College of MedicineMD ProgramCurriculumMedical Education Program ObjectivesObjectives, Competencies, and Milestones

Medical Education Program Objectives, Competencies, and Milestones

The information on this page applies to cohorts 2027, 2028, and 2029. Learn more for cohorts 2030 and beyond. To request a visual framework of the Objectives, Competencies, and Milestone please email medicine.cmu@wsu.edu.

Milestones Framework Components

Domains/Competencies – Education Program Objectives – Sub-competencies – Enabling Competencies)

Medical and Scientific Knowledge: Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral concepts in caring for healthy, ill patients and the community.
- 1.1 Knowledge Building
  - 1.1.1 Structure and Function of the Human Body
- 1.2 Knowledge Integration
  - 1.2.1 Application and Integration
  - 1.2.2 Evidence-based Knowledge Acquisition
  - 1.2.3 Knowledge Transfer
Patient Care and Health Promotion: Provide evidence-based care that is compassionate, culturally appropriate, and effective for illness prevention, health promotion, treatment of disease, and improvement in quality of life, including appropriate end-of-life care.
- 2.1 Medical History
  - 2.1.1 Medical History
- 2.2 Physical Examination
  - 2.2.1 Physical Examination
- 2.3 Clinical Reasoning
  - 2.3.1 Clinical Reasoning
  - 2.3.2 Differential diagnosis
  - 2.3.3 Diagnostic work-up
- 2.4 Management
  - 2.4.1 Assessment and Plan
  - 2.4.2 Consultations and Referrals
  - 2.4.3 Patient-Centered Care and Health Promotion
  - 2.4.4 Longitudinal Patient Care
- 2.5 Documentation
  - 2.5.1 Documentation
- 2.6 Procedural Skills
  - 2.6.1 Technical Skills / Procedures
- 2.7 Informed Consent
  - 2.7.1 Informed Consent
- 2.8 Urgent Care
  - 2.8.1 Urgent Care
Professionalism and Self Awareness: Demonstrate commitment to professional services, adherence to ethical principles, and awareness of one’s own interests, personal biases, vulnerabilities, and limitation of knowledge.
- 3.1 Professionalism
  - 3.1.1 Attitude / Demeanor
  - 3.1.2 Compassion and Respect
  - 3.1.3 Integrity
  - 3.1.4 Accountability
- 3.2 Self-awareness
  - 3.2.1 Discernment
  - 3.2.2 Intercultural Awareness
- 3.3 Ethical Practice
  - 3.3.1 Ethics
  - 3.3.2 Values
Practice-based and Life-long Learning: Demonstrate the ability to appraise, assimilate, innovate, and incorporate scientific evidence to evaluate and improve patient care practices based on continuous self-evaluation and life-long learning.
- 4.1 Self-ownership of Learning
  - 4.1.1 Informed Self-assessment
  - 4.1.2 Receptivity to Feedback
  - 4.1.3 Feedback Practices
- 4.2 Continual Improvement
  - 4.2.1 Curiosity and Inquiry
  - 4.2.2 Limitation of Knowledge/Skills
  - 4.2.3 Reflection on Practice
System-based and Inter-professional Practice: Demonstrate awareness of and responsiveness to the larger context of health care and the ability to call on system resources, including other health care professionals, to provide optimal care.
- 5.1 Teambuilding and Teamwork
  - 5.1.1 Roles and Responsibilities
  - 5.1.2 Initiative and Contribution
  - 5.1.3 Interpersonal Collaboration
- 5.2 Professional Relationships
  - 5.2.1 Insights
  - 5.2.2 Adaptability
  - 5.2.3 Inclusivity
- 5.3 Health Systems Science
  - 5.3.1 Structure and Function of Health Care Delivery
  - 5.3.2 Patient Safety
  - 5.3.3 Quality Improvement
- 5.4 Population and Community Health
  - 5.4.1 Social Determinants and Health Equity
  - 5.4.2 Advocacy and Health Advocate
Interpersonal and Communication Skills: Demonstrate effective information exchange and collaboration with patients, their families, peers, and other health professionals to enhance their care.
- 6.1 Communication
  - 6.1.1 Medical Information
  - 6.1.2 Active Listening
  - 6.1.3 Respectful communication
- 6.2 Written/Oral Fluency
  - 6.2.1 Content
  - 6.2.2 Organization
  - 6.2.3 Flow and Style

Domain/Competency: Medical and Scientific Knowledge

Education Program Objective

Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and socialbehavioral concepts in caring for healthy, ill patients and the community.

Sub-Competency: Knowledge Building

Enabling Competency: Structure and Function of the Human Body
- Milestone Year 1–4: Analyze the normal and abnormal structure and function of the human
  body.

