Western Medicine

Select appropriate candidates for statin therapy; List the effects of RhoA activation; Counsel patients about the benefits of statins for stroke prevention; Identify statins most likely to be associated with adverse cognitive effects; Explain the development and use of the objective structured clinical examination.

Apply the appropriate scalars for adjusting doses of medication for obese patients; Summarize the importance of volume of distribution in the adjustment of drug doses; Estimate patients' ideal body weight and lean body weight; Identify drugs as lipophilic or hydrophilic and use the appropriate scalars for each; Assess obesity and calculate ideal body weight in children.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Propose ways that patients can apply nutritional principles for weight management to food preparation and repurposing; Address common challenges with implementing principles of the Mediterranean-style diet into real-life food preparation; Advise patients on ways to incorporate healthy eating habits into diets from different cultures, when living in a food desert, and while eating in restaurants; Address common barriers to health care for patients from culturally diverse and medically underserved populations.

Describe techniques for rewarming and resuscitating patients with hypothermia; Use functional tests to assess orthopedic defects following acute injury; Provide appropriate management and specialist referral for common orthopedic injuries; Choose an appropriate method of wound management according to location and severity of injury and duration of wound support needed; Discuss techniques to decrease skin tension, prevent tearing of fragile skin, and reduce risk for complications when performing wound closures.

QUALIFIES FOR TRAUMA

List the possible causes of CAP; Plan the diagnostic workup of a patient with suspected CAP; Select the appropriate patients to undergo the Legionella urinary antigen test; Choose the appropriate antibiotic treatment for a patient with CAP; Determine the most likely cause of febrile illness in a returning traveler.

Explain the continuum of levels of sedation; Monitor patients undergoing procedural sedation (PS); Choose an appropriate drug for PS; Determine whether a patient might benefit from regional anesthesia; Improve the accuracy of peripheral nerve blocks (PNBs) through the use of ultrasound guidance.

QUALIFIES FOR PAIN MANAGEMENT

Determine which patients with chest pain require transfer to the emergency department; Recognize the importance of an accurate patient history in evaluating patients with chest pain; Use appropriate tests to screen for acute coronary syndrome and other causes of chest pain; Accurately identify life-threatening and serious causes of chest pain without overtesting or overtreating patients with less serious causes; Consider the role of anxiety when managing noncardiac chest pain.

Identify women at increased risk for breast cancer and recurrence of breast cancer; Select appropriate treatment for prevention of breast cancer; Advise women about their risk for hereditary breast cancer and the need for genetic screening; Counsel men about therapy for symptoms of overactive bladder; Identify men who require referral to a urologist.

Explain the frequency and clinical implications of cachexia in patients with advanced illness; Outline key challenges in monitoring and treating cachexia; Compare available treatments for cachexia in advanced illness; Manage dyspnea and constipation in patients receiving palliative care; Communicate with families of a loved one in palliative care.

QUALIFIES FOR END OF LIFE/PALLIATIVE CARE

State current recommendations for adult vaccination; Apply effective techniques to counter opposition to vaccination; Treat uncomplicated UTIs; Recognize situations in which asymptomatic bacteriuria should be treated; Consider options for preventing and treating recurrent UTIs.

QUALIFIES FOR INFECTIOUS DISEASE

Assess evidence on the effects of increased physical activity on cardiometabolic risk; Recommend lifestyle modifications that reduce risk for diabetes and cardiovascular disease; Outline best practice guidelines for screening for and diagnosis of Cushing syndrome; Diagnose and manage Cushing syndrome; Recognize features of primary adrenal insufficiency.

Define problematic patterns of alcohol use; Choose appropriate screening methods for detecting patterns of at-risk alcohol use in the primary care setting; Provide brief intervention and referral to treatment for patients with alcohol use disorder; List clinical implications of vitamin D deficiency; Prevent and treat vitamin D deficiency.

Summarize trends related to triage for chest pain in emergency departments and their related costs; Discuss lessons learned from trials comparing anatomic to functional diagnostic strategies in patients with suspected coronary artery disease; Review management options for managing the patient with atrial fibrillation and a drug-eluting stent, including the role of aspirin; Explain potential advantages and disadvantages to the use of electronic cigarettes to help patients stop smoking.

Provide patients with effective treatment for recurrent acute pancreatitis; Assess the effectiveness of surgery in the management of acute pancreatitis; Select patients most likely to benefit from endoscopic retrograde cholangiopancreatography; Determine the role of endoscopic retrograde cholangiopancreatography for patients with common bile duct and pancreatic stones; Evaluate the role of sphincterotomy in the management of sphincter of Oddi dysfunction and recurrent acute pancreatitis.

