start to develop skills in teaching with patients, staff, and colleagues

Progressive responsibilities

Program Year 2: PGY-4

All of the above and additionally

Be able to formulate, search, and answer clinical questions using the scientific literature
Use an evidence-based approach to providing patient care
Demonstrate continual self-evaluation to correct deficiencies and develop new skills
Demonstrate teaching initiative and skills with patients, students, and colleagues

Program Year3: PGY-5

All of the above and additionally:

Be able to appraise and assimilate scientific literature into daily practice
Appropriately integrate EBM with expert opinion and professional judgment when available
Effectively and efficiently utilize consultation services to improve both patient care and self-knowledge
Be able to analyze personal practice patterns systematically, and look to continuously improve
Demonstrate use of teaching skills to create an effective learning environment for students, junior house staff, and patients

6) Systems-Based Practice:

Residents are required to develop an understanding of the local and national healthcare systems within which they operate, as well as the legitimate time and monetary constraints inherent to such systems. Likewise, they are required to employ the tools and techniques with which they are provided during initials orientation to control costs and ensure equitable allocation of resources while attempting to negate detrimental impact on patients and/or patient families.

Residents are expected to:

Program Year 1: PGY-3

To demonstrate the ability to interact with many other entities and services within the medical center
Meet hospital requirements of medical practice l including: timely dictations and notes, timely evaluations of attendings, peers, others
Display sensitivity to costs and be able to incorporate fundamental cost-effective analysis into care approaches, minimizing unnecessary care
Assist patients in dealing with system complexity
Be able recognize system problems

Progressive responsibilities

Program Year 2: PGY-4

All of the above and additionally:

Work well with their core team that includes other physicians, nurses, therapists and other healthcare professionals to assess, coordinate and improve patient care
Be able to guide patients and families through the complex healthcare environment
Demonstrate effective and timely participation in the system-approach to outpatient follow-up in order to improve the quality of patient care delivery in the outpatient setting
Demonstrate a basic understanding of the methods of controlling healthcare costs and appropriate allocation of resources

Program Year 3: PGY-5

All of the above and additionally:

Demonstrate the ability to adapt to change
Be able to effectively coordinate care with other healthcare providers as needed
Demonstrate familiarity of utilization of resources that assist with patient care and disposition
Develop an understanding of medical delivery systems, including alternative care resources, ambulatory care resources, rehabilitation resources and continuing care resources
Be able to practice effective allocation of health care resources that does not compromise the quality of care
Provide improvement opportunities for the healthcare system