CDIM/SGIM Guide

At the beginning of each clerkship, medical students might wonder "What do I need to learn during this clerkship?"  For the Internal Medicine Clerkships (Inpatient and Outpatient), this simple question is, unfortunately, not so easy to answer.  It is clearly not possible during an 8-week clerkship (Inpatient) or a 4-week clerkship (Outpatient) to learn (or to teach) all that comprises internal medicine.  There are, however, some core clinical competencies that all students must master.  A select group of members of the Clerkship Directors in Internal Medicine and the Society of General Internal Medicine created a list of major core clinical competencies.  Within each topic, the pertinent learning objectives (knowledge, skills and attitudes) are enumerated.  Students are expected to be well along the path to mastering these core clinical competencies by the end of the Internal Medicine Clerkships (Inpatient and Outpatient combined).

Diagnostic Decision-Making Prevention
Case Presentation Skills Coordination of Care
History Taking and Physical Examination Basic Procedures
Communication/Relations with Patients and Colleagues Geriatric Care
Test Interpretation Community Health Care
Therapeutic Decision Making Nutrition
Bioethics of Care Advanced Procedures
Self Directed Learning

Students will learn most of the above competencies during their participation in clinical care (including contact with their patients and the medical providers) and by supplementing these experiences with appropriate educational materials.  When they are learning about specific topics, students often ask "What do I need to know about this?"  Again, while it is impossible for educators to tell students everything they must learn, it is possible to offer some guidance.  To this end, the CDIM/SGIM group also created a set of common clinical complaints and conditions.  Within each topic, specific learning objectives are listed.  While there are many topics that are not listed, students can use these outlines to get a sense of the depth and breadth of knowledge they are expected to acquire during the Clerkships (Inpatient and Outpatient).

Patients with a Symptom, Sign, or Lab Abnormality Patients with a Known Disease Condition
Abdominal Pain Congestive Heart Failure
Altered Mental Status COPD
Anemia Depression
Back Pain Diabetes Mellitus
Chest Pain Dyslipidemia
Cough HIV Infection
Dysuria Hypertension
Fluid, Electrolyte, and Acid-Base Disorders Smoking Cessation
Joint Pain Substance Abuse
Healthy Patient Common Cancers

Many of these topics will be covered during the Inpatient Clerkship lecture series and with the Outpatient Clerkship required readings.  Students also need to read broadly from an appropriate, mid-sized medicine textbook to ensure that they are covering all the critical topics relevant to internal medicine.  We encourage students to ask their residents, attendings, and the clerkship directors for guidance as needed.