Medicine in the 21st Century

Define disruptive behavior; Recognize the consequences of disruptive behavior on the physician, the team, and the health care institution; Implement strategies for mitigating disputes and minimizing disruptive behavior in the health care setting; Choose appropriate preoperative evaluations for patients scheduled for surgery; Identify patients for whom surgery in an ambulatory center is contraindicated.

Explain the principles of medical ethics; Recognize and resolve ethical conflicts in the management of perioperative pain; Apply ethical principles to the perioperative management of pain; Use objective tools in the preoperative assessment of frailty in surgical patients; Consider frailty status in the provision of health care to elderly patients.

Implement checklists in the performance of anesthesia-related tasks; Maximize the benefits of simulation in the practice of anesthesia; Summarize the grading systems used to assess the severity of subarachnoid hemorrhage; Select the most appropriate modalities for the diagnosis of subarachnoid hemorrhage; Optimize treatment in patients with subarachnoid hemorrhage.

Recognize the effects of preoperative hypertension and hypotension on surgical outcomes; Appropriately manage blood pressure medications during the perioperative period; Implement an effective process for preoperative assessment; Generate value by minimizing delays and cancellations on the day of surgery; Involve patients in shared decision making.

Identify common hospital-acquired pathogens; Select appropriate perioperative antibiotics based on the source of potential infection and likely pathogens; Recognize risk factors for antimicrobial resistance; Select efficacious anesthetic techniques and agents for GI endoscopy procedures.

Select appropriate equipment for airway exchange through a supraglottic airway; Recognize the limitations of the designs of supraglottic airways; Risk-stratify patients at the time of tracheal extubation; Discuss the epidemiology and outcomes of extubation failure; Use effective tools and techniques for efficient decontamination of the airway.

Optimize the anesthetic care of patients with placental abruption; Recognize the risk factors and incidence for placenta accreta; Identify risk factors and signs of uterine rupture in pregnant patients; Cite current literature addressing the effects of using ultrasound guidance on the characteristics of peripheral blocks; Discuss the effects of ultrasound on patient safety during and after performance of regional anesthesia.

Employ strategies for optimizing care of pregnant women with cardiac abnormalities; Cite recent literature about risk factors for perioperative nausea and vomiting; Minimize the occurrence of postdischarge nausea and vomiting; Recognize signs of developing sepsis; Optimize the support and treatment of patients with sepsis.

List the important components of Fontan anatomy and physiology; Optimize the perioperative hemodynamics of patients who have undergone a Fontan procedure; Recognize the long-term comorbidities of patients with a previous Fontan reconstruction; Select appropriate candidates for outpatient tonsillectomy; Identify patients at risk for obstructive sleep apnea.

Select appropriate candidates for lung transplantation; Interpret nomenclature in current literature about chronic rejection; Explain the epidemiology and clinical significance of AKI; Prevent the development of AKI in critically ill patients; Cite recent studies that propose strategies for management of AKI in the intensive care unit.

Use peripheral nerve blocks to control pain in patients after repair of hip fracture; Select optimal anesthetic modalities in patients undergoing repair of hip fracture; ncorporate principles of orthogeriatrics into postoperative care in patients with hip fracture; Optimize the experience of dying in patients approaching the end of life; Resolve ethical dilemmas regarding end-of-life care.

Assess intraoperative cardiac status and hemodynamics; Determine the etiology of elevated end-tidal CO2 during laparoscopy; Evaluate and treat patients with difficult ventilation and hemodynamic instability in the prone position; Summarize the function and effect on physiology of left ventricular assist devices (LVADs); Optimize the perioperative care of patients with LVADs.

Recognize etiologies of circulatory failure; Choose appropriate vasopressors for the treatment of circulatory failure; Monitor and assess patients for delirium; Prevent the onset of delirium in the ICU; Optimize the treatment of patients with delirium.

Review the physiologic mechanisms of action for common cancer-related therapies; Recognize the common complications related to therapies for treating cancer; Optimize the perioperative care of patients during and after treatment for cancer; Assess the utility of nitrous oxide as an anesthetic agent, based on pharmacokinetics; Evaluate the safety profile of nitrous oxide.

Cite literature comparing liberal and restrictive strategies for transfusion; Select appropriate levels of hemoglobin to use as thresholds for triggering transfusion; Summarize the principles of ethical medical practice; Discuss the ethics of providing anesthesia services to close family members; Apply ethical principles of medical practice to clinical scenarios that may be encountered by the anesthesiologist.

Substitute alternatives to perioperative opioids for patients undergoing ophthalmic surgery; Implement protocols for pain management targeted at multiple sites in the pain pathway; Recognize factors that affect survival rates of patients with cancer admitted to the intensive care unit; Cite studies investigating modalities of intensive care in patients with cancer; Apply appropriate criteria for admission of patients with cancer to the intensive care unit.

Recognize the source of errors in the perioperative setting; Use decision-making tools to avoid cognitive errors; Increase perioperative safety using tools to manage risk; Determine the effectiveness of Enhanced Recovery After Surgery protocols in various health care environments; Apply principles of Enhanced Recovery After Surgery in pediatric patients.

Recognize the challenges of accurately monitoring depth of anesthesia; Evaluate claims of causality between depth of anesthesia and mortality or cognitive dysfunction; Summarize the adverse effects of postoperative delirium; Cite literature showing an association between depth of anesthesia and delirium; Select patients for whom it is most appropriate to monitor depth of anesthesia.

Distinguish between systolic and diastolic heart failure; Recognize the clinical signs of compensated and decompensated systolic heart failure; Perform appropriate preoperative evaluations in patients with congestive heart failure; Ameliorate preoperative anxiety in children and parents; Assess risk for and appropriately manage anesthesia for children with upper respiratory infections, and postoperative nausea and vomiting and emergence delirium in children

Summarize the indications for initiation and termination of massive transfusions; Use viscoelastic testing to guide resuscitation in patients with hemorrhagic shock; Enumerate the risks associated with anemia and elevated levels of hemoglobin; Cite literature about outcomes associated with restrictive vs liberal strategies for transfusion; Optimize outcomes for therapeutically anticoagulated patients undergoing surgical procedures or experiencing active bleeding.

Determine the stage of a patient with lung cancer; Summarize the advantages and limitations of radiotherapy for treating lung cancer; Refer appropriate candidates for surgical treatment of lung cancer; Select appropriate diagnostic tests for assessment of lung cancer; Explain the role of targeted therapy and immunotherapy as adjuvant treatments in lung cancer.

Recognize signs and predictors of difficult airways in pediatric patients; Safely intubate and induce anesthesia in children with difficult airways; Explain the pathophysiology of MH; Provide optimal treatment for patients who experience MH in the operating room; Cite current literature about management of MH.

Recognize factors that contribute to the increasing rates of maternal morbidity and mortality in the United States; Develop a plan to reduce risk associated with anesthesia in obese parturients; Perform optimal cardiac resuscitation in a parturient; Summarize the physiologic changes involved in the definitive management of fractures; Assess patients for concomitant injuries that may preclude definitive management of fractures.

Recognize risk factors for surgical site infections; Implement intraoperative practices to reduce the risk for surgical site infections; Define the role of the advanced practice provider in the preoperative clinic; Establish protocols for effective preoperative evaluation; Mentor advanced practice providers as they develop relevant quality and safety projects.

List indications for a surgical airway; Proficiently perform percutaneous cricothyrotomy; Identify factors contributing to the severity of the current opioid crisis; Delineate neural pathways involved in transmission and modulation of pain; Select appropriate nonopioid medications for treatment of acute and chronic pain.

Differentiate between anaphylactic and anaphylactoid reactions; Recognize potential triggers for anaphylactic and anaphylactoid reactions; Diagnose allergic reactions during anesthesia and surgery; Treat perioperative allergic reactions; Minimize risk for anaphylactic reactions in patients with allergies to latex.

QUALIFIES FOR RISK MGMT/PATIENT SAFETY/MEDICAL ERRORS-R160

Recognize risk factors for preeclampsia; List criteria for the diagnosis of preeclampsia and severe preeclampsia; Develop an anesthetic plan that considers the pathophysiology of preeclampsia; Implement strategies that reduce waste of pharmaceuticals; Estimate the half-life of injectable medications prepared in the pharmacy under class 5 sterile conditions.

Weigh the advantages and disadvantages of using a pulmonary artery catheter; Implement American Society of Anesthesiologists guidelines on the use of pulmonary artery catheters; Evaluate patients with suspected gastrointestinal bleeding; Resuscitate patients experiencing gastrointestinal bleeding; Assess the implications of a recent study evaluating the association between morbid obesity and difficult intubation.

Implement evidence-based practices to improve maternal outcomes; Locate and navigate online resources for improving maternal safety; Recognize the presentation and progression of chronic liver disease; Differentiate acute-on-chronic liver disease from acute liver failure and acute decompensation of chronic liver disease. Select the most effective surgical and nonsurgical therapies for patients with hepatic encephalopathy.

Select appropriate patients for interventional pain procedures; Perform diagnostic and therapeutic nerve blocks; Optimize tidal volumes in patients with ARDS; Set appropriate levels of positive end-expiratory pressure in patients with ARDS; Treat refractory hypoxemia in patients with ARDS.

Select appropriate doses and routes of administration of acetaminophen for perioperative control of pain in children; Recognize the differences in metabolism of acetaminophen between children and adults; Treat children with acetaminophen overdose; Maintain appropriate pressures and tidal volumes during mechanical ventilation in children undergoing surgical procedures; Deliver appropriate positive end-expiratory pressure in pediatric patients with and without acute lung injury.

Identify potential perioperative triggers for allergic reactions in children; Modify the perioperative environment to minimize the risk for anaphylactic reaction to latex; Summarize the components of the immune system that help the body defend itself against cancer; Recognize the effects of surgery and anesthetic agents on long-term outcomes in patients with cancer; Select anesthetic modalities associated with improved survival in patients with cancer

Define mentorship; Recognize the benefits of mentorship for trainees and faculty; Overcome barriers to implementation of a program for mentorship; Preoperatively optimize patients for surgery; Justify the creation of a preoperative clinic to hospital administration.

Cite the updated definitions for sepsis and septic shock; Recognize and treat maternal sepsis; Implement protocols for structured handoffs; Maximize the rate of success for ultrasound-guided IV access; Optimize ultrasonographic visualization for placement of epidural catheters.

Follow guidelines for determining whether death has occurred; List the 3 cardinal features of brain death; Perform a neurologic examination to assess a patient for brain death; Cite literature about the efficacy of fibrinogen concentrate and prothrombin complex concentrate; Differentiate indications for fibrinogen concentrate and prothrombin complex concentrate approved by the Food and Drug Administration from off-label uses.

