Training Problems

A review of the basic clinical competencies underscores the fact that internal medicine is a very broad field that emphasizes cognitive work and interpersonal skills. Some argue that any patient will suffice to teach internal medicine's basic approach to clinical problem solving, but most faculty agree that mastery of a substantial fund of knowledge should be emphasized in the core clerkship. Consequently, high-priority "training problems" have been specified that help to define the core knowledge base. The training problems listed below received the highest scores from internal medicine faculty in a national survey.

Healthy Patients

1. Health Promotion

Patients Presenting with a Symptom, Sign, or Lab Abnormality

1. Cough
2. Dysuria
3. Back pain
4. Altered mental status
5. Joint pain
6. Chest pain
7. Abdominal pain
8. Fluid, electrolyte, or acid-base disorder
9. Anemia
10. Dyspnea
11. Fever
12. GI bleeding
13. Rash

Patients Presenting with a Known Condition

1. Hypertension
2. Chronic obstructive pulmonary disease
3. HIV infection
4. Congestive heart failure
5. Diabetes mellitus
6. Dyslipidemia
7. Lung cancer
8. Colorectal cancer
9. Breast cancer
10. Acute MI
11. Liver disease
12. Nonsociomial infections
13. Obesity
14. Pneumonia
15. Rheumatological problems
16. VTE