Medical Education Program Objectives, Competencies, and Milestones
The information on this page applies to cohorts 2030 and beyond. Learn more for cohorts 2027, 2028, and 2029. 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.
- Knowledge Building
- MK1.1 Foundations of Human Health and Disease
- Knowledge Integration
- MK2.1 Evidence-based Inquiry and Data Interpretation
- MK2.2 Critical Thinking and Clinical Decision Making
- MK2.3 Knowledge Transfer
- Knowledge Building
- 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.
- Medical History
- PC1.1 Medical History
- Physical Examination
- PC2.1 Physical Examination
- Plan
- PC3.2 Differential Diagnosis
- PC3.3 Diagnostic Work-up
- PC4.1 Treatment and Management
- PC4.4 Consultations and Referrals
- PC4.2 Longitudinal Patient Care
- Patient-centered Health Care
- PC9.1 Health Promotion
- PC4.3 Patient-centered Care
- Documentation
- PC5.1 Medical Documentation
- Procedural Skills
- PC6.1 Technical Skills/Procedures
- Informed Consent
- PC8.1 Informed Consent
- Urgent Care
- PC7.1 Urgent Care
- Medical History
- Professionalism and Ethical Practice: Demonstrate commitment to professional services, adherence to ethical principles, and awareness of one’s own interests, personal biases, vulnerabilities, and limitation of knowledge.
- Professional Conduct
- PS1.1 Culturally Responsive Conduct
- PS1.3 Recognition and Bias Mitigation
- PS1.4 Accountability
- PS1.5 Confidentiality and Boundaries
- PS1.6 Addressing Unprofessional Conduct
- Self-Awareness
- PS2.3 Reflective Practice
- PS2.1 Discernment
- PS1.9 Resilience and Adaptability
- Ethical Decision Making
- PS3.1 Ethical Reasoning
- PS3.2 Values and Personal Identity
- Professional Conduct
- 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.
- Self-ownership of Learning
- PL1.1 Informed Self-assessment
- PL1.2 Receptivity to Feedback
- PL1.3 Feedback Practices
- Continual Improvement
- PL2.1 Curiosity and Inquiry
- PL2.2 Limitation of Knowledge/Skills
- PL2.4 Life-long Learning
- Self-ownership of Learning
- 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.
- Collaboration and Leadership
- SI1.1 Roles and Responsibilities
- SI1.2 Initiative and Contribution
- SI1.3 Interpersonal Collaboration
- SI1.4 Interprofessional Collaboration
- SI1.5 Social Skills
- Health Systems Science
- SI2.1 Structure and Function of Health Care Delivery
- SI2.2 Patient Safety
- SI2.3 Quality Improvement
- Community and Population Health
- SI3.1 Population Intervention
- SI3.2 Health Advocacy
- SI3.3 Service Orientation
- Collaboration and Leadership
- Interpersonal and Communication Skills: Demonstrate effective information exchange and collaboration with patients, their families, peers, and other health professionals to enhance their care.
- Communication
- IC2.1 Medical Information
- IC2.4 Interpersonal Responsiveness
- Written/Oral Fluency
- IC3.1 Communication Content
- IC3.2 Information Organization
- IC3.3 Information Delivery
- Communication
Domain/Competency: Medical and Scientific Knowledge
Education Program Objective
Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral concepts in caring for healthy, ill patients and the community.
Sub-Competency: Knowledge Building
- Enabling Competency: Foundations of Human Health and Disease
- Milestone Year 1–4: Analyze the structure and function of the human body alongside the social, environmental, and behavioral factors that influence health and disease.
Sub-Competency: Knowledge Integration
- Enabling Competency: Evidence-based Inquiry and Data Interpretation
- Milestone Year 1: Describe the core principles of evidence-based medicine, including how evidence is generated and the roles of qualitative and quantitative data in evidence-informed clinical decisions.
- Milestone Year 2: Formulate structured clinical questions that specify patients, interventions, comparisons, and outcomes to guide the search for appropriate evidence.
- Milestone Year 3: Apply evidence-informed biomedical, social, clinical, and health systems principles to select and justify diagnostic and management options in patient-centered care.
- Milestone Year 4: Apply evidence-informed biomedical, social, clinical, and health systems principles to select and justify diagnostic and management options in patient-centered care.
- Enabling Competency: Critical Thinking and Clinical Decision Making
- Milestone Year 1: Apply the steps of clinical decision making to deliver evidence-informed care in standardized and simulated clinical environments.