Recognize risk factors for failure of epidural anesthesia during labor and cesarean delivery; Optimize anesthesia in women with inadequate epidural blockade; Assess the airway in women undergoing cesarean delivery; Mitigate potential complications related to cesarean delivery; Maximize perioperative comfort and safety in women undergoing cesarean delivery.

List factors that contributed to the current opioid crisis; Provide adeuate management of pain while minimizing potential for addiction to or abuse of opioids; Manage blood and fluids during complex spinal procedures; Recognize risk factors and preventive measures associated with perioperative visual loss in patients undergoing spinal surgery; Explain the effects of patient frailty on surgical outcomes

List types of protected assets; Structure businesses to minimize exposure of personal assets; Minimize the incidence of persistent pain after surgical procedures; Identify patients at higher risk for development of persistent pain; Implement strategies to minimize the occurrence of persistent postsurgical pain.

Follow the current algorithm for neonatal resuscitation; Apply ethical principles to the care of pregnant women; Define RRT; Recognize indications for initiation of RRT; Identify patients likely to experience complications of RRT.

Summarize the pathophysiologic effect of liver disease on coagulation; Minimize the perioperative risks of bleeding and thrombosis in patients with liver disease; Describe the attributes of an effective anesthesia information system; Leverage information in anesthesia information systems to improve care; Optimize the use of data from anesthesia information systems for research and quality assurance.

Weigh advantages and limitations of single-injection techniques for analgesia; Cite current literature about the efficacy of liposomal bupivacaine; Identify characteristics of generation Y; Provide leadership to millennials entering the health care workforce; Recognize generational differences in motivations and values.

Differentiate characteristics of ophthalmic surgery from those of other ambulatory surgeries; Minimize anxiety in patients undergoing ophthalmic surgery without use of sedatives; Optimize perioperative anesthetic care for children with pulmonary hypertension; Optimize perioperative anesthetic care for children with Kawasaki disease; Optimize perioperative anesthetic care for children with transplanted hearts.

Standardize processes to optimize efficiency in the OR; Reduce errors and improve patient safety in the OR; Implement evidence-based guidelines and algorithms for treatment of patients with asthma; Differentiate among phenotypes and endotypes of asthma; Appropriately apply targeted therapies to patients with asthma.

Recognize that anesthesia professionals transmit infectious organisms in the clinical setting; Implement work practices that minimize the risk for perioperative transmission of infections; Summarize the physiology of LVADs; Intraoperatively monitor patients with LVADs; Resuscitate patients with LVADs.

Summarize the United States Food and Drug Administration's warning about anesthesia in children younger than 3 yr of age; Critique human and animal studies about the potential effects of anesthesia on developing brains; Assess recent studies (eg, the PANDA and GAS studies) of using anesthesia in children; Cite consensus statements from national and international organizations about the safety of anesthesia for young children; Provide appropriate counseling to parents concerned about anesthesia for their children.

Recognize how innervation affects perception of pain during different stages of labor; Design an effective plan for analgesia throughout the process of labor; Improve communication among members of the obstetric team; Recognize the potential of laryngoscopes for transmission of infections; Compare advantages and disadvantages of reusable and single-use laryngoscopes.

Recognize common causes of postoperative complications in the postanesthesia care unit (PACU); Diagnose postoperative complications in patients in the PACU; Provide optimal treatment for patients with postoperative complications in the PACU; Elaborate on the physiologic changes associated with obesity; Optimize perioperative anesthesia in obese patients.

Assess the efficacy of peripheral nerve blocks for thoracic procedures in comparison with thoracic epidural analgesia; Integrate nerve blocks into protocols for multimodal analgesia in thoracic surgical patients; Differentiate between children with idiopathic and neuromuscular scoliosis; Optimize perioperative anesthetic care of children undergoing spinal fusion; Recognize the effects of anesthetic agents on intraoperative neurophysiologic monitoring.

Cite current literature about the effects of anesthesia on children under 3 years of age; Counsel parents of young children who are concerned about the effects of anesthesia; Identify lifestyle choices that have the greatest impact on wellness; Adopt lifestyle practices that promote personal wellness; Initiate institutional programs that foster employee and patient wellness.

Summarize the hemodynamic effects of mechanical ventilation; Select appropriate candidates for goal-directed fluid therapy; Assess dynamic indices intraoperatively to determine patients' fluid responsiveness; Implement algorithms for goal-directed therapy; Optimize administration of fluids throughout the perioperative continuum.

Recognize the adverse effects of opioids; Evaluate evidence from studies of acute opioid-related hyperalgesia; Implement perioperative multimodal analgesia as an alternative to opioid-based analgesia; Reduce the need for large prescriptions for opioids in patients discharged from the hospital; Consider alternatives to opioids for perioperative pain control based on each agent's pathophysiology and effects.

QUALIFIES FOR PAIN MANAGEMENT, CLINICAL PHARMACOLOGY OR CONTROLLED SUBSTANCES-CSB004

Recognize the prevalence and consequences of burnout among clinicians; Identify factors that contribute to burnout; Cite literature demonstrating the benefits of mindfulness training; Use available resources for mindfulness training and stress reduction; Integrate techniques for mindfulness into daily life and work.

Recognize the advantages and limitations of videolaryngoscopy; Differentiate supraglottic from retroglottic devices used in airway management; Exchange supraglottic airway devices for endotracheal tubes; Elaborate on the anatomic differences between the airways in children and adults; Optimize mask ventilation and intubation in pediatric patients.

Discuss a variety of situations that may cause impairment in anesthesiologists; Describe the natural course of the disease of addiction; Identify warning signs and symptoms of an impaired colleague; Overcome barriers to reporting an impaired colleague; Support colleagues returning to work after rehabilitation.

QUALIFIES FOR RISK MANAGEMENT/PATIENT SAFETY/MEDICAL ERRORS
QUALIFIES FOR SUBSTANCE ABUSE-SA091

Select appropriate agents and timing for prophylaxis against aspiration of gastric contents; Provide appropriate treatment to patients who aspirate during surgery; Compare risks associated with laparoscopic surgery to those associated with open surgery; Preoperatively assess patients with hepatic disease; Optimize perioperative management of patients with hepatic failure.

Recognize the value of health care quality improvement; Implement programs to improve the quality of health care; Select appropriate ratios of blood products for use in massive transfusion protocols; Cite current literature about optimal transfusion practices in trauma patients; Compare outcomes of transfusions guided by conventional laboratory studies to those guided by thromboelastography.

QUALIFIES FOR RISK MGMT/PATIENT SAFETY/MEDICAL ERRORS
QUALIFIES FOR SUBSTANCE ABUSE

Recognize the many potential roles for anesthesiologists in reducing the cost of health care; Assume positions of leadership to effect change in the delivery of health care; Summarize the evolution of the residency training system in the United States; Identify leadership training programs that are available to anesthesiologists wishing to reorient their careers; Estimate the economic costs of longer residencies to institutions and individuals.

Recognize risk factors for perioperative complications in patients undergoing orthopedic surgery; Select appropriate anesthetic techniques for orthopedic patients; Provide safe and effective anesthesia for patients undergoing spinal surgery; Respond to changes in somatosensory and motor evoked potentials; Minimize the risk for postoperative vision loss after orthopedic surgery.

Summarize the known genetic elements underlying malignant hyperthermia susceptibility; Discuss the 4 ways to predict the presence of malignant hyperthermia susceptibility; Recognize and respect the right of patients to refuse treatment that goes against their religious beliefs; Consider patients' differing cultural and religious attitudes toward providers of health care; Weigh the need to follow accepted standards for monitoring against the need to provide urgent patient care.

Identify unique aspects of providing anesthesia in nonoperating room settings; Optimize the efficiency of anesthesia delivery in locations outside of the operating room; Select appropriate candidates for nonoperating room anesthesia; Recognize how the anesthesia care team can improve patients' outcomes; Implement a collaborative decision-making process for guiding perioperative care.

Recognize potential adverse effects of perioperative opioids; Use nonopioid alternatives to manage perioperative pain; Develop protocols for perioperative multimodal analgesia; Select appropriate candidates for ambulatory surgery and anesthesia; Discuss the roles of a patient's American Society of Anesthesiologists class, age, and frailty in determining appropriateness for ambulatory surgery.

Preoperatively assess patients with tracheoesophageal fistulae; Distinguish among the different types of tracheoesophageal fistulae; Treat neonates after primary repair of tracheoesophageal fistulae; Avoid common errors in the use of monitors; Recognize when and why data provided by monitors should be disregarded.

Classify different types of PE; Recognize the advantages and disadvantages of different methods for diagnosing PE; Apply evidence-based algorithms to the treatment of PE; Summarize the pathophysiology of postoperative delirium; Predict and prevent postoperative delirium in surgical patients.

Recognize risk factors for morbidity and death in patients with hip fractures; Optimize the operative treatment of patients with hip fractures; Design a standardized anesthetic approach for use in patients with hip fractures; Reexamine accepted dogma regarding obstetric anesthesia; Provide optimal peripartum care for obstetric patients.

Report adverse events to the Anesthesia Incident Reporting System; Use crisis checklists during intraoperative emergencies; Recognize potential sources of intraoperative adverse events; Apply efficiency and management metrics to nonoperating room anesthesia; Optimize scheduling and staffing for nonoperating room anesthesia cases.

Take a targeted pain history; Accurately identify the source of a patient's pain; Recognize the high risk for maladaptive behaviors among medical professionals after adverse patient outcomes; Seek support after experiencing a traumatic adverse outcome; Identify cases that carry the highest risk for producing the "second victim" phenomenon among anesthesiologists.

Recognize risk factors for postmastectomy pain syndrome; Delineate the innervation of the breast and underlying muscles; Select the most appropriate analgesic block for the type of breast surgery planned; Minimize risks for adverse events during induction and intubation of trauma patients; Implement protocols for damage-control resuscitation.

Explain the mechanism of action of lipid emulsion in the treatment of local anesthetic systemic toxicity; Recognize clinical signs of local anesthetic systemic toxicity; Provide appropriate resuscitation in patients with local anesthetic systemic toxicity; Optimize the use of ultrasonography to identify landmarks for erector spinae plane blocks; Cite findings of recent studies on the effective use of erector spinae plane blocks in a variety of surgical procedures.

Identify reasons to postpone a pediatric surgical procedure; Apply a variety of topical and subcutaneous approaches for procedural pain management; Reduce anxiety in children undergoing anesthesia as well as in their parents; Prevent or mitigate postanesthesia nausea and vomiting; Interact and bond with pediatric patients and their parents.

QUALIFIES FOR PAIN MANAGEMENT-PM

Recognize how the anatomy of the lung contributes to gas exchange; Optimize the perioperative function of the respiratory system; Assess risk for intraoperative fires; Implement strategies for prevention of fires in the operating room; Respond to fires in the operating room.