Sub-Competency: Knowledge Integration

Enabling Competency: Application and Integration
- Milestone Year 1 & 2: Integrate biomedical, social, clinical sciences, and health systems knowledge to address simulated clinical scenarios.
- Milestone Year 3 & 4: Integrate biomedical, social, clinical sciences, and health systems knowledge to address clinical scenarios.
Enabling Competency: Evidence-based Knowledge Acquisition
- Milestone Year 1: Formulate clinical questions and identify appropriate resources to address them.
- Milestone Year 2 & 3: Formulate clinical questions, identify clinical sources, and critically appraise evidence to address simulated clinical problems.
- Milestone Year 4: Critically appraise information to solve clinical problems.
Enabling Competency: Knowledge Transfer
- Milestone Year 1 & 2: Organize and synthesize medical and scientific knowledge.
- Milestone Year 3 & 4: Organize and synthesize relevant medical and scientific knowledge for educating peers, healthcare team members.

Domain/Competency: Patient Care and Health Promotion

Education Program Objective

Provide evidence-based care that is compassionate, culturally appropriate, and effective for illness prevention, health promotion, treatment of disease, and improvement in quality of life, including appropriate end-of-life care.

Sub-Competency: Medical History

Enabling Competency: Medical History
- Milestone Year 1: Demonstrate a fluent collection of a thorough medical history.
- Milestone Year 2: Obtain a hypothesis driven medical history in a standardized environment.
- Milestone Year 3: Obtain a complete or focused medical history considering the patient’s clinical situation.
- Milestone Year 4: Obtain a relevant, thorough, and reproducible medical history considering the patient’s clinical situation.

Sub-Competency: Physical Examination

Enabling Competency: Physical Examination
- Milestone Year 1: Demonstrate a skillful comprehensive physical examination.
- Milestone Year 2: Perform a relevant and complete physical examination in a standardized environment.
- Milestone Year 3: Perform a relevant physical exam pertinent to the setting and purpose of the patient’s visit.
- Milestone Year 4: Perform a relevant, thorough, and reproducible physical exam pertinent to the setting and purpose of the patient’s visit.

Sub-Competency: Clinical Reasoning

Enabling Competency: Reasoning
- Milestone Year 1 & 2: Identify and use clinical information to support a plausible reasoning argument in simulated clinical scenarios.
- Milestone Year 3: Use clinical information to defend a plausible reasoning argument in real patient care.
- Milestone Year 4: Use clinical information to defend a plausible reasoning argument in real patient care in a variety of settings and contexts.
Enabling Competency: Differential diagnosis
- Milestone Year 1: Formulate and prioritize a differential diagnosis in a standardized environment.
- Milestone Year 2: Formulate and prioritize a plausible differential diagnosis in a standardized environment.
- Milestone Year 3: Formulate and prioritize a plausible differential diagnosis considering all relevant sources of information for common conditions.
- Milestone Year 4: Independently formulate and prioritize a plausible differential diagnosis considering all relevant sources of information for common and complex clinical presentations.
Enabling Competency: Diagnostic work-up
- Milestone Year 1 & 2: Recommend evidence-based investigations to discriminate between diagnoses in a standardized environment.
- Milestone Year 3: Recommend and defend evidence-based investigations to discriminate between diagnoses for common conditions taking into consideration the patient preferences and the specific clinical context.
- Milestone Year 4: Recommend and defend evidence-based investigations to discriminate between diagnoses for common and complex conditions taking into consideration the patient preferences and the specific clinical context.

Sub-Competency: Management

Enabling Competency: Assessment and Plan
- Milestone Year 1 & 2: Propose a treatment and management plan based on synthesis and interpretation of clinical and diagnostic investigations in a standardized environment.
- Milestone Year 3: Recommend and defend treatment and management plans based on synthesis and interpretation of clinical and diagnostic investigations for common conditions taking into consideration the patient’s preferences and the specific clinical context.
- Milestone Year 4: Recommend and defend treatment and management plans based on synthesis and interpretation of clinical and diagnostic investigations for common and complex conditions taking into consideration the patient’s preferences and the specific clinical context.
Enabling Competency: Consultations and Referrals
- Milestone Year 1 & 2: Identify clinical scenarios that might require consultations and or referrals in clinical scenarios.
- Milestone Year 3 & 4: Identify and participate in consultations and or referrals.
Enabling Competency: Patient-Centered Care and Health Promotion
- Milestone Year 1 & 2: Recognize and where appropriate propose health promotion activities taking into consideration the patients’ culture and preferences.
- Milestone Year 3: Support patient engagement in health promotion activities considering the individual’s health goals, culture, and preferences.
- Milestone Year 4: Promote patient engagement in health promotion activities considering the individual’s health goals, culture, and preferences.
Enabling Competency: Longitudinal Patient Care
- Milestone Year 1 & 2: Outline opportunities and potential barriers to providing continuity of care.
- Milestone Year 3 & 4: Independently develop plans to assure continuity of care considering patients preferences and specific clinical context, including handovers and transition of care.