- Milestone Year 2: Integrate organized diagnostic thinking to guide hypothesis testing and management planning in standardized and simulated clinical environments.
- Milestone Year 3: Refine prioritized differential diagnoses as new clinical data emerge, providing a rationale for evolving clinical plans and recommendations.
- Milestone Year 4: Evaluate biomedical, social, clinical, and health systems principles using logic and reasoning to support evidence informed, patient centered care decisions.
- Enabling Competency: Knowledge Transfer
- Milestone Year 1: Analyze medical and scientific knowledge collaboratively to build shared understanding as a team in standardized and simulated clinical environments.
- Milestone Year 2: Use explanations that educate others using medical and scientific knowledge across diverse clinical contexts.
- Milestone Year 3: Generate clinically sound explanations and solutions using medical and scientific knowledge to support team-based patient care.
- Milestone Year 4: Integrate medical and scientific knowledge to construct evidence-based explanations and solutions that advance patient-centered care and team education.
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: Obtain a comprehensive medical history in standardized and simulated clinical environments.
- Milestone Year 2: Obtain a hypothesis-driven medical history in standardized and simulated clinical environments.
- Milestone Year 3: Obtain a comprehensive or hypothesis-driven medical history tailored to the clinical situation using reasoning to guide inquiry in diverse clinical environments.
- Milestone Year 4: Adapt comprehensive or hypothesis-driven medical histories using clinical reasoning tailored to the patient’s presentation and healthcare needs in real-world clinical care.
Sub-Competency: Physical Examination
- Enabling Competency: Physical Examination
- Milestone Year 1: Perform a comprehensive screening physical examination in standardized and simulated clinical environments.
- Milestone Year 2: Perform a hypothesis-driven physical examination in standardized and simulated clinical environments.
- Milestone Year 3: Performa comprehensive screening or hypothesis-driven physical examination based on the clinical situation in diverse clinical environments using clinical reasoning to guide inquiry.
- Milestone Year 4: Adapt comprehensive screening or hypothesis-driven physical examinations to the patient’s presentation and healthcare needs using clinical reasoning in real-world clinical care.
Sub-Competency: Plan
- Enabling Competency: Differential diagnosis
- Milestone Year 1: Formulate a clinically appropriate differential diagnosis in a standardized and simulated environments.
- Milestone Year 2: Prioritize a clinically appropriate differential diagnosis in standardized and simulated clinical environments.
- Milestone Year 3: Formulate a prioritized differential diagnosis by integrating primary clinical information with evidence-based guidelines and clinical reasoning.
- Milestone Year 4: Justify a prioritized differential diagnosis using primary and secondary clinical information, evidence-based guidelines, and reasoning.
- Enabling Competency: Diagnostic work-up
- Milestone Year 1: Develop a diagnostic workup for a differential diagnosis in standardized and simulated clinical environments.
- Milestone Year 2: Develop a clinically accurate diagnostic workup for a differential diagnosis using clinical guidelines in standardized and simulated clinical environments.
- Milestone Year 3: Select evidence-based diagnostic investigations using clinical reasoning and medical knowledge to refine differential diagnoses in diverse clinical environments.
- Milestone Year 4: Justify evidence-based diagnostic investigations using clinical reasoning and medical knowledge to refine differential diagnoses, accounting for patient preferences and healthcare context.
- Enabling Competency: Treatment and Management
- Milestone Year 1: Recommend a treatment and management plan for patients in standardized and simulated clinical environments.
- Milestone Year 2: Recommend a clinically accurate treatment and management plan using clinical findings and diagnostic data in standardized and simulated clinical environments.
- Milestone Year 3: Develop clinically accurate, evidence-based treatment and management plans using multiple sources of clinical information in diverse clinical environments.
- Milestone Year 4: Justify clinically accurate, evidence-based treatment and management plans incorporating patient preferences and clinical context using multiple sources of clinical information.
- Enabling Competency: Consultations and Referrals
- Milestone Year 1: Recognize clinical presentations that may require consultation or referral in standardized and simulated clinical environments.
- Milestone Year 2: Identify clinical presentations requiring consultation or referral incorporating patient preferences and context in standardized and simulated clinical environments.
- Milestone Year 3: Recommend consultations and referrals by synthesizing clinical information with patient-specific and contextual factors.
- Milestone Year 4: Facilitate consultations and referrals by synthesizing clinical information with patient-specific and contextual factors.