Use analytics to inform clinical decisions; Improve outcomes through use of information gleaned through big data; Apply predictive risk modeling to reduce the rate of preventable hospital admissions; Institute a patient blood management (PBM) program to reduce transfusions and maintain safety; Manage patients with preoperative anemia by applying the tenets of PBM.

Determine the presence and severity of obesity in children; Recognize the perioperative effects of obesity in children; Implement strategies to maximize perioperative safety for obese children; Identify obese patients at risk for airway-related morbidity; Apply novel methods for extending the safe apnea period in obese patients.

Adjust medication doses to account for obesity; Perform preoperative evaluation of obese patients; Safely extubate and monitor obese patients postoperatively; Recognize the prevalence and physiologic consequences of OSA; Minimize perioperative risks for patients with diagnosed or suspected OSA.

Recognize unique airway challenges associated with head and neck surgery; Elaborate on factors associated with failed ventilation and intubation that have been identified in large national databases; Thoroughly assess the airways of patients scheduled for head and neck surgery; Use techniques and devices designed to maximize safe apnea time during difficult intubation; Perform a surgical airway when indicated.

Elaborate on the pathway leading to pulmonary embolism; Differentiate the presentation and diagnosis of intraoperative pulmonary embolism from an ambulatory or emergency department presentation; Select appropriate interventions for treating pulmonary embolism; Implement transparent pricing for health care; Consider applications of disruptive innovation to health care that can improve the value of care.

Recognize risk factors for major and nonmajor perioperative cardiac events; Implement protocols for detection of nonmajor perioperative cardiac events; Assess preoperative functional status of patients; Identify risk factors for perioperative adverse events in pediatric patients undergoing anesthesia; Minimize institutional risk factors in pediatric anesthesia.

Diagnose amniotic fluid embolism; Treat obstetric patients with suspected amniotic fluid embolism; Describe the pharmacology of methadone and buprenorphine; Summarize current theories on the physiologic mechanisms of addiction and dependence; Select appropriate analgesic regimens for obstetric patients on maintenance therapy for addiction and dependence.

Summarize recent data on the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists on risk for cardiovascular events in patients with type?2 diabetes; Adjust a patient's medication regimen before starting an SGLT2 inhibitor or GLP-1 receptor agonist to reduce risk for side effects and drug interactions; Discuss the benefits of different types of physical activity for individuals with diabetes; Counsel patients on how to incorporate physical activity into their lifestyles.

Discuss community-specific challenges to implementation, recruitment, and retention of participants in the Medicare DPP; Summarize requirements for receiving recognition from the Centers for Disease Control and Prevention as a provider of Medicare DPP; Use positive, strength-based language to discuss self-management with patients who have diabetes; Provide guidance for healthy eating plans for patients with diabetes based on their starting point and individual health concerns.

Identify patients at extreme risk for cardiovascular events according to recent AACE/ACE guidelines; Summarize AACE/ACE guidelines for LDL and non-HDL cholesterol, as well as apolipoprotein B, in patients at very high or extreme risk for cardiovascular events; Discuss how coronary artery calcium score can be used to determine which patients need aggressive treatment with cholesterol-lowering agents; Describe how a multidimensional community-based program improved community health and increased access to healthy food, physical activity, and health services in a small town.

Determine when to refer patients to a nephrologist based on their clinical condition and changes in kidney parameters; Explain the effects of different types of antihypertensive agents on short- and long-term kidney function; Manage potassium levels in patients with diabetes and chronic kidney disease; Summarize the role of community health workers in the prevention and management of diabetes.

Summarize general indications for bariatric surgery and weight-loss pharmacotherapy; Explain how pharmacotherapy can improve response to a weight loss intervention in individuals who have difficulty maintaining a low-calorie diet; Adjust diabetes medications for patients starting a weight loss intervention based on their level of glycemic control; Discuss how to calibrate, interpret, and use CGMs to assess trends in blood glucose.

Discuss common barriers to access and implementation of diabetes self-management education; Identify common features and functions of smartphone apps for diabetes self-management that provide clinical benefits; Predict which patients are most likely to benefit from using an app for diabetes self-management; Evaluate ways of incorporating apps into self-management of diabetes.

Explain how differences in insulin clearance among different races may contribute to different pathophysiologies of type?2 diabetes; Summarize how the complex communication among various organs and tissues affects glucose levels in the body; Select antidiabetes medications based on a patient's cardiovascular risk factors and comorbidities; Discuss how the benefits of new antidiabetes drugs on cardiovascular outcomes may affect diabetes management in the future.

Explain why establishing healthy eating behaviors in childhood and adolescence is important for prevention of chronic disease in adulthood; Identify ways to improve dietary quality and eating habits in adult and pediatric patients; Summarize how big data could be used to predict risk for insulin resistance and type?2 diabetes; Describe how data from wearable devices could be used for early detection of insulin resistance or to guide laboratory testing in the future.

Adjust management strategies and glycemic targets to align with the patient's financial resources and preferences for self-management; Cite resources for obtaining medications, testing supplies, fresh produce, and exercise programs at a lower cost; Discuss the benefits and drawbacks of using free samples of medications for patients with limited financial resources; Assist patients with managing expectations when using new medications and therapeutic devices.

Manage patients with type?2 diabetes who have symptoms of low testosterone and/or sexual dysfunction; Perform neurologic examinations to identify and manage diabetic neuropathy in its early stages; Summarize the different mechanisms through which diabetes medications improve glucose control; Select a therapeutic regimen based on clinical presentation as well as accessibility and convenience of medications and devices.

Select optimal instruments for assessing quality of life in patients with diabetes; Help patients make therapeutic choices that are most likely to provide benefit; Determine the appropriate time to intensify treatment in patients with diabetes; Implement solutions to overcome clinical inertia in diabetes management.

Educate patients on the features and benefits of continuous glucose monitors; Summarize recommendations for cessation of smoking and management of blood pressure and lipid levels; Explain how diabetes can contribute to hearing loss and disruption of the vestibular system; Describe how a collaboration between a community pharmacy and local primary care providers can improve diabetes education and management in a small town.

Adjust the treatment goals and medication regimens for patients with diabetes and cognitive impairments; Discuss nutrition and weight loss goals with patients in the primary care setting; Identify diabetes- and medication-related factors associated with increased risk for bone fractures; Diagnose and treat osteoporosis in patients with diabetes.

Assist patients with diabetes in selecting tools that can improve disease management and quality of life; Monitor the impact of lifestyle changes on blood glucose levels to sustain patients' motivation for improved health behaviors; Implement practices to enhance cybersecurity of network-connected devices for the management of diabetes; Direct patients toward resources that provide information on constructing a hybrid closed-loop system for insulin delivery.

Review the strategic goals for the continued development of the National Diabetes Prevention Program; Discuss ways of improving patient access to and provider referral for the National Diabetes Prevention Program; Identify risk factors that warrant screening for peripheral artery disease; Prescribe management strategies for peripheral artery disease that may improve walking distance.

Customize insulin regimens to achieve optimal glycemic control; Individualize glycemic goals based on patient characteristics and clinical status; Devise appropriate treatment strategies for patients with diabetes and comorbid cardiovascular disease; Counsel patients about the cardiovascular effects of various antidiabetic medications.

Discuss the differences in adherence to diabetes therapy between patients in trials and "real-world" patients; Identify factors that reduce patients' adherence to therapy and review the effectiveness of approaches to improve adherence; Develop positive, trusting relationships with patients to improve adherence to therapy; Improve communication with patients with diabetes by choosing clear, effective, and positive language.

Educate patients with diabetes on managing their disease in times of natural disaster; Detect insulin resistance in patients with suggestive clinical features; Recommend early interventions in patients with insulin resistance to prevent the development of diabetes (ie "decompensated insulin resistance"); Discuss the possible roles of personalized therapies in the management of diabetes.

Describe the relationships between sleep and obesity, diabetes, and mortality; Identify patients at high risk for sleep apnea; Develop management strategies for elderly patients with diabetes based on comorbidities, geriatric syndromes, and frailty; Summarize the benefits and drawbacks of common diabetes medications

Compare and contrast the eligibility requirements, delivery modes, and staffing requirements for the Centers for Disease Control and Prevention (CDC) and Medicare Diabetes Prevention Programs (DPPs); Summarize requirements for pending, preliminary, and full CDC recognition for an organization providing a DPP; Identify resources for training prospective lifestyle coaches to deliver CDC-approved curricula for a DPP; Choose appropriate incentives for participants in the Medicare DPP.

Differentiate among the various types of bariatric surgical procedures that may be encountered in patients presenting to the emergency department; Determine the cause of clinical abnormalities occurring in patients who have undergone bariatric surgery; Recognize causes of nociceptive and neuropathic pain; Calculate doses for rescue pain medication; Effectively interpret diagnostic studies in patients with renal disease presenting with chest pain.

QUALIFIES FOR PAIN MANAGEMENT

Use clinical judgement to determine if a patient has decision-making capacity; State the requirements for using medical restraints in the emergency department, and describe available drug options for chemical restraint; Recognize the legal, ethical, and moral duties of the emergency physician when treating patients who are intoxicated; List the criteria required to name an emergency physician in a medical malpractice lawsuit; Identify risks and complications related to medications that are commonly used in the emergency department.

QUALIFIES FOR RISK MANAGEMENT/PATIENT SAFETY/MEDICAL ERRORS

Differentiate among forms of heat illness; Rapidly implement effective cooling techniques and supportive care for patients with heat stroke; Identify house fire victims at high risk for airway compromise; Select appropriate treatment for cyanide poisonings; Determine whether a patient being treated for smoke inhalation is an appropriate candidate for hyperbaric oxygen therapy.

QUALIFIES FOR TRAUMA

Determine whether it is necessary to comply with a request for medical evaluation of an individual being detained by law enforcement officers; Differentiate assault from medical battery; Minimize the invasiveness of procedures used in the evaluation of detainees; Correctly complete death certificates; Recognize indications for and initiate use of devices that achieve thermoregulation.

Identify patients who require reversal of NOACs; Select optimal reversal agents based on specific NOAC and patient characteristics; Determine which patients require workup for SAH based on suggestive clinical features and history; Set adequate targets for blood pressure control in patients with SAH or ICH; Initiate critical care interventions to reduce morbidity and mortality associated with SAH and ICH.

Identify the symptoms of subtle, atypical, and evolving strokes; Determine whether a patient is a candidate for thrombolytic treatment of acute stroke; Perform adequate workup for medical clearance and stabilization of a psychiatric patient; Safely clear the pediatric cervical spine without the use of radiography; Distinguish pseudosubluxation from true subluxation of the cervical spine in pediatric trauma patients.

Determine the mechanism of injury of common pediatric fractures based on fracture patterns; List the necessary components of a trauma evaluation in a pediatric patient; Make appropriate treatment decisions based on grading of open fractures; Follow an appropriate sequence of steps for resuscitation of a neonate; Assess risk for serious bacterial infection in a febrile infant.