Sub-Competency: Documentation

Enabling Competency: Documentation
- Milestone Year 1–4: Organize and document medical information in writing.

Sub-Competency: Procedural Skills

Enabling Competency: Technical Skills / Procedures
- Milestone Year 1 & 2: Perform clinical procedures, patient education, and counseling in a standardized environment.
- Milestone Year 3 & 4: Perform clinical procedures, patient education, and counseling in clinical environment.

Sub-Competency: Informed Consent

Enabling Competency: Informed Consent
- Milestone Year 1–4: Obtain informed consent as appropriate for patient care and research activities.

Sub-Competency: Urgent Care

Enabling Competency: Urgent Care
- Milestone Year 1: Recognize patients requiring urgent care in a standardized environment.
- Milestone Year 2: Recognize patients requiring urgent care, ask for help, and propose an intervention and management plan.
- Milestone Year 3: Recognize patients requiring urgent care, ask for help, and participate in the intervention and management plan.
- Milestone Year 4: Recognize patients requiring urgent and escalating care, ask for help, and initiate intervention and management plan.

Domain/Competency: Professionalism and Self Awareness

Education Program Objective

Demonstrate commitment to professional services, adherence to ethical principles, and awareness of one’s own interests, personal biases, vulnerabilities, and limitation of knowledge.

Sub-Competency: Professionalism

Enabling Competency: Attitude / Demeanor
- Milestone Year 1–4: Demonstrate professional verbal and non-verbal behavior, mannerisms, and respect even under duress.
Enabling Competency: Compassion and Respect
- Milestone Year 1–4: Demonstrate sympathy and empathy and willingness to help others with due regard for the feelings, wishes, rights, or traditions of others.
Enabling Competency: Integrity
- Milestone Year 1–4: Demonstrate honesty, fairness and adhere to strong moral and ethical principles and values.
Enabling Competency: Accountability
- Milestone Year 1–4: Demonstrate ownership of required tasks, patient care responsibilities, and prioritize competing demands.

Sub-Competency: Self-awareness

Enabling Competency: Discernment
- Milestone Year 1 & 2: Demonstrate awareness of one’s limitations and seek help when needed.
- Milestone Year 3: Recognize limitations, act only within one’s capabilities, and ask for help when needed.
- Milestone Year 4: Recognize limitations, proactively anticipate situations requiring help, act only within one’s capabilities, and ask for help when needed.
Enabling Competency: Intercultural Awareness
- Milestone Year 1–4: Maintain an interpersonal stance that is other-oriented and respectful of others’ beliefs, assumptions, and values.

Sub-Competency: Ethical Practice

Enabling Competency: Ethics
- Milestone Year 1: Identify and discuss ethical issues and frameworks.
- Milestone Year 2: Analyze and apply appropriate ethical frameworks to simulated clinical scenarios.
- Milestone Year 3: Analyze and apply appropriate ethical frameworks to clinical practice.
- Milestone Year 4: Integrate ethical decision making into clinical practice.
Enabling Competency: Values
- Milestone Year 1 & 2: Accept one’s own moral stance might differ from others’.
- Milestone Year 3: Engage in respectful discourse when moral conflict arises between peers and with supervisors.
- Milestone Year 4: Engage in respectful discourse in situations when moral conflict arises between peers, supervisors, healthcare team members, patients, and their family members.

Domain/Competency: Practice-based and Life-long Learning

Education Program Objective

Demonstrate the ability to appraise, assimilate, innovate, and incorporate scientific evidence to evaluate and improve patient care practices based on continuous self-evaluation and life-long learning.

Sub-Competency: Self-ownership of Learning

Enabling Competency: Informed Self-assessment
- Milestone Year 1–4: Identify opportunities for learning and improvement by reflecting on multiple sources of information and utilizing them to analyze performance.
Enabling Competency: Receptivity to Feedback
- Milestone Year 1–4: Demonstrate receptivity to feedback information from multiple sources.
Enabling Competency: Feedback Practices
- Milestone Year 1–4: Seek and translate feedback from multiple sources and incorporate with informed self-assessment to develop and follow through on personal learning plans.