- Enabling Competency: Longitudinal Patient Care
- Milestone Year 1 & 2: Identify factors that promote or limit continuity of care from patient, provider, and system-level perspectives in common ambulatory and inpatient scenarios.
- Milestone Year 3 & 4: Apply clinical care tools (e.g., care plans, registries, follow up reminders, EMR task lists) to support longitudinal patient care in simulated and early clinical encounters.
Sub-Competency: Patient-centered Healthcare
- Enabling Competency: Health Promotion
- Milestone Year 1: Identify common health promotion strategies for preventing disease and supporting wellness.
- Milestone Year 2: Describe health promotion strategies that align with a patient’s cultural background and personal preferences.
- Milestone Year 3: Apply health promotion strategies by aligning activities with an individual’s health goals, cultural background, and personal preferences.
- Milestone Year 4: Develop health promotion care plans by tailoring approaches to an individual’s health goals, cultural values, and personal preferences in partnership with patients.
- Enabling Competency: Patient-Centered Care
- Milestone Year 1: Identify patient values, preferences, and contextual factors relevant to clinical care decisions.
- Milestone Year 2: Describe how patient values, preferences, and cultural context influence shared clinical decision making.
- Milestone Year 3: Apply patient centered approaches to clinical decision making by incorporating patient values, preferences, and context.
- Milestone Year 4: Integrate patient values, preferences, and contextual factors into shared decision making to co develop patient centered care plans.
Sub-Competency: Documentation
- Enabling Competency: Medical Documentation
- Milestone Year 1: Document and present a comprehensive medical history and physical examination using structured, standardized formats in simulated environments, ensuring accuracy, clarity, and organization to support clinical reasoning and patient care.
- Milestone Year 2: Document and present focused, hypothesis-driven clinical encounters in structured, simulated settings, integrating key findings with assessment and management plans while maintaining accuracy, clarity, and organization to support clinical reasoning and patient care.
- Milestone Year 3 & 4: Document and present clinical encounters across diverse healthcare settings, integrating and prioritizing key findings with assessment and management plans to support clinical decision-making, continuity, and safety of patient care.
Sub-Competency: Procedural Skills
- Enabling Competency: Technical Skills / Procedures
- Milestone Year 1 & 2: Perform common clinical procedures in standardized or simulated settings while adhering to established protocols and safety standards to demonstrate foundational technical skill and procedural competence.
- Milestone Year 3 & 4: Perform clinical procedures in real-world clinical environments while adhering to established protocols, ensuring patient safety, and providing appropriate education and counseling to support effective patient care and shared decision-making.
Sub-Competency: Informed Consent
- Enabling Competency: Informed Consent
- Milestone Year 1: Explain the ethical, legal, and clinical components of informed consent.
- Milestone Year 2: Conduct an informed consent process in a simulated setting, clearly explaining indications, risks, benefits, and alternatives, and confirming patient understanding.
- Milestone Year 3 & 4: Obtain informed consent for clinical procedures or research in real patient settings under supervision with accurate documentation.
Sub-Competency: Urgent Care
- Enabling Competency: Urgent Care
- Milestone Year 1: Recognize abnormal vital signs in a standardized or simulated clinical setting.
- Milestone Year 2: Recognize patients requiring urgent evaluation in a standardized or simulated clinical setting.
- Milestone Year 3: Identify patients requiring urgent care in clinical settings, promptly notify appropriate team members, and propose a preliminary management plan.
- Milestone Year 4: Prioritize patients requiring urgent or escalating care, promptly notify appropriate team members, and initiate the intervention and plan.
Domain/Competency: Professionalism and Ethical Practice
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: Professional Conduct
- Enabling Competency: Culturally Responsive Conduct
- Milestone Year 1–4: Uses effective communication and professional behaviors to create psychological safety, trust, and dignity across diverse cultural contexts based on patients’ lived experiences and culture.
- Enabling Competency: Recognition and Bias Mitigation
- Milestone Year 1 & 2: Mitigate personal biases and biased behavior in self/others on learning and interactions.
- Milestone Year 3: Mitigate the influence of bias in clinical reasoning and team interactions.
- Milestone Year 4: Integrate bias-mitigation strategies into decision-making and professional leadership.
- Enabling Competency: Accountability
- Milestone Year 1–4: Assume ownership of assigned academic and clinical tasks by prioritizing commitments and fulfilling responsibilities consistently and reliably.
- Enabling Competency: Confidentiality and Boundaries
- Milestone Year 1–4: Maintain appropriate professional boundaries and protect confidential and sensitive information across educational, clinical, and digital contexts.