Create and utilize a general approach to treating poisoned patients; Identify symptoms that correlate with use of long-acting or high-potency opioids; List the mainstays of treatment for patients with amphetamine poisoning; Effectively treat complications related to abuse of intravenous drugs; Distinguish ischemic from nonischemic priapism.

Use appropriate studies and resources to manage the patient with acute stroke symptoms; Facilitate and initiate treatment for acute stroke within the time frames outlined in current stroke guidelines; Recognize potential presentations of emergent conditions in the nonverbal patient with ASD; Diagnose catatonia in a patient with ASD; Create a clinical environment that is conducive to evaluating a patient with ASD.

Identify signs of impending hemorrhagic shock; Treat hemorrhagic shock using guided resuscitation; Determine whether immediate laparotomy is indicated; Evaluate penetrating trauma caused by a stab wound through physical examination and imaging studies; Apply recommendations from updated evidence-based medicine to manage trauma.

QUALIFIES FOR TRAUMA

Differentiate Physician Orders for Life-Sustaining Treatment (POLST) documents from other forms of advance directives. 2. Recognize the components required for proper execution of a Physician Orders for Life-Sustaining Treatment (POLST) document; Determine the validity of a Physician Orders for Life-Sustaining Treatment (POLST) document; Identify which advance directive documents act as actionable medical orders for a patient who experiences cardiopulmonary arrest in the field; Develop skills to start end-of-life conversations with dying patients and their family members.

QUALIFIES FOR END OF LIFE/PALLIATIVE CARE

Differentiate peritonsillar cellulitis from peritonsillar abscess; Choose appropriate radiologic modalities with which to accurately diagnose oropharyngeal emergencies; Identify which oropharyngeal emergencies may acutely lead to airway compromise; List subtle differences in examination results for herpes simplex virus vs varicella zoster keratitis; Isolate cranial nerve palsies based on the results of ocular examination.

RISK MANAGEMENT/PATIENT SAFETY/MEDICIAL ERRORS-R159

Recognize the impact of radiation from computed tomography in trauma patients; Use clinical decision tools to direct the selective imaging of trauma patients; Assess the need for computed tomography based on results from ultrasonography and physical examination; Describe the physiologic responses of elderly patients to trauma; List the most common causes and areas of injury in the elderly trauma patient.

QUALIFIES FOR TRAUMA-IG023

Risk stratify children presenting with abdominal pain; Interpret ultrasonography findings and integrate them into the evaluation of children with abdominal pain; Obtain an optimal history and physical examination for children with abdominal pain; Formulate a differential diagnosis for abdominal pain in children according to age at presentation; Differentiate acute gastroenteritis and gastroesophageal reflux from more serious causes of abdominal pain.

Outline strategies for weight loss that include bariatric surgery; List complications that may develop after Roux-en-Y gastric bypass surgery; Explain how emergency departments are failing the transgender community; Improve greeting culture to optimize the patient interview; Manage complications associated with gender-affirming procedures and surgeries.

Weigh the benefits and risks of venous arterial extracorporeal membrane oxygenation; Choose appropriate medical treatment for ventricular arrhythmias; Prepare for resuscitation and manage stress during an arrest; Consider use of humeral and sternal intraosseous lines; Optimize patients prior to intubation.

Evaluate the evidence supporting current emergency therapies; Ensure that clinical practice is consistent with evidencebased emergency medicine; Administer epinephrine at the appropriate time and dosage in patients with anaphylaxis; Anticipate potential difficulties associated with the use of automated injection devices for delivery of epinephrine; Incorporate patterns of prescribing that decrease the risk for long-term use of opioids by patients

Apply principles of medical ethics to patients in the emergency department; Make decisions about administering life-saving treatments to patients who are unable to consent; Appropriately apply restrictions on individual liberties during an epidemic; Weigh the advantages against the disadvantages of imposing a quarantine; Allocate resources when rationing is required.

QUALIFIES FOR ETHICS

Differentiate emergent from nonemergent stridor in infants; List the phases of stridor and establish a differential diagnosis based on auscultation findings; Manage oropharyngeal trauma in small children; Safely evaluate potential laryngotracheal trauma in children; Participate in community programs that encourage safe decision-making among children and adolescents.

List options for the medical treatment of hyperkalemia; Identify electrocardiographic changes caused by hyperkalemia; Ensure maximum engagement during a patient encounter; Anticipate signs of failed attempts at de-escalation in an agitated patient; Develop a clinical pathway for treating pediatric mental health patients in the emergency department.

Recognize viral hemorrhagic fevers and pox diseases that require patients to be placed in biocontainment units; Identify Nipah virus and Hendra virus infections; Prevent the spread of febrile respiratory illnesses and plague by using appropriate isolation precautions; Discuss current guidelines about testing for ika virus; Counsel patients about risk for transmission of tularemia, West Nile virus, and Powassan virus.

QUALIFIES FOR INFECTIOUS DISEASE

Discuss the roles of serotonin and other monoamines in pain and in psychological functioning; Describe the mechanisms of actions of antidepressant, antiepileptic, and antipsychotic agents; List the features of intractable headache; Select appropriate therapy for medication overuse headache; Counsel patients with headache about lifestyle modifications.

QUALIFIES FOR PAIN MANAGEMENT-HE017

Make recommendations about timing of surgery in patients with coronary stents; Manage perioperative anticoagulation in patients with atrial fibrillation and mechanical heart valves; Follow evidence-based guidelines to prevent postoperative myocardial infarction and ischemia; Assess preoperative patients for potential obstructive sleep apnea; Evaluate the efficacy of employer-endorsed programs for the management of obesity and wellness.

Assess the appropriateness of practices (eg, use of docusate, supplemental oxygen, and chemotherapy) commonly used in palliative care; Counsel patients about the benefits of specialty-level palliative care; Assist patients and their caregivers with advance care planning; Recognize the importance of cardiorespiratory fitness for a variety of medical conditions; Compare the benefits of high-intensity interval training (HIIT) to those of moderate-intensity continuous training.

Employ appropriate strategies in the treatment of patients with asymptomatic bacteriuria; Adopt updated guidelines to manage uncomplicated and multidrug-resistant urinary tract infections; Incorporate the principles of antimicrobial stewardship in clinical decision making in patients with urinary tract infection; Diagnose sleep-related movement disorders; Use evidence-based approaches to treat patients with sleeprelated movement disorders.

Incorporate evidence-based nonmedical approaches into the management of patients with IBS; Discuss the use of cognitive behavioral therapy to treat gastrointestinal-specific anxiety; Review the pathophysiologic mechanisms of chronic constipation; Choose appropriate diagnostic tests for patients with chronic constipation; Counsel patients on evidence-based over-the-counter and prescription treatments for subtypes of constipation.

Identify patients at high risk for recurrence of C difficile infection; Select appropriate medications for treatment of C difficile recurrence; Consider fecal microbial transplantation for patients with C difficile infection; Counsel patients about PPIs and their effects on vitamin and mineral absorption; Weigh risks and benefits of PPI use in patients with Barrett esophagus, gastroesophageal reflux disease, and erosive esophagitis.

Assess and evaluate common causes of back pain in the primary care setting; Appropriately recommend treatment for patients with back pain; Explain current information about interventional strategies for pain management; Identify optimal treatment strategies for patients with osteoporosis; Determine best practices for monitoring patients undergoing osteoporosis treatment.

Differentiate ulcerative colitis from Crohn disease; Use diagnostic testing tools to assess the degree of inflammation and complications in patients with suspected inflammatory bowel disease; Counsel patients with inflammatory bowel disease about medications, diet, and nutrition; Establish systolic blood pressure targets for patients with diabetes mellitus; Summarize the effects of therapy with statin drugs and nonstatin lipid-lowering agents in patients with diabetes mellitus.

Weigh the advantages and disadvantages of warfarin and direct-acting oral anticoagulannt agents; Recognize indications for warfarin, direct-acting oral anticoagulant agents, and low-molecular-weight heparin; Employ American College of Chest Physicians guide-lines for antithrombotic therapy; Select appropriate agents for reversal of anticoagulation; Provide effective options to patients who cannot take direct-acting oral anticoagulant agents or warfarin for anticoagulation therapy and prevention of stroke.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Recognize sleep problems in patients with psychiatric disorders; Weigh the beneficial and deleterious effects of psychotropic medications on sleep; Optimize the use of psychotropic medication in patients with comorbid insomnia and psychiatric disorders; Elaborate on the findings of recent research trials of agents to manage Alzheimer disease; Counsel patients about the safety and effectiveness of supplements in the treatment of Alzheimer disease.

Screen for and diagnose hepatitis C virus (HCV) infection; Use evidence-based guidelines to select appropriate treatment for patients with HCV; Effectively communicate with pharmacists and insurers to obtain treatment for patients with HCV; Identify strategies to minimize thromboembolism and bleeding in anticoagulated patients undergoing elective procedures; Assess data from a pivotal trial of perioperative bridging anticoagulation in patients with atrial fibrillation.

Classify severity of CKD based on glomerular filtration rate and albumin-to-creatinine ratio; Diagnose common comorbidities of CKD, such as hypertension and dyslipidemia; List side effects of sodium-glucose cotransporter 2 inhibitors; Review current recommendations for administration of the zoster vaccine to older adults; Select effective pharmacologic therapy for patients with acute or chronic low back pain.

List symptoms commonly reported by women transitioning through menopause; Explain the pathophysiology of common menopause symptoms; Formulate a nonhormonal treatment plan for women with bothersome menopausal symptoms; Counsel patients with diabetes at risk for renal disease about options for treatment; Implement strategies for prevention of mrCDI.

Counsel patients about the risks and benefits of prostatespecific antigen (PSA) screening; Review recommendations for PSA screening; Discuss data about cardiovascular risks associated with testosterone replacement therapy; Recognize urologic emergencies such as testicular torsion and Fournier gangrene; Select appropriate treatments for lower urinary tract symptoms.

Explain the impact of smoking on individual and public health; Develop a management plan to help smokers successfully quit; Counsel teens about risks associated with e-cigarettes; Use appropriate assessments for diagnosing for pneumonia; Limit the duration of antibiotic therapy for bacterial pneumonia according to evidence-based guidelines.

Explain the term "delirium."; Propose a workup plan for the patient with suspected delirium; Distinguish delirium from dementia; List pharmacologic treatment options for delirium; Prevent delirium in hospitalized patients.

Identify common causes of kidney stones; Select appropriate treatment of kidney stones based on stone size, location of the stone, and presence of infection; Describe surgical procedures used in the management of kidney stones; Counsel men with postprostatectomy incontinence about pelvic floor muscle training and bladder control; Diagnose and treat common sexually transmitted infections in men.