Prescribe appropriate antibiotic therapy for multidrug-resistant bacterial infections; Implement the procalcitonin-based algorithm when planning treatment of patients with suspected bacterial pneumonia; Choose an appropriate test for the diagnosis of tuberculosis; Diagnose soft tissue tumors on the basis of physical characteristics of lesions; Identify features that increase the likelihood of malignancy of soft tissue tumors.

Distinguish between the Adult Treatment Panel III guidelines and the updated American College of Cardiology/American Heart Association guidelines for treating hyperlipidemia; Select appropriate patients for treatment with high-intensity, moderate-intensity or low-intensity statins; Explain the mechanism of action of proprotein convertase subtilisin/kexin type 9 inhibitors; Choose appropriate treatment for a patient with intolerance to statin therapy; Explain the concept of reverse cholesterol transport.

Implement screening guidelines for cervical cancer for average-risk women recommended by the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology; Discuss the current model of HPV-induced cervical carcinogenesis; Recommend HPV vaccination for all boys and girls 11 or 12 yr of age; Evaluate the reasons that outcomes of heart disease for women are worse than those for men; Recommend lifestyle choices to minimize risk factors for heart disease in women.

Choose appropriate imaging tests as adjuncts in the diagnosis of DSTI; Recommend adequate fluid resuscitation, appropriate antibiotics, and emergent surgical consultation for the management of DSTIs; Cite recent changes to the Third International Consensus Definitions for Sepsis and Septic Shock; Adopt a head-to-toe approach to identify the source of infection in sepsis; Predict prognosis and outcomes in patients with sepsis using the Sepsis-related Organ Failure Assessment (SOFA) and quickSOFA (qSOFA).

QUALIFIES FOR INFECTIOUS DISEASE

Recommend appropriate treatment regimens for infective endocarditis based on bacterial etiology; Identify antibiotic combinations that are synergistic and those that contribute to emergence of resistance or side effects; Explain the pathophysiology of Listeria infection; List risk factors for listeriosis; Diagnose infection with Listeria.

QUALIFIES FOR INFECTIOUS DISEASE

Recognize the early signs and symptoms of dementia; Interpret findings of analyses of cerebrospinal fluid in patients with dementia; Recognize indications for genetic testing of patients with dementia; Differentiate among different types of dementia on the basis of brain imaging findings; Distinguish between Parkinson dementia and Lewy body disease on the basis of the patient's clinical course.

QUALIFIES FOR GERIATRICS

Relate the anatomy of the wrist to the signs and symptoms of CTS; Diagnose CTS through history, physical examination, and imaging; Consider and diagnose TTS in patients with foot pain; Use electrodiagnostic studies and imaging to evaluate patients with possible TTS; Recognize the risk factors for, and signs of, cerebral palsy in young children.

Cite established and evidence-based interventions for prevention of secondary stroke; Recognize the currently known and potential benefits of using newer oral anticoagulant agents; Evaluate the current evidence on long-term cardiac monitoring for atrial fibrillation and anticoagulation in patients with cryptogenic stroke and embolic stroke of unknown source; Identify appropriate patients for monotherapy or combination antiplatelet therapy; Discuss the use of medical vs surgical therapy in patients with intracranial stenosis.

Counsel a pregnant woman about the optimal interpregnancy interval; Explain the relationship between pregnancy rates and access to top-tier contraceptive methods in postpartum women; Summarize recommendations for contraceptive methods in lactating and nonlactating women; Identify women at risk for thromboembolic events during or after pregnancy; Create protocols for a clinic or practice striving to meet current and future quality metrics for care of postpartum women.

Identify patients with insomnia; Explain natural changes in sleep architecture to an elderly patient; Choose the appropriate treatment for a patient with insomnia; Select appropriate patients to undergo polysomnography; Counsel a patient about sleep times and medications during airplane travel.

Create an algorithm for the surveillance of women at high risk for EC; Perform preoperative evaluation and staging in a patient with EC; Interpret a pathology report in a patient with endometrial hyperplasia; Summarize the findings of major trials assessing radiotherapy for treatment of EC; Manage a patient with uterine sarcoma.

Diagnose myelofibrosis (MF); Explain the significance of the molecular profile of MF; Compare the risk-stratification scoring systems for MF; Understand the role of Janus kinase inhibition in the treatment of MF; Plan appropriate medical and surgical treatments for MF.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Illustrate the relationships among patient age, hormonal sensitivity of tumor, and progression-free survival in patients with breast cancer; List the major findings of the ATLAS trial in patients with breast cancer; Use exemestane to improve the treatment of patients with breast cancer; Explain the benefits and risks of treatment with an aromatase inhibitor for breast cancer; Summarize the role of CDK4/6 inhibitors in treatment of breast cancer.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Review the epidemiology of anaplastic thyroid cancer; Apply National Comprehensive Cancer Network and American Thyroid Association guidelines for the diagnosis and management of anaplastic thyroid cancer; Evaluate the use of the tyrosine kinase inhibitors sorafenib and lenvatinib for patients with thyroid cancer; Consider new therapies, including immune checkpoint inhibitors, for the treatment of thyroid cancer; Interpret cytology and pathology reports for patients with thyroid disease.

