Core of Discipline (CD)
Core of Discipline (CD)
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Core of Discipline
Core of Discipline
The Core of Discipline Phase is where our residents will build on the skills learned in the Foundations phase as well as learn more advanced and difficult skills. After this phase, the resident will be adept at handling the majority of situations they will encounter practising Internal Medicine and will be ready to transition to practice or further training. In our program, this stage begins in July of the R2 year and continues until the end of R3. However, because many residents go into subspecialty training after R3, they may choose to get started on Transition to Practice EPAs during R3 while still working on Core EPAs. During Core, residents are expected to achieve the following EPAs:
CD1: Assessing, diagnosing and managing patients with complex or atypical acute medical presentations
CD2: Assessing, diagnosing, and managing patients with complex chronic diseases
CD3: Providing internal medicine consultation to other clinical services
CD4: Assessing, resuscitating, and managing unstable and critically ill patients
CD5: Performing the procedures of Internal Medicine
CD6: Assessing capacity for medical decision-making
CD7: Discussing serious and/or complex aspects of care with patients, families, and caregivers
CD8: Caring for patients who have experienced a patient safety incident (adverse event)
CD9: Caring for patients at the end of life
CD10: Implementing health promotion strategies in patients with or at risk for disease
CD11: Teaching and assessing junior learners through supervised delivery of clinical care
EPA
EPA
Instruction
Instruction
Assessment
Assessment
High Yield Rotations
High Yield Rotations
Workplace Instruction (Especially GIM Senior + ED rotation, sub-specialty consultations, ICU)
AHD Topics, numerous
EPA Observation CD1 - 18 successful
ITER (Consults/Clinics, ED/ICU/CCU, Nightfloat, Ward Senior)
R2 OSCE
ED Consults (UAH and RAH)
Community GIM
Emergency
ICU
Neurology
Subspecialty Consults
Most Selectives
Workplace Instruction (Especially sub-specialty clinics, GIM Ward Consults + PAC/UAC)
AHD Topics, numerous
EPA Observation CD2A - 12 successful
EPA Observation CD2B - 5 successful
ITER (Consults/Clinics, Clinics, Ward Senior)
R2 OSCE
UAC/PAC/Ward Consults
Community GIM
Neurology
Subspecialty Consults
Clinic Rotations
Any selective
Senior Medicine (CTU/IMT)
Workplace Instruction (All sub-specialty consultation rotations, GIM Ward Consults + PAC/UAC, R3 Ob Med rotation)
EPA Observation CD3A - 10 successful
EPA Observation CD3B - 6 successful
EPA Observation CD3C - 2 successful
ITER (Consults/Clinics, Clinics)
UAC/PAC/Ward Consults
RAH Consults service/senior med
Obs Med rotation
Preop clinics
Obs Med clinics
Other Consultation rotations
Workplace Instruction (Especially ICU/CCU, GIM Senior)
AHD Topics, numerous
Simulation Sessions
EPA Observation CD4A - 14 successful
EPA Observation CD4B - Collect multisource feedback from 6 individuals
ITER (ED/ICU/CCU, Nightfloat)
R2 OSCE
CD4A: ED Consults, Emergency, ICU, Senior Medicine (CTU/IMT)
CD4B: ICU, Senior Medicine (CTU/IMT)
Workplace Instruction
Simulation Sessions
EPA Observation CD5
Airway and Intubation - 3 successful
Art Line - 2 successful
Central Line - 5 successful
Joint arthrocentesis - 2 successful
Lumbar puncture - 3 successful
Paracentesis - 3 successful
Thoracentesis - 3 successful
ICU, Emerg
ICU, Emerg
ICU, Emerg, GIM Jr or Sr
Emerg, Rheum, GIM Jr or Sr
Emerg, ID, Neuro, GIM Jr or Sr
Emerg, GI, GIM Jr or Sr
Emerg, Pulmonary, GIM Jr or Sr
Workplace Instruction
AHD Topic – capacity/competency assessment
EPA Observation CD6 - 3 successful
Geriatric Medicine, ED Consults, Community GIM, Senior Medicine, Emerg
Workplace Instruction (Especially ICU, GIM Senior)
EPA Observation CD7 - 3 successful
Senior Medicine (CTU/IMT)
Some Consultation rotations for breaking bad news
Workplace Instruction
EPA Observation CD8 - 2 successful
Any
Workplace Instruction
AHD Topics, various
EPA Observation CD9A - 3 successful
EPA Observation CD9B - 2 successful
Senior Med
Palliative Care
Geriatric Medicine
Workplace Instruction
AHD Topics, various
UAC/PAC/Ward Consults
Outpatient clinics
Any consults service
Workplace Instruction (Especially GIM Senior)
Mandated AHD teaching for medical students ED consults, AM teaching while GIM Senior
AHD/Journal Club presentation required annually
EPA Observation CD11A - MSF with 4 successful
EPA Observation CD11B - 2 successful
ITER (Ward Senior) rating scale on
Teaching and Supervising Learners
Senior Medicine (CTU/IMT)
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