Evaluate the efficacy of medication-assisted therapy in patients with OUD; List diagnostic criteria for substance use disorders; Distinguish medication dosing for use in pain control from that in treatment of OUD; Classify medications used in the treatment of OUD according their mechanisms of action; Choose the most appropriate routes of administration for MAT.

QUALIFIES FOR SUBSTANCE ABUSE AND CLINICAL PHARMACOLOGY

Counsel patients about a low-carbohydrate diet for weight loss; Compare benefits of a low-carbohydrate diet with those of a low-fat diet; Educate patients about lifestyle modification and pharmacologic therapy for prevention of diabetes; Explain obesity as an outcome of coping with stress and other environmental factors; List strategies for prevention and treatment of obesity in black women and other high-risk groups.

Develop an evidence-based management plan for infants with fever without a source; Employ appropriate diagnostic and treatment strategies for young children with urinary tract infection; List diagnostic and treatment regimens for children with suspected streptococcal pharyngitis, pertussis, or pneumonia; Diagnose common childhood exanthems; Counsel patients about etiology, pathology, and management
of epistaxis.

Distinguish type 1 from type 2 endometrial cancer; Determine whether a patient with endometrial cancer is a candidate for surgery, radiation therapy, or chemotherapy; Counsel patients with endometrial cancer about risk for recurrence and survival rates; Identify patients with dysfunctional voiding; Perform an appropriate workup for patients with symptoms of dysfunctional voiding.

Diagnose LPR on the basis of reflux symptom index and reflux finding scores; Identify causes and potential mechanisms of LPR; Choose appropriate diagnostic tests for children with chronic sinusitis and nasal polyps; Select appropriate management of nasal polyps; Recognize signs and symptoms of sleep apnea and vocal cord dysfunction syndrome.

Identify primary sarcomas and metastatic bone lesions in adults and children; Work up and select appropriate treatment for benign lesions and soft tissue masses; Recognize shoulder stiffness caused by frozen shoulder; Counsel patients about treatment options for rotator cuff tears; Discuss surgical and nonsurgical treatment options for shoulder instability and shoulder roughness.

Explain the pathophysiology of chronic pain; Develop ways to communicate and form effective doctorpatient relationships with patients who have chronic pain; Formulate an evidence-based, comprehensive treatment plan for patients with chronic pain; Employ appropriate diagnostic strategies for patients with chronic diarrhea; List treatment recommendations for different causes of chronic diarrhea, including microscopic colitis and exocrine pancreatic insufficiency.

Make treatment decisions about common traumatic injuries, such as traumatic brain injury, blunt cardiac injury, and abdominal compartment syndrome; Optimize management of patients with traumatic pancreas, liver, and/or spleen injuries; Assess the safety and efficacy of anticoagulation therapy and enteral feeding in multitrauma patients; Determine causes of hip pain based on clinical findings; Select appropriate treatment of common hip problems, such as hip impingement and hip dysplasia.

Individualize contraception for women with developmental disabilities based on medical conditions and efficacy; Cite recommended methods for emergency contraception; State female cancer screening guidelines for women with developmental disabilities; Review recent trials of stroke prevention in patients with asymptomatic CAS; Implement best medical management for patients with asymptomatic CAS.

List common causes of immune deficiency; Identify fungal and viral infections in immunocompromised patients; Implement vaccine recommendations for patients with immune deficiency; Differentiate migraine headache from other headache types; Counsel patients about migraine prevention and lifestyle modifications.

Adhere to updated immunization guidelines from the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices; Compare the efficacies of newly approved vaccines to those of vaccines introduced in the past; Formulate an evidence-based medical therapy plan for patients with congestive heart failure; Follow updated diabetes treatment algorithms; Choose treatment for diabetes that minimizes risk for adverse cardiovascular outcomes.

Recognize iron deficiency in patients with heart failure; Prescribe an effective regimen for oral iron supplementation; Adhere to AABB practice guidelines for red blood transfusions in a variety of patients; Cite clinical trial evidence supporting the use of omega-3 fatty acids for preventing cardiovascular disease; Counsel patients about omega-3 fatty acid intake and supplementation.

Differentiate characteristics of traditional combustible cigarettes from those of electronic cigarettes; Identify various electronic nicotine delivery systems and their components; Compare types of cannabinoids and forms of marijuana; Recognize risk factors and signs of cannabis use disorder; Inform patients about medical and recreational marijuana laws.

QUALIFIES FOR SUBSTANCE ABUSE

Optimize the treatment of puncture wounds caused by mammalian bites; Differentiate the signs and symptoms of bites from black widow and brown recluse spiders; Recognize and treat injuries and toxicities caused by envenomation from marine animals; Identify postmenopausal women who may benefit from hormone therapy for treatment of osteoporosis; Weigh the risks and benefits of taking selective estrogen receptor modulators and calcitonin.

Rule out reversible causes of AF; Select appropriate antiarrhythmic therapy for patients with AF; Counsel patients about the risks and benefits of catheter-based ablation for treatment of AF; Identify common causes of acute urticaria; Distinguish lesions of urticaria from those of urticarial vasculitis.

Recognize signs and symptoms of sarcoidosis; Treat skin manifestations of sarcoidosis; Counsel patients about BP targets and management, based on updated hypertension guidelines; Implement colorectal cancer screening, based on American College of Gastroenterology guidelines; Compare the recombinant adjuvanted zoster vaccine with the live zoster vaccine.

Compare early interventions for ED to newer therapies; Identify and treat men with Peyronie disease; Diagnose nonalcoholic fatty liver disease (NAFLD); Interpret imaging studies and laboratory studies for patients with NAFLD; Design a lifestyle modification treatment plan for patients with NAFLD.

Recognize the personal, professional, and financial effects of clinician burnout; Implement combination physician-directed and institution-directed interventions to develop physician wellness; Recommend sources of heart-healthy unsaturated fats; Inform patients about the benefits of red wine, garlic, and cocoa; Modify diets to include foods shown to reduce cholesterol.

Identify and treat causes of amenorrhea; Recognize symptoms of hyperandrogenism and evaluate patients for polycystic ovary syndrome (PCOS); Counsel postmenopausal women about risks and benefits of hormone therapy; Provide effective prophylaxis to reduce incidence of urinary tract infection; Evaluate and treat women with urinary incontinence.

Review guidelines and recommendations for statin therapy; Counsel patients with dyslipidemia about lifestyle and pharmacologic interventions; Identify causes of acute aortic syndromes; Recognize indications for surgery in patients with thoracic aortic aneurysm; Select appropriate treatment for patients with peripheral artery disease.

Evaluate patients with suspected attention-deficit/hyperactivity disorder using the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and self-rating scales; Provide patients with effective options for treatment of attention-deficit/hyperactivity disorder; Select patients most likely to benefit from nonsurgical treatment of common ankle, knee, and shoulder injuries; Optimize recovery and safe return to play in athletes with concussion; Recognize the risk factors for, and causes of, heat illness, vasovagal syncope, and overtraining syndrome.

Select effective pharmacologic and nonpharmacologic treatments to address atopic dermatitis; Provide standard-of-care treatment of hemangiomas and warts; Recognize various presentations of Lyme disease; Identify risk factors for photoaging; Counsel patients about the prevention and treatment of changes in skin texture and dyspigmentation caused by sun exposure.

Identify and treat myofascial trigger points with pharmacologic and nonpharmacologic therapies; Optimize the use of trigger point injections and dry needling techniques in the treatment of myofascial pain; Provide patients with effective options for treatment of fibromyalgia; Recognize signs and symptoms of paroxysmal hemicrania and other common trigeminal autonomic cephalalgias; Select appropriate treatment for patients with trigeminal autonomic cephalalgias and facial neuralgias.

Implement the most recent guidelines for identification of patients at increased risk for cardiovascular disease; Provide patients with effective nonpharmacologic interventions to treat hypertension; Individualize the treatment of hypertension with appropriate medication and monitoring for adherence; Identify factors that contribute to polypharmacy in elderly patients; Develop a systematic approach to deprescribing medication in older adults.

Distinguish among different types of insulin based on onset of action, peak time, duration, and concentration; Provide patients with effective options for insulin therapy; Compare concentrated insulin with nonconcentrated insulin; Elaborate on the evidence and recommendations for preoperative laboratory testing; Use a test- or disease-based approach to determine the need for preoperative laboratory testing.

List contraindications for insertion of intrauterine devices and subdermal hormonal implants; Counsel patients about bleeding irregularities that occur after insertion of LARC devices; Consider advantages and disadvantages of immediate postpartum insertion of an intrauterine device; Inform patients about criteria for hospice eligibility and Medicare benefits; Evaluate and refer patients to hospice in a timely manner.

Recognize limitations of commonly used pulmonary diagnostic tests; Select appropriate pulmonary screening tests based on history and symptoms; Distinguish among types of asthma and their triggers; Classify the severity of chronic obstructive pulmonary disorder (COPD); Counsel patients about interventions to reduce COPD exacerbations.

Distinguish primary open-angle glaucoma from primary angle-closure glaucoma; Select appropriate treatments for glaucoma, conjunctivitis, and corneal abrasion; Test for nystagmus, head impulse, and skew deviation in patients who complain of dizziness; Determine whether a patient's dizziness is caused by a peripheral or central vestibulopathy; Recognize benign paroxysmal positional vertigo.

Select effective therapy for asthma control; Identify patients who should undergo allergy testing; Recommend appropriate treatment of allergic rhinitis, including use of over-the-counter allergy medications; Assess the value of cardiac stress testing in the management of patients with chest pain; Make clinical decisions based on results of cardiac stress testing.

Assess the relationship between poor glycemic control and poor outcomes; Cite findings and conclusions of major diabetes studies, such as the Veterans Affairs Diabetes Treatment study and ADVANCE trial; Weigh risks and benefits of pharmacologic agents for type 2 diabetes; Apply results of recent studies about the efficacy and safety of zoster vaccine, treatment of subclinical hypothyroidism, and oral antipsychotic drugs to care for older patients; Counsel patients about preventing progression of cognitive impairment and age-related macular degeneration.

QUALIFIES FOR GERIATRICS

Formulate a relevant differential diagnosis in patients with infectious diseases based on host characteristics, exposure history, and physical examination findings; Recognize and treat necrotizing fasciitis; Follow appropriate steps to evaluate patients with suspected meningitis; Counsel individuals who are of child-bearing age about the dangers of travel to regions endemic for Zika virus; Identify and choose appropriate antibiotic therapy for tetanus.

QUALIFIES FOR INFECTIOUS DISEASE

Explain the mechanism of action of immune checkpoint inhibitors; Determine whether a patient is an appropriated candidate for immune checkpoint inhibitor therapy; Select appropriate antipsychotic agents for patients with dementia secondary to Parkinson disease; Treat pseudobulbar affect, sleep disturbance, and hallucinations in patients with dementia; Distinguish frontotemporal dementia from Lewy body dementia.