Select appropriate immunotherapy for bladder cancer; Explain the benefit of adding entinostat to interleukin-2 in the treatment of renal cell carcinoma; Consider sipuleucel-T for the treatment of prostate cancer; Recognize the significance of mutations of ESR1 in the treatment of breast cancer; Compare immunotherapeutic drugs used to treat breast cancer.

Explain the basic science of bone formation and remodeling; Identify hormones and regulatory molecules involved in the formation and resorption of bone; Compare the mechanisms of action of different therapies for osteoporosis; Assess the risks and benefits of current medications for the treatment of osteoporosis; Cite current literature that discusses medications under development for the treatment of osteoporosis.

Overcome barriers to the treatment of osteoporosis in patients with fractures; Summarize current understanding of the biology of fracture healing; Cite evidence from the literature concerning the effects of medications used to treat osteoporosis on the process of fracture healing; Initiate appropriate treatment of osteoporosis in a patient with a fracture; Implement protocols for the treatment of patients with atypical femur fractures.

Evaluate traumatic injuries of the lower leg; Weigh the advantages and disadvantages of various surgical options for lower-leg injuries; Manage concomitant injuries of the ankle syndesmosis and posterior malleolus; Define a treatment plan, including timing of various interventions, for open tibia fractures; List potential complications and limitations of tibial plateau repair.

QUALIFIES FOR TRAUMA

Counsel a patient considering sialendoscopy; Summarize epidemiologic studies focusing on the relationship between sinus disease and asthma; Elaborate on the benefits of targeted therapies for cancers of the head and neck; Select appropriate candidates for surgical treatment of multinodular goiter; Collaborate with the anesthesia team to provide excellent surgical care for patients with multinodular goiter.

List common organisms and hosts involved in infections that cause Lyme disease; Recognize rare as well as common manifestations of Lyme disease; Interpret serologic tests for Lyme disease; Explain contemporary theories about the etiology of chronic rhinosinusitis; Manage a patient with chronic rhinosinusitis.

QUALIFIES FOR INFECTIOUS DISEASE

Evaluate and treat selective mutism and expressive language delay; Utilize pattern recognition to diagnose developmental disorders; Screen for autism in the office setting; Develop a differential diagnosis for fatigue in the pediatric patient; Recognize signs and symptoms associated with neurologic conditions.

Define the risk factors for infection with Staphylococcus aureus; Recognize the implications of antibiotic resistance in Staphylococcus aureus; Manage patients with skin and soft tissue infections caused by methicillin-resistant S aureus and other organisms; Identify the organisms that are most likely to cause fever in infants; Describe the testing and treatment regimens for bacteria and viruses that cause fever in infants.

QUALIFIES FOR INFECTIOUS DISEASE

Explain the principles of prescribing psychiatric medications to patients and their families; Prescribe medications for attention-deficit/hyperactivity disorder and depression; Monitor for common and serious side effects of commonly prescribed psychiatric medications; Incorporate screening tools for the identification of behavioral disorders into daily practice; Appropriately refer cases that require the attention of a specialist.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Communicate the definition of mental illness, as well as specified exclusions to a diagnosis of mental illness, in DSM-5; Evaluate various criticisms of DSM-5, eg, its "pathologizing of everyday life"; Apply the "other specified psychiatric disorder" diagnostic approach in cases that do not adequately fit into standard criteria; Identify new diagnoses in DSM-5, including hoarding disorder and binge eating disorder; Discuss revisions to the categorizations or criteria for diagnosing schizophrenia, major depressive disorder, and substance abuse disorders.

Recognize when high levels of persistent or residual anxiety may be interfering with the treatment of depression; Augment antidepressants with agents proven to help induce responses in patients with anxious subtypes of depression; Discuss the potential benefits of using pharmacogenetic testing before giving specific medications, as well as whether these benefits justify the costs involved; Provide rapid relief from depressive and suicidal symptoms in patients experiencing psychiatric emergencies; Compare new and emerging therapies that may yield lasting improvements in depression after a single treatment.