Sub-Competency: Continual Improvement

Enabling Competency: Curiosity and Inquiry
- Milestone Year 1 & 2: Formulate questions and pursue answers.
- Milestone Year 3 & 4: Demonstrate a systematic approach to track and pursue emerging questions.
Enabling Competency: Limitation of Knowledge/Skills
- Milestone Year 1 & 2: Recognize knowledge limitations and ask for help.
- Milestone Year 3: Recognize knowledge limitations, accept advancing responsibility to individually address them and ask for help.
- Milestone Year 4: Anticipate potential knowledge limitations and proactively seek guidance and/or learning opportunities to individually address them.

Enabling Competency: Reflection on Practice
- Milestone Year 1 & 2: Develop a learning plan for personal improvement in response to external guidance.
- Milestone Year 3 & 4: Independently generate a plan for continuous personal improvement by regularly reflecting on and assessing performance.

Domain/Competency: System-based and Inter-professional Practice

Education Program Objective

Demonstrate awareness of and responsiveness to the larger context of healthcare and the ability to call on system resources, including other healthcare professionals, to provide optimal care.

Sub-Competency: Team-building, and Teamwork

Enabling Competency: Roles and Responsibilities
- Milestone Year 1 & 2: Recognize roles and responsibilities and enact them as necessary for effective team functioning.
- Milestone Year 3 & 4: Accept advancing responsibility for effective team functioning, leading when necessary.
Enabling Competency: Initiative and Contribution
- Milestone Year 1 & 2: Participate in and lead team activities in all academic environments.
- Milestone Year 3 & 4: Participate in and lead team activities in healthcare settings.
Enabling Competency: Interpersonal Collaboration
- Milestone Year 1 & 2: Share information and align activities to achieve desired team outcomes.
- Milestone Year 3 & 4: Share authority, responsibility, and accountability for desired team outcomes.

Sub-Competency: Professional Relationships

Enabling Competency: Insights
- Milestone Year 1–4: Interpret and appropriately respond to emotional and behavioral cues.
Enabling Competency: Adaptability
- Milestone Year 1–4: Demonstrate open mindedness and adapt behaviors.
Enabling Competency: Inclusivity
- Milestone Year 1–4: Invite and encourage others to participate.

Sub-Competency: Health Systems Science

Enabling Competency: Structure and Function of Healthcare Delivery
- Milestone Year 1 & 2: Identify structures and functions within the healthcare system that enhance or impede the health of individuals and populations, including systemic biases.
- Milestone Year 3: Anticipate structural and functional aspects of the healthcare system that enhance or impede the health of individuals and populations, including systemic biases
- Milestone Year 4: Propose interventions to address healthcare system gaps and/or dysfunctions to improve the health of individuals and populations, including systemic biases.
Enabling Competency: Patient Safety
- Milestone Year 1 & 2: Demonstrate knowledge of patient safety practices.
- Milestone Year 3 & 4: Apply knowledge of patient safety practices.
Enabling Competency: Quality Improvement
- Milestone Year 1 & 2: Describe quality improvement methods.
- Milestone Year 3 & 4: Apply quality improvement methods to enhance healthcare delivery.

Sub-Competency: Population and Community Health

Enabling Competency: Social Determinants and Health Equity
- Milestone Year 1 & 2: Incorporate social determinants of health and equity when addressing patient care.
- Milestone Year 3 & 4: Develop and implement strategies to address social determinants that impact the health of individuals and their communities.
Enabling Competency: Advocacy and Health Advocate
- Milestone Year 1 & 2: Design strategies to engage in advocacy and health advocacy initiatives to improve the health of patients and populations.
- Milestone Year 3 & 4: Engage in advocacy and health advocacy initiatives to improve the health of patients and populations.

Domain/Competency: Interpersonal and Communication Skills

Education Program Objective

Demonstrate effective information exchange and collaboration with patients, their families, peers, and other health professionals to enhance their care.

Sub-Competency: Communication

Enabling Competency: Medical Information
- Milestone Year 1–4: Translate medical and scientific knowledge as appropriate for educating peers, healthcare team members, patients and their caregivers, and the community.
Enabling Competency: Active Listening
- Milestone Year 1–4: Demonstrate active listening.
Enabling Competency: Respectful communication
- Milestone Year 1–4: Demonstrate professional, respectful, and culturally appropriate communication.

Sub-Competency: Written/Oral Fluency

Enabling Competency: Content
- Milestone Year 1 & 2: Present complete and accurate information.
- Milestone Year 3: Present relevant and accurate information.
- Milestone Year 4: Present prioritized, relevant, and accurate information.
Enabling Competency: Organization
- Milestone Year 1 & 2: Organize information following checklist prompts.
- Milestone Year 3: Organize information with minimal reliance on prompts and checklists.
- Milestone Year 4: Adapt the organization and structure of the information to the context.
Enabling Competency: Flow and Style
- Milestone Year 1–4: Communicate information clearly and cohesively.