QUALIFIES FOR GERIATRICS

Prevent complications in patients with diabetes mellitus; Summarize current controversies about glycemic control in patients with diabetes mellitus; Weigh the advantages and disadvantages of available medications for patients with diabetes mellitus; Evaluate the impact of influenza and invasive pneumococcal disease on adults and children in the United States; Implement current recommendations for influenza and pneumococcal vaccination from the Advisory Committee on Immunization Practices.

Apply new recommendations for age-appropriate screening for cervical cancer; Distinguish the roles for cytology-based vs human papillomavirus tests in screening for cervical cancer; Assess risk factors for the development of endometrial cancer; Recognize the roles of disease characteristics, test sensitivity and specificity, and burden of follow-up in determining the benefits of screening for ovarian cancer; Employ current recommendations for vaccinations for adults from the Advisory Committee on Immunization Practices

Explain the adaptive changes associated with sickness behavior; Recognize the potential deleterious effects of providing nutritional support to severely ill patients; Describe the findings of recent research on the potential benefits and harms of oral and enteral nutritional support in older adults; Diagnose opioid use disorder in older adults; Recommend effective treatment options for older adults with opioid use disorder.

QUALIFIES FOR GERIATRICS

Weigh the advantages and disadvantages of cholangioscopy compared with endoscopic retrograde cholangiopancreatography for visualization of the bile duct; Optimize the use of cholangioscopy in patients with stones and strictures that require direct visualization of the common bile duct; Recognize the limitations of endoscopic retrograde cholangiopancreatography, brush cytology, and intraductal biopsy in identifying biliary malignancy; Select methods for accurate diagnosis in patients with indeterminate biliary strictures. 5. Manage bile duct stones that are difficult to remove.

Characterize hospital readmission in patients with cirrhosis; Assess the effectiveness of interventions for reducing hospital readmissions of patients with cirrhosis; Identify drugs that commonly cause injury to the liver; Differentiate between immune-mediated and metabolic causes of drug-induced liver injury; List clinical and histologic characteristics of various types of drug-induced liver injury.

Recognize the indications for local therapy, systemic therapy, and combination therapy for the management of inflammatory bowel disease; Identify the predictors of severity in Crohn disease and ulcerative colitis; Recommend the appropriate drugs for inflammatory bowel disease in patients who have undergone organ transplantation and in patients with previous cancer; Counsel women with inflammatory bowel disease of reproductive age about fertility, pregnancy planning, and other reproductive issues; Identify and prescribe drugs that are safe for pregnant and breastfeeding women with inflammatory bowel disease.

Explain how novel mechanisms of action of new therapies for IBD may improve clinical outcomes and reduce risk for side effects; Summarize the effects of previous exposure to anti-tumor necrosis factor therapies on response to novel agents for IBD; Identify common side effects and adverse events associated with use of novel treatments for IBD; Counsel patients with IBD on risk factors for malignancy; Provide recommendations for surveillance of malignancies associated with IBD.

Assess the value of manometry for predicting long-term outcomes of sphincterotomy in patients with biliary pain or SOD; Discuss the role of empiric sphincterotomy for management of SOD; Summarize adverse events associated with long-term use of PPI therapy; Use strategies to minimize long-term exposure to PPI therapy; Implement strategies for removal of foreign bodies from the gastrointestinal tract based on characteristics of patient and foreign body.

Identify dietary factors that increase the risk for inflammatory bowel disease; Counsel patients on strategies for diet and supplementation that address deficiencies in protein and micronutrients and that maintain nutritional status during disease flares; Discuss the role of enteral and total parenteral nutrition in the management of nutritional status; Perform clinical measurements and nutritional assessments to evaluate disease activity, nutritional status, and response to therapy; Evaluate patients for depression and anxiety, infectious diseases and immunization status, and risk for cancer.

Review the principles of allocation used in organ, and particularly liver, transplantation; Explain the concept of liver transplant redistribution (or broader sharing) to improve fairness in geographic access to transplantation; Discuss the concerns involved with HCV-positive donors and HCV-positive recipients in liver transplantation; Describe the advantages and disadvantages of telehealth in transplant hepatology; Identify conditions and situations that lend themselves well to management via telehealth in hepatology

Identify patients at high risk for anal dysplasia and cancer; Assess the efficacy of aggressive management for preventing recurrence of high-grade dysplasia or development of anal cancer; Use tumor testing, clinical and pathologic criteria, and prediction models to estimate probability of a germline mutation associated with colorectal cancer; Explain inheritance patterns, extracolonic manifestations, associated malignancies, and screening and management strategies for colorectal cancer syndromes; Weigh the pros and cons of screening tests for colorectal cancer.

Assess the reasons for discrepancies in data reporting of postoperative complications; Describe the disadvantages associated with the common mechanisms of measuring quality of care; Determine the risks associated with the use of biologic agents in patients requiring surgery for inflammatory bowel disease; Follow recent guidelines for performing colonoscopy and chromoendoscopy in patients with inflammatory bowel disease; Identify patients who may benefit from extended chemoprophylaxis for venous thromboembolism.

Select appropriate treatments for portal hypertension based on severity, cardiac output, and comorbidities; Compare and contrast methods for the management of variceal bleeding in patients with cirrhosis; Assess possible causes and options for the management of sarcopenia in patients with cirrhosis; Identify patients with acute-on-chronic liver failure using clinician assessment or scoring systems; Apply scoring systems to determine eligibility for liver transplantation and probability of survival in patients with acute-on-chronic liver failure.

Compare efficacy, mortality, and complications among surgical procedures for perforated diverticulitis; Summarize a proposed algorithm for pre- and perioperative management of perforated diverticulitis in patients with septic shock; Discuss the benefits and drawbacks of different techniques for surgical repair of parastomal hernias; Utilize strategies during creation of stomas to prevent the future development of parastomal hernias. Identify and manage anastomotic leaks based on their anatomic location and the condition of the patient.

Implement recommendations for screening HIV from Centers for Disease Control and Prevention; Review the indications for pre-exposure prophylaxis (PrEP) for prevention of HIV; Stress the importance of adherence to PrEP for prevention of HIV in high-risk groups; Adopt strategies and interventions to reduce stigma in HIV-infected individuals; Review the diagnostic criteria for HIV-associated neurocognitive disorders.

QUALIFIES FOR HIV/AIDS AND INFECTIOUS DISEASE

Review the indications for testing and treating H pylori infection; Communicate to patients the importance of adherence to a prescribed H pylori treatment regimen; Recognize indications for triple therapy, bismuth quadruple therapy, and concomitant therapy for treating H pylori infection; Choose the appropriate treatment regimens for severe and complicated C difficile infection and for recurrent C difficile infection; Treat C difficile infection in the presence of underlying inflammatory bowel disease.

QUALIFIES FOR INFECTIOUS DISEASE

Identify risk factors for a difficult cholecystectomy; Choose appropriate bailout procedures when cholecystectomy is not possible; Select optimal surgical treatment of acalculous cholecystitis; Recognize the relationship between chronic inflammation and loss of lean muscle mass in PICS; Utilize multimodality therapies to treat PICS.

Motivate patients with substance use disorders to obtain treatment; Identify drugs for the treatment of patients with alcohol use disorder; Recognize the effects of sleep fragmentation on health; Assess patients for sleep disturbance; Explain how disruption of the circadian rhythm affects the gastrointestinal tract and cancer pathways.

Recognize signs and symptoms of sarcoidosis; Treat skin manifestations of sarcoidosis; Counsel patients about BP targets and management, based on updated hypertension guidelines; Implement colorectal cancer screening, based on American College of Gastroenterology guidelines; Compare the recombinant adjuvanted zoster vaccine with the live zoster vaccine.

Implement the surveillance guidelines for individuals at high risk for hepatocellular carcinoma; Describe the therapeutic options for hepatocellular cancer and the indications for each; Characterize the 3 types of gastric neuroendocrine tumors; Recognize the morphologic or endoscopic features of sessile serrated polyps; Recommend the appropriate endoscopic treatment method for sessile serrated polyps.

Perform an appropriate workup for a patient with elevated alkaline phosphatase.; Counsel patients on lifestyle modification to manage nonalcoholic fatty liver disease; Identify the possible causes of elevated liver enzymes; Describe how machine perfusion improves preservation of donor livers; Explain the concept of warm perfusion for preservation of donor livers.

Counsel patients with inflammatory bowel disease how to reduce stress and improve self-confidence and self-regulation; Identify the clinical scenarios in which biomarkers can be used in the management of inflammatory bowel disease; Explain how biomarkers can help with a treat-to-target approach for better control of inflammatory bowel disease; Recognize the indications for fecal microbiota transplantation; Prescribe appropriate antibiotics for Clostridium difficile infection, based on severity of disease.

Employ appropriate strategies to enhance communication with patients with inflammatory bowel disease; Describe the benefits and potential side effects of therapies for inflammatory bowel disease; Review the risks for developing cancer associated with different therapies for inflammatory bowel disease; Recommend behavioral therapy as part of multidisciplinary care for inflammatory bowel disease and functional gastrointestinal disorders; Identify which patients with inflammatory bowel disease and functional gastrointestinal disorders would benefit from referral to a gastrointestinal psychologist.

Reduce the false-negative rate of sentinel lymph node biopsy after neoadjuvant chemotherapy; Perform lymph node biopsy using targeted axillary dissection; Adopt consensus guidelines for adequate surgical margins in patients with invasive breast cancer and ductal carcinoma in situ; Lower the risk for local recurrence in patients with ductal carcinoma in situ; Recognize the role of the radiologist in the treatment of patients with breast cancer.

Prepare for aging and retirement from surgical practice; Appropriately select patients for preoperative cardiac evaluation; Explain the effects of patient frailty on surgical outcomes; Determine adequate radial margins for primary excision of melanoma; Identify patients with melanoma likely to benefit from sentinel lymph node biopsy and completion lymph node dissection.

Outline the surgical approaches for treating adults with congenital diaphragmatic hernias; Plan diagnostic and therapeutic strategies for patients with intestinal obstruction following gastric bypass surgery; Choose effective strategies to treat patients with ventral hernias and morbid obesity; Identify surgical techniques for sleeve gastrectomy that reduce the risk for leak and stenosis; Formulate an algorithm for the management of stenosis following sleeve gastrectomy.

Select treatment options for patients with anaplastic thyroid cancer; Recognize the indications for surgery in patients with secondary and tertiary hyperparathyroidism; Identify candidates for remote-access thyroid surgery; Weigh the advantages and challenges of the transoral endoscopic thyroidectomy vestibular approach (TOETVA); Explain the potential therapeutic applications of stem cell therapy in trauma patients.