Effectively employ pharmacologic and nonpharmacologic management for inpatients with schizophrenia; Adjust medications for a patient with schizophrenia; Select the appropriate patients with schizophrenia to treat with clozapine; Explain why the World Health Organization definition of adherence is limited in patients with schizophrenia; Consider communication techniques that improve adherence in patients with schizophrenia.

QUALIFIES FOR CLINICAL PHARMACOLOGY

List established behavioral interventions for autism; Recommend effective treatment for a child with autism and attention-deficit/hyperactivity disorder; Choose the appropriate medication for treating irritability in autism; Manage medical comorbidities in patients with autism; Consider biomedical therapeutic strategies for autism.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Correctly use terms commonly applied to or used by transgender individuals; Compare the 3 major approaches that have been used to treat children with gender dysphoria; Counsel the parents of a child with gender dysphoria about the etiology and natural history of the condition; Weigh the advantages and disadvantages of retaining the diagnosis of gender dysphoria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; Choose optimal tools for screening and diagnosing patients with suspected borderline personality disorder.

Select pharmacologic therapies for patients at risk for mania; Successfully combine medications from different classes for a patient with bipolar depression; Counsel a patient regarding the risks and benefits of recommended medications for bipolar disorder; Describe the mechanisms of action and common side effects of recently approved drugs for acute bipolar depression; Manage add-on and adjunctive therapies for patients with acute bipolar depression.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Diagnose cognitive impairment in a patient with cancer; Use appropriate criteria for detecting thiamine-related encephalopathy in patients with cancer; Manage a patient with cancer who reports cognitive problems; Summarize legal cases that led to establishment of the rights of patients to have and to refuse treatment; Describe and critique 3 contemporary models of the right to refuse treatment as they relate to patients for whom psychiatric care is recommended.

Explain how genetic risk is evaluated; Describe the implications of overlapping biologic processes in patients with various psychiatric disorders; Diagnose treatment-resistant depression; Discuss the role of atypical antipsychotics for patients with treatment-resistant depression; Manage a patient with treatment-resistant depression.

Incorporate brief behavioral treatment for insomnia into a psychiatric practice; Discuss the risks and benefits of prescribing suvorexant for insomnia; Manage a patient with restless legs syndrome; Create a treatment plan for a patient with a mood disorder who is unresponsive to medications; Describe current experimental treatments for depression.

Diagnose and manage co-occurring disorders; Describe the mechanisms of action of drugs used to manage patients with substance use disorders; Advise a patient being treated for depression who is contemplating a pregnancy; Manage depression and psychotic disorders during pregnancy and breastfeeding; Discuss the risks for malformation associated with psychotropic drugs commonly prescribed to women of reproductive age.

Diagnose paraphilia based on the definition in Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition); Describe the elements of a comprehensive evaluation of an individual with a paraphilic disorder; List the goals of the evaluation and treatment of paraphilias; Evaluate the benefits and risks of medications used to treat paraphilias; Counsel a teenager engaging in "sexting."

QUALIFIES FOR SEXUAL ASSAULT

Diagnose schizophrenia and other psychotic disorders based on definitions in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition); Select appropriate medications for a patient with psychosis; Counsel a patient considering ECT; Safely deliver ECT to a patient who is pregnant or in the postpartum period; Manage complications and adverse effects associated with ECT.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Choose the appropriate treatment for patients with PTSD; Explain prolonged exposure therapy; List the 4 areas of focus of interpersonal therapy; Adapt present-centered therapy to a group setting; Select the appropriate patients to receive trauma-informed guilt reduction therapy.

QUALIFIES FOR TRAUMA

Discuss characteristic patterns and organization of borderline personality; Explain the importance of transference and countertransference in split treatment work; Determine when borderline patients should be referred for a medication consult; Recognize the cardinal features of AN; Provide patients with options for behavioral therapies effective in the management of AN.

Define types of sexual harassment; Recognize legal milestones and landmark cases in sexual harassment; Evaluate sexual harassment cases based on objective and subjective factors and psychological outcomes; Quantify the effects of mental illness on risks for violence and suicide; Cite firearm legislation and other measures to
reduce gun violence.

Establish the diagnosis of testosterone deficiency; Select appropriate treatment for men with low levels of testosterone; Determine the safety of testosterone therapy for men with benign prostatic hyperplasia; Implement effective medical therapy for the treatment of erectile dysfunction; Incorporate treatment of sexual dysfunction for women partners of men with erectile dysfunction.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Specify indications for surgery in the treatment of patients with constipation; Determine the role of pelvic organ prolapse in patients with constipation; Identify the major factors that cause pelvic organ prolapse; Implement key techniques for optimizing results when using native tissue in vaginal repairs; Compare native tissue repair to mesh repair for treating women with pelvic organ prolapse.