- Enabling Competency: Addressing Unprofessional Conduct
- Milestone Year 1–4: Address unprofessional behavior in self and others through established feedback channels, prioritizing patient safety and team integrity.
Sub-Competency: Self Awareness
- Enabling Competency: Reflective Practice
- Milestone Year 1 & 2: Identify personal cognitive and emotional responses and their potential impact on academic or clinical decisions.
- Milestone Year 3: Adjust academic or clinical decisions based on reflection on personal cognitive biases and emotional responses to improve patient care outcomes.
- Milestone Year 4: Evaluate personal decision-making patterns using reflective insights to inform ethical and patient-centered decisions in clinical settings.
- Enabling Competency: Discernment
- Milestone Year 1 & 2: Apply sound judgment in academic, simulated, or clinical scenarios by weighing context, risk, and ethical considerations.
- Milestone Year 3 & 4: Justify clinical decisions using relevant clinical evidence and ethical principles.
- Enabling Competency: Resilience and Adaptability
- Milestone Year 1–4: Use performance feedback to mitigate biases, maintain well-being, and model ethical/collaborative behavior while recovering constructively and sustaining professionalism
Sub-Competency: Ethical Decision Making
- Enabling Competency: Ethical Reasoning
- Milestone Year 1 & 2: Analyze simulated and clinical challenges using ethical frameworks to guide patient-centered decisions.
- Milestone Year 2: Analyze and apply appropriate ethical frameworks to simulated clinical scenarios.
- Milestone Year 3 & 4: Integrate ethical principles and professional standards with clinical reasoning to evaluate potential outcomes and formulate patient-centered decisions.
- Enabling Competency: Values and Personal Identity
- Milestone Year 1 & 2: Align professional behavior with articulated personal values while respecting professional standards and diverse perspectives.
- Milestone Year 3 & 4: Contribute to discussions and decisions during complex moral disagreements in clinical or team settings while maintaining professionalism and empathy.
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: Use feedback to identify learning gaps and areas for improvement.
- Enabling Competency: Receptivity to Feedback
- Milestone Year 1–4: Reflect on feedback received to identify areas for improvement.
- Enabling Competency: Feedback Practices
- Milestone Year 1–4: Seek feedback to identify areas for improvement.
Sub-Competency: Continual Improvement
- Enabling Competency: Curiosity and Inquiry
- Milestone Year 1 & 2: Formulate clinical and scientific questions to guide inquiry and learning.
- Milestone Year 3 & 4: Apply a systematic approach to investigate emerging clinical and scientific questions.
- Enabling Competency: Limitation of Knowledge/Skills
- Milestone Year 1 & 2: Identify personal knowledge gaps and seek support to address them.
- Milestone Year 3: Identify evolving knowledge limitations in increasingly complex settings and independently seek guidance or resources to address them.
- Milestone Year 4: Anticipate areas of knowledge uncertainty and implement timely, independent strategies to ensure safe and informed decision-making.
- Enabling Competency: Life-long Learning
- Milestone Year 1 & 2: Develop a targeted learning plan in response to external feedback and personal reflection, incorporating specific goals and self-directed strategies to support ongoing personal and professional development.
- Milestone Year 3 & 4: Create a personal improvement plan through independent reflection, self-assessment, and integration of external feedback, fostering self-directed habits of lifelong learning and professional growth.
Domain/Competency: System-based and Inter-professional Practice
Education Program Objective
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.
Sub-Competency: Collaboration and Leadership
- Enabling Competency: Roles and Responsibilities
- Milestone Year 1 & 2: Analyze roles and responsibilities within a team to support effective collaboration and shared goals.
- Milestone Year 3 & 4: Contribute to team effectiveness by adapting to team needs, facilitating collaboration, and assuming leadership roles when appropriate.
- Enabling Competency: Initiative and Contribution
- Milestone Year 1 & 2: Collaborate in team-based activities by contributing meaningfully to shared goals, and assume leadership roles when appropriate to facilitate coordination, communication, and collective success.
- Milestone Year 3 & 4: Contribute to and lead interprofessional team activities in clinical settings by coordinating tasks, communicating clearly, and supporting collaborative decision-making.
- Enabling Competency: Interpersonal Collaboration
- Milestone Year 1 & 2: Share information and coordinate individual contributions to align with team objectives and support effective collaboration.
- Milestone Year 3 & 4: Share leadership by distributing authority, embracing collective responsibility, and upholding accountability to achieve team goals and ensure high-quality outcomes.
