Internal Medicine — Transition to Practice

TTP2a Managing longitudinal aspects of care in a medical clinic - Part A: Overall Patient Care

Key Features:
- This EPA focuses on the efficient management of a longitudinal outpatient clinic in the role of the physician most responsible for patient care.
- This EPA may be observed in a variety of clinics: general Internal Medicine clinics with a variety of patient presentations; focused clinics with patients with a narrow spectrum of presentations (e.g. COPD clinic); general subspecialty clinics with a variety of patient presentations.
- The observation of this EPA is divided into two parts: overall patient care and working effectively and efficiently with the interprofessional team in an outpatient setting.

Assessment Plan:

Part A: Overall Patient Care

Chart review (e.g. review of consult letter) by supervisor.

Use Form 1. Form collects information on:
- Type of clinic: general IM; focused; general subspecialty

Collect 10 observations of achievement

Milestones

• ME 1.4. Perform relevant and time-effective clinical assessments

• ME 2.2. Select investigation strategies demonstrating awareness of availability and access in the outpatient setting

• ME 2.4. Establish a patient-centered management plan

• ME 2.4. Formulate treatment plans that are suitable for implementation in the outpatient setting

• COL 1.3. Use referral and consultation as opportunities to improve quality of care and patient safety

• ME 4.1. Coordinate investigation, treatment and followup when multiple physicians and health care professionals are involved

• S 3.4. Integrate best evidence and clinical expertise into decision-making

• COM 5.1. Document clinical encounters to adequately convey clinical reasoning and the rationale for decisions

• COL 1.3. Provide accurate, timely and relevant written information to the referring/primary care physician

• COL 1.3. Address the questions and concerns of the referring/primary care physician when acting in the consultant role

• L 2.1. Allocate health care resources for optimal patient care

• P 2.2. Adhere to institutional policies and procedures in delivering clinical care