Clinical Distinction

Your future, by you

Learning Outcomes: The Core Competencies

You are the Instructor of your Clinical Distinction course.

If you want to be a great instructor, there are a few things you need to understand about creating a curriculum. These are the ingredients of a successful curriculum:

teacher discussing her lesson with her student

The Core Competencies are the course learning outcomes for the Clinical Distinction Course. 

The framework of the core competencies has been carefully chosen to ensure that through your clinical distinction course you are

  1. Becoming prepared to be an intern and a physician
  2. Able to communicate effectively at a residency interview about your learning process and progress.
  3. Writing about your Clinical Distinction Course in a way that residency directors will find compelling.

The Core Competencies Describe What the Student Should Learn‘s

But wait, why not use these as learning outcomes?

  • Publish a paper
  • Do a lit review
  • Learn medical Spanish
  • Teach nutrition to an underserved population

These are the activities of projects. And they might in fact be goals students set for their project – but they are not learning outcomes! Learning outcomes describe what you learned. If you published a paper, you probably learned about a bit about evidence-based medicine. You probably got better at the process of communicating through the written word. You likely learned some medical knowledge or perhaps you learned about patient care options.

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Your competency growth is, without a doubt, more important than what activity you complete and what topic you choose.

Common Misconceptions

I have to do a specialty track in the area of medicine I’m planning to apply for residency.

If your specialty track demonstrates competency attainment in the core competencies it will be impressive to any residency director in any specialty. The competencies are CORE to every medical specialty.

If I do research it will make my dean’s letter look better than if I do something creative or outside of the medical field.

The best projects are the ones students are passionate and excited about. It doesn’t matter what the activity is if your unique self truly shines through you will have the attention of any residency director.


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In selecting Core Competencies it’s important to dive into what each one means, as the list on this page is just a shorthand that does not give the depth or detail of learning expected in each Core Competency. To adequately select Core Competencies download this document and review those that you are considering.

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If you use the same activities for two CD courses, you might choose different competencies. For example, in course 1 focus on systems-based practice and evidence-based medicine and structural competency as you learn about abortion and in the second clinical distinction (CLIN 718) you may be focused on patient care and communication and professionalism as you perform clinical activities at a planned parenthood clinic that provides abortions.

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Even though many activities allow learning in all or most of the core competencies, the student’s task is to select 1-4 competencies on which they will focus. It’s about quality, not quantity. This allows students to describe an authentic, and specific, process of growth.

Using the Competencies to Create a Project

Ideas before Competencies

Many students will have chosen a topic before they get to competency selection for their course project. In this case they might choose the competencies they are most likely to work with based on that idea or topic. For example, a student who is doing a research project on hand washing will likely choose practice-based learning and improvement and systems-based practice.

Competencies First

Students can also start with the competencies and develop a project around the decision of which competencies they want to work on. For example, a student might want to focus on Interpersonal Communication Skills and choose to take histories in a variety of different types of “difficult” patient encounters, such as a patient in pain, a very young pediatric patient, and a patient with dementia.

Competency as Driver

Students can choose also competencies because of their interests – for example a student might choose a track focused on traditional osteopathy and choose the first competency – Osteopathic Principles and Practice, and Patient Care. Or a student can choose competencies in areas they feel they need more practice – for example Medical knowledge or Systems Based Practice.

The key is that the student is selecting course learning outcomes that they will focus on using the Core Competencies of Medical Education.

More Information

This is a key step in selecting your track and designing your project. This is a great topic of conversation to have with your CD course director.

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The following video is a great introduction to Competencies, EPAs, and understanding how to use them in your contract.

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Check out these learning modules on Canvas (Coming soon)