- Enabling Competency: Interprofessional Collaboration
- Milestone Year 1–4: Contribute to the interprofessional healthcare team functioning by sharing relevant information, seeking and integrating input from other professionals, and co‑creating care plans that support safe, coordinated care.
- Enabling Competency: Social Skills
- Milestone Year 1–4: Exhibit respectful and professional verbal and nonverbal behaviors with patients, peers, and team members by adapting communication and actions to diverse social and professional contexts and maintaining constructive, collaborative interactions.
Sub-Competency: Health Systems Science
- Enabling Competency: Structure and Function of Health Care Delivery
- Milestone Year 1 & 2: Identify key structures and functions of the health care system and their impact on the health of individuals and populations, including the influence of systemic biases.
- Milestone Year 3: Analyze the influence of structural and functional components of the health care system, including systemic biases, on health outcomes for individuals and populations.
- Milestone Year 4: Advocate for evidence-informed interventions to address structural gaps or dysfunctions in the health care system, including systemic biases, to improve health outcomes for individuals and populations.
- Enabling Competency: Patient Safety
- Milestone Year 1 & 2: Analyze the fundamental patient safety principles and practices that contribute to safe and effective health care delivery.
- Milestone Year 3: Propose evidence-informed strategies to improve patient safety and address system-level risks in health care delivery.
- Milestone Year 4: Integrate patient safety practices into clinical decision-making and team-based workflows to reduce risk and improve outcomes.
- Enabling Competency: Quality Improvement
- Milestone Year 1 & 2: Examine core principles and methods of quality improvement used to enhance health care delivery and improve patient outcomes.
- Milestone Year 3 & 4: Analyze quality improvement methods to address gaps in health care delivery and improve patient outcomes.
Sub-Competency: Community and Population Health
- Enabling Competency: Population intervention
- Milestone Year 1 & 2: Apply social determinants of health and principles of equity into clinical reasoning and patient care planning to address individual health needs.
- Milestone Year 3 & 4: Design strategies to address social determinants of health and promote equity in individual and community outcomes.
- Enabling Competency: Health Advocacy
- Milestone Year 1 & 2: Formulate strategies to engage in advocacy efforts that address health-related needs and promote well-being at individual and population levels.
- Milestone Year 3 & 4: Participate in advocacy initiatives to address health disparities and improve health outcomes for patients and populations.
- Enabling Competency: Service Orientation
- Milestone Year 1–4: Engage in activities that promote the health and well-being of others, including patients, community members, and other individuals.
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: Communicate medical and scientific knowledge using a structured, scripted approach that is primarily task- and information-focused.
- Milestone Year 2: Communicate medical and scientific knowledge using a structured approach that integrates interpretation and contributes meaningfully to discussion of patient care.
- Milestone Year 3 & 4: Communicate medical and scientific knowledge effectively to diverse audiences, adapting language, depth, and format to the needs of each group.
- Enabling Competency: Interpersonal Responsiveness
- Milestone Year 1: Use core communication skills in standardized and simulated settings.
- Milestone Year 2: Apply core communication skills and integrate advanced techniques in standardized and simulated clinical settings.
- Milestone Year 3 & 4: Adapt communication to diverse clinical contexts, demonstrating empathy, respect, and inclusive collaboration with patients and team members.
Sub-Competency: Written/Oral Fluency
- Enabling Competency: Communication Content
- Milestone Year 1 : Identify pertinent medical information required for different communication methods and clinical contexts.
- Milestone Year 2: Communicate accurate and relevant information tailored to the audience and intended purpose.
- Milestone Year 3 & 4: Communicate prioritized, accurate, relevant, and well-organized information that advances clinical reasoning and informs decision-making.
- Enabling Competency: Information Organization
- Milestone Year 1: Organize medical information clearly using structured, standardized formats.
- Milestone Year 2: Organize medical information clearly using structured formats tailored to the audience and intended purpose.
- Milestone Year 3: Organize information coherently and logically with minimal reliance on external supports.
- Milestone Year 4: Organize information independently and strategically to suit clinical, educational, or interpersonal contexts without reliance on external supports.
- Enabling Competency: Information Delivery
- Milestone Year 1: Deliver medical information using the most appropriate structured method for standardized and simulated clinical contexts.
- Milestone Year 2: Deliver medical information in a clear, coherent, and logically sequenced manner.
- Milestone Year 3 & 4: Deliver information strategically with clear logical flow, adapting to diverse audiences and contexts while ensuring understanding.