Formulate a protocol for treating patients with small bowel obstruction; Outline treatment strategies for the management of pancreatic trauma; Choose operative strategies for repair of duodenal injuries; Evaluate the risk of venous thromboembolic events in patients undergoing surgery for inflammatory bowel disease; Identify and plan treatment of patients with suspected anastomotic leak

Identify transference and countertransference during patient encounters; Select strategies to enhance interaction with narcissistic, hostile, and seductive patients; Optimize interviews with difficult patients; Recognize the 7 factors that signal risk for violence on the Dynamic Appraisal of Situational Aggression tool; Use Dynamic Appraisal of Situational Aggression to evaluate patients in the emergency department.

List risk factors for Clostridium difficile disease; Select appropriate tests for the diagnosis of Clostridium difficile disease; Formulate treatment plans for severe and recurrent Clostridium difficile disease; Identify patient-specific factors that alter the pharmacodynamics and pharmacokinetics of antibiotics; Consider the use of continuous infusions and dosing software to optimize antibiotic therapy in critically ill patients.

Implement strategies to reduce the cost of care for patients undergoing repair of incisional hernias; Modify preoperative risk factors in patients requiring repair of incisional hernias; List the perioperative steps of enhanced recovery protocols; Identify technical factors that reduce risk for recurrence of incisional hernia; Determine mesh locations associated with optimal outcomes.

Dermine the preferred diagnostic modality for evaluating patients with small bowel obstruction; Choose patients with small bowel obstruction who are suitable for laparoscopic surgery; Evaluate the role of the endoscopic stent in the treatment of large bowel obstruction; Select patients with gastroesophageal reflux disease who are appropriate candidates for magnetic sphincter augmentation; Compare outcomes of gastric bypass to sleeve gastrectomy in patients with morbid obesity.

Interpret the electrocardiographic findings in patients with pacemakers; Recognize normal and abnormal pacemaker function; Perform a thorough physical examination, including examination of the pacemaker site, to diagnose conditions associated with pacemaker implantation; Describe the preparation for and administration of fecal microbiota transplantations; Discuss the role of fecal microbiota transplantation for the treatment of recurrent Clostridium difficile infection and other diseases.

Identify risk factors for and comorbidities that contribute to the development of carpal tunnel syndrome; Weight the advantages and disadvantages of open vs endoscopic release of the median nerve; Recommend nonpharmacologic treatment for osteoporosis to prevent fractures and further bone loss; Recognize the indications for pharmacologic therapy to treat osteoporosis; Advise patients of the potential side effects of bisphosphonates.

Explain the pathologic changes in osteoarthritis; Identify risk factors and symtoms of osteoarthritis; Diagnose melanoma using the ABCDE criteria and biopsy; Provide early and long-terrm treatment fo onychomycosis; Recommend stretching exercises to prevent and cure plantar fasciitis.

Identify indications for transcatheter aortic valve replacement (TAVR); Discuss the studies comparing TAVR with surgical aortic valve replacement; Perform appropriate testing and imaging to diagnose stable coronary artery disease (CAD) and determine prognosis; Recommend lifestyle modification and drugs for the conservative management of stable CAD; Recognize the indications for invasive therapy for CAD.

Integrate telemedicine into clinical practice; Explain legal regulatory and licensure issues affecting telemedicine; Educate patients with NAFLD about how to maintain a healthy weight; List the benefits of Mediterranean diet and physical activity for patients with NAFLD; Counsel patients with NAFLD on how to avoid episodic alcohol consumption.

Use laboratory procedures in combination with history and physical examination to definitively diagnose vaginitis; Prescribe effective therapy for the management of vaginitis; Differentiate physiologic vaginal discharge from various types seen in vaginitis; Identify the risk factors for recurrent Candida vaginitis; Recognize instances when treatment of the male partner is indicated and provide measures to prevent sexually transmitted infection.

QUALIFIES FOR INFECTIOUS DISEASE

Describe the spectrum of disease caused by NTM; Adopt the American Thoracic Society guidelines for diagnosis of NTM; Recommend the appropriate drug regimen and duration for the treatment of NTM disease; Adopt the recommendations from the Centers for Disease Control and Prevention for vaccination against pertussis; Recommend the appropriate treatment and postexposure prophylaxis regimen for pertussis.

QUALIFIES FOR INFECTIOUS DISEASE

Recognize and monitor for the adverse effects of integrase strand transfer inhibitors (INSTIs); Discuss changes in the National Institutes of Health guidelines for use of antiretroviral agents in adults with HIV infection; Counsel patients about potential drug-drug interactions with INSTIs and how to avoid or manage them; Educate HIV-concordant and serodifferent couples on their reproductive options. 5. Prevent mother-to-child transmission of HIV infection.

QUALIFIES FOR HIV/AIDS and INFECTIOUS DISEASE

Explain the effects of aging on the urinary system; Identify and treat reversible causes of urinary incontinence; Diagnose emptying disorders and storage disorders in patients with urinary incontinence; Adopt the United States Preventive Services Task Force recommendations for the use of aspirin; Weigh the risks and benefits of prescribing aspirin for various indications.

Differentiate between the approaches of the American College of Cardiology/National Heart Association guidelines and National Lipid Association guidelines on reducing atherosclerotic cardiovascular risk in adults; List indications for use of nonstatin therapy in adults with atherosclerotic cardiovascular risk; Assess data on the efficacy of proprotein convertase subtilisin kexin 9 inhibitors; Recommend lifestyle changes to modify risk factors for stroke; Compare outcomes of patients placed in inpatient rehabilitation facilities vs skilled nursing facilities for postacute stroke care.

Interpret the electrocardiographic findings in patients with pacemakers; Recognie normal and abnormal pacemaker function; Perform a thorough physical examination, including examination of the pacemaker site, to diagnose conditions associated with pacemaker implantation; Identify and manage underlying causes of syncopal episodes; Select appropriate strategies for symptom control and prevention of syncopal episode.

Utilize a single-question screening test to screen for opiate use; Employ the motivational interviewing approach to encourage patients with substance use disorders to make positive changes in behavior; Adopt the Centers for Disease Control and Prevention guidelines for the use of opioids for noncancer pain; Identify the approved indications for newer antimicrobial drug combinations; Adopt strategies to reduce the inappropriate prescribing of antibiotics.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Recognize the adverse effects, contraindications, and interactions of medications used to treat patients with rheumatoid arthritis; Reduce the risk for cardiovascular disease in patients with rheumatoid arthritis; Explain the mechanisms of action of targeted and biologic therapies in patients with lupus; Optimize the use of kidney biopsy to diagnose and manage lupus nephritis; Guide patients in obtaining approval for and taking biologic agents.

Elaborate on the relationship between diabetes and heart failure; Describe the structural, autonomic, and metabolic changes that occur with diabetes and heart failure; Identify the antidiabetes drugs that can worsen heart failure; Discuss how the staging of presymptomatic type 1 diabetes can aid in the development of new therapies; Identify the factors that increase the rate of progression of type 1 and type 2 diabetes.

Discuss the impact of dementia on caregivers; Describe the differences between normal aging and dementia; Review the diagnostic criteria for dementia; Characterie the different types of dementia based on clinical presentation; Use appropriate reimbursement codes for comprehensive geriatric assessment with cognition as focus of evaluation.

QUALIFIES FOR GERIATRICS

Characterize the different categories of pulmonary hypertension; Utilize the appropriate tests and procedures to confirm a diagnosis of pulmonary hypertension; Recognize the risk factors for chronic thromboembolic pulmonary hypertension; Review studies of the outcomes of screening for lung cancer; Apply the National Comprehensive Cancer Network guidelines on who should and should not be screened for lung cancer.

Classify the stage of disease in a patient with chronic hepatitis B; Manage hepatitis B in a pregnant woman; Choose among common regimens employing directacting antivirals agents for treatment of hepatitis C; List risk factors for autoimmune hepatitis; Identify patients with autoimmune hepatitis who need pharmacologic treatment or liver transplantation.

Discuss the adverse effects of obesity on health and longevity; Identify candidates for bariatric surgery; Reduce the freuency of complications following bariatric surgery; Characterize commonly performed bariatric surgery procedures; Counsel patients about recently developed bariatric procedures or devices.

Characterize the stages of Lyme disease; Employ appropriate testing based on the stage of disease and the clinical symptoms present; Recommend?the?appropriate?antibiotic?and?duration?of?treatment for Lyme disease; Describe the preparation for and administration of fecal microbiota transplantations; Discuss the role of fecal microbiota transplantation for the treatment of recurrent Clostridium difficile infection and other diseases.

Explain the pathophysiology of nonvalvular atrial fibrillation; Choose the appropriate agents for rate and rhythm control of atrial fibrillation; Adopt the guidelines for anticoagulation in atrial fibrillation; Utilize the appropriate tests for evaluation of a patient with premature ventricular contractions; Recognize the indications for treatment of premature ventricular contractions.

Manage blood sugar in a hospitalized patient with diabetes; Create an order set for insulins used for inpatient treatment; List common drugs that may promote weight gain; Select appropriate candidates for weight loss medications and bariatric surgery; Summarize the side effects of drugs approved for treatment of obesity.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Identify etiologies of knee and shoulder pain using physical examination maneuvers; Select appropriate imaging modalities for assessment of knee and shoulder pain; Optimize treatment strategies for various knee and shoulder pathologies; Differentiate benign exercise (exertional) headache from life-threatening conditions; Prescribe appropriate medications for treatment of sports-related headaches.

QUALIFIES FOR PAIN MANAGEMENT

Explain the difference between a primary stroke center and a comprehensive stroke center; Manage a patient with acute ischemic stroke; List the five pillars of stroke prevention; Create a protocol for emergent management of transient ischemic attack; Select secondary preventive agents for patients with ischemic stroke.

Explain the pathophysiology of anxiety; Diagnose a patient with an anxiety disorder; Manage anxiety and comorbidities; Choose an appropriate add-on therapy for a patient with a psychiatric disorder who responds only partially to a selective serotonin reuptake inhibitor; Order follow-up tests to detect side effects of second-generation antipsychotics.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Explain the pathophysiologies of chronic obstructive pulmonary disease and asthma; Create management algorithms for patients with chronic obstructive pulmonary disease or asthma; Identify patients likely to benefit from triple therapy for chronic obstructive pulmonary disease; Recognize typical computed tomography patterns in patients with bronchiolar diseases; Interpret pulmonary function tests in patients with bronchiolar diseases.

Monitor a man on androgen replacement therapy; List the most specific symptoms of hypogonadism in men; Distinguish between primary and secondary hypogonadism; Diagnose polycystic ovary syndrome; Manage a patient with polycystic ovary syndrome.

List key changes in the 2018 recommendations issued by the US Preventive Services Task Force about screening for prostate cancer; Summarize the findings of major clinical trials that have established current practices for prostate cancer screening; Identify men who are at high risk for prostate cancer; Counsel a patient with prostate cancer who is considering surgery, radiation therapy, and active surveillance; Appropriately treat metastatic prostate cancer.

Manage failure to respond to an initial vaccination series for hepatitis B; Create a clinic-wide protocol for pneumococcal vaccination; Select appropriate candidates for vaccination against herpes zoster; Counsel the parent of a child with head lice; Identify serious sequelae of parasitic infestations.

Create a protocol for assessment of blood pressure in the outpatient setting; Recommend effective nonpharmacologic interventions for patients with hypertension; Add an appropriate additional drug for a patient with poorly controlled hypertension; Assess the role of aspirin in the prevention of adverse cardiovascular outcomes; Counsel a patient with patent foramen ovale about potential benefits of closure.

Explain the physiology of normal sleep; Counsel a patient with chronic insomnia; Diagnose common parasomnias; Discuss the differences between type I and type III sleep studies; Manage a patient with obstructive sleep apnea.

Summarize the risks and benefits of currently available sodium-glucose cotransporter 2 inhibitors; Manage a patient on concentrated insulin therapy; Explain how to administer glucagon-like peptide 1 agonists; Discuss the risks and benefits of using e-cigarettes; Advise a patient who wants to stop smoking.

Use common liver function tests to diagnose disorders of the liver; Evaluate a patient with suspected ischemic liver injury; List the expected changes in liver function during pregnancy and assess more concerning symptoms; Manage a patient with intrahepatic cholestasis of pregnancy; Diagnose common porphyrias.

Identify the etiology of stroke in a patient presenting with stroke; Prescribe secondary preventive strategies for patients with stroke; List risks and benefits of various novel oral anticoagulants; Assess a patient who may have secondary hypertension; Diagnose pheochromocytoma.

Interpret ultrasonographic signs in thyroid nodules; Use the Thyroid Imaging, Reporting and Data System to manage a patient with a thyroid nodule; List common mutations found in thyroid cancers; Counsel a patient asking about the relationship between obesity and hypothyroidism; Explain the actions of leptin and discuss its relationship to obesity and thyroid function.

Differentiate between human papillomavirus (HPV)-associated cancers of the head and neck and non-HPVassociated tumors; Evaluate a patient with a suspected HPV-associated cancer of the head and neck; Create a treatment plan that maximizes long-term function for a patient with an HPV-associated cancer of the head and neck; Diagnose Zika and other vector-borne viruses; Manage a patient with malaria.

Decide when to add a sodium-glucose cotransporter-2 inhibitor to an antidiabetic treatment regimen; Treat a patient with primary or recurrent diarrhea caused by Clostridium difficile; Determine whether aspirin should be discontinued in patients with a history of percutaneous coronary intervention who is undergoing noncardiac surgery; Prescribe medication to manage mild persistent asthma; Create a risk assessment and screening algorithm for patients with suspected pulmonary embolism.

Outline past and contemporary models of care and decision making and the ethical principles supporting them; Define the phrase %u201Creasonable patient standard; List expected changes in microbial flora in critically ill patients; Identify risk factors for replacement of the normal oropharyngeal flora by gastrointestinal microbes; Manage a critically ill patient who is at risk for dysbiosis affecting the flora of the gut, lung, and other organs.

Identify trigger points to diagnose myofascial pain; Recognize typical neuroendocrine changes in patients with fibromyalgia; Optimize the pharmacologic and nonpharmacologic treatment of patients with fibromyalgia; Counsel patients requesting a prescription for medical marijuana about safety issues associated with cannabis; Evaluate the safety and efficacy of hallucinogenic drugs used to treat pain.

QUALIFIES FOR PAIN MANAGEMENT

Select appropriate candidates for statin therapy; Manage hyperlipidemia and hypertriglyceridemia; Treat black patients with cardiovascular risk factors according specific guidelines for this population; Make recommendations about the safety of proceeding with noncardiac surgical procedures in patients with cardiac issues; Manage perioperative anticoagulation for a patient undergoing an elective surgical procedure.

Manage refractory overactive bladder; Prescribe appropriate therapies for a woman with overactive bladder and dyspareunia; Select candidates for urodynamic studies; Counsel a patient interested in neuromodulatory techniques for overactive bladder; Evaluate etiologic factors and comorbidities in a man with erectile dysfunction.

Prevent progression of disease in a patient with chronic kidney disease; Compare the advantages and disadvantages of hemodialysis and peritoneal dialysis; Treat common comorbidities in patients with chronic kidney disease; Manage a patient with Barrett esophagus; List factors associated with the progression of esophageal disease to dysplasia.

Review the epidemiology of HIV/AIDS and the effect of contemporary therapies on the prevalence of the disease; Design a screening protocol for HIV for a primary care setting; Manage a patient on antiretroviral therapy; Explain the implications of the HPTN 052 study; Counsel a serodiscordant couple asking about prevention of transmission of HIV infection.

QUALIFIES FOR HIV/AIDS-A111
QUALIFIES FOR INFECTIOUS DISEASE

Explain the pathophysiology of common sprains of the shoulder; Use the mechanism of injury to help diagnose and manage patients with athletic injuries; Examine the shoulder of an injured athlete; Manage a tear of the medial collateral ligament; Diagnose pain in the knee in an injured athlete.

QUALIFIES FOR SPORTS MEDICINE

Advise patients on the risk for squamous cell carcinoma associated with consuming hot beverages and the reduction in risk for hepatocellular carcinoma associated with coffee consumption; Manage pancreatic cysts, including assessment of risk for malignancy; Screen patients for colon cancer using tier 1 tests; Define and differentiate between exercise and physical activity; Use step goals, activity trackers, and other motivational techniques to help patients increase activity and lose weight.

Identify medications and dietary components linked to acute gout; Implement strategies to prevent recurrent gout; Formulate a treatment plan for a patient with acute gout; Describe the challenges of treating patients with alopecia areata; Evaluate the role of Janus kinase inhibitors for the treatment of patients with alopecia areata.

Diagnose acute kidney injury and chronic kidney disease; Identify patients at risk for acute kidney injury; Manage a patient with hypernatremia; Distinguish between hyperkalemia caused by electrolyte shifts and hyperkalemia caused by inadequate renal excretion of potassium; List medications associated with hyperkalemia.

Review the differential diagnosis of a patient with esophageal eosinophilia; Evaluate the response to therapy of patients with eosinophilic esophagitis; Select an appropriate treatment for the initial management of inflammation from eosinophilic esophagitis; Implement dietary modifications for patients with gastroparesis; Ensure adequate nutrition in patients with gastroparesis.

Differentiate among types of diarrhea; Formulate an approach to the evaluation of patients with diarrhea; Optimize treatment in patients with chronic diarrhea; Evaluate patients with symptoms of gastroesophageal reflux to diagnose functional heartburn, reflux hypersensitivity, and true pathologic reflux. Provide patients with effective options for treatment of gastroesophageal reflux disease.

Distinguish between influenza and influenza with bacterial superinfection; Manage care of a hospitalized patient with influenza; Offer prophylactic treatment to appropriate populations of patients recently exposed to influenza; Summarize current knowledge about the physiology of the pulmonary microbiome; Explain experimental findings about the relationship between the pulmonary microbiome and hypoxia.

Diagnose and triage patients with digital discoloration; Manage a patient with Raynaud syndrome; Evaluate a patient with stroke according to the most recent guidelines from the American Heart Association; Manage a patient with cryptogenic stroke; Advise and treat a patient with patent foramen ovale and recent stroke.

Describe the hemodynamic and cardiac changes that occur in patients with heart failure; Comply with guidelines in the treatment of patients with stage B and stage C heart failure; Refer patients with stage D heart failure who require advanced heart failure treatment; Select patients with history of stroke who may be candidates for closure of a patent foramen ovale; Evaluate the role of closure of a patent foramen ovale in patients with platypnea-orthodeoxia syndrome and decompression sickness.

Write institutional guidelines for treatment of acute and chronic pain; Discuss the various causes of the opioid crisis in the United States; Create a plan for postoperative pain management with a patient planning a major surgical procedure; Evaluate pain, function, and comorbidities in patients taking opioids; Recognize and manage opioid-induced hyperalgesia.

QUALIFIES FOR CLINICAL PHARMACOLOGY AND CONTROLLED SUBSTANCES

Evaluate the utility of different point-of-care tests for the diagnosis of infectious diseases in a range of settings; Discuss the advantages and disadvantages of lateral flow immunoassays and molecular platforms for point-of-care testing; Describe the potential applications of newer technologies for point-of-care testing; Implement appropriate diagnostic stewardship interventions in the preanalytic, analytic, and postanalytic phases of diagnostic testing; Recognize situations where diagnostic stewardship interventions can improve the management of and outcomes for patients with infectious diseases.

QUALIFIES FOR INFECTIOUS DISEASE

Diagnose and treat invasive candidiasis; Distinguish respiratory illness due to Cryptococcus from that caused by other organisms; List some risks and benefits of fosfomycin for treatment of urinary tract infection; Prescribe safe and effective treatment for an upper respiratory viral infection; Manage recurrent Clostridium difficile.

QUALIFIES FOR INFECTIOUS DISEASE

Recognize the benefits of neuropsychological evaluation in patients with brain injury; Weigh the benefits and limitations of the fixed and flexible approaches to neuropsychological testing.; Determine the level of premorbid functioning in patients with brain injury; Assess appropriate and inadequate effort in patients during neuropsychological testing; Use appropriate batteries of tests to assess neurocognitive function.

ST008

Recognize the role of abortive medications when treating acute migraine headache; Apply principles of stratified care for treating acute migraine; Choose the most appropriate medications for treating migraine in various patient populations; Explain the importance of defining refractory or intractable headaches in patients with chronic headache; Identify and treat patients with refractory or intractable headaches.

QUALIFIES FOR PAIN MANAGEMENT-HE018

Recognize the role of synucleinopathies in sleep disorders; Diagnose sleep disorders in patients with Parkinson disease; Improve quality of sleep and safety in patients with restless legs syndrome and rapid eye movement sleep behavior disorder; Evaluate evidence about the use of caffeine to maintain wakefulness and over-the-counter agents to promote sleep and improve its quality; Provide patients with information on the appropriate use of over-the-counter agents to induce and maintain sleep and to treat insomnia.

Describe pituitary histology and the role of the hypothalamic-pituitary axis in the regulation of levels of hormones; Distinguish between functional and structural causes of pituitary failure; Select the appropriate diagnostic tests to assess the different pituitary deficiencies; Use appropriate medical therapy for pituitary adenomas, including treatment of resistant disease; Recognize the role of surgery and adjuvant therapies for treatment of pituitary adenomas in selected patients.

EN030

Define death by neurologic criteria (DNC); Identify patients with DNC using specific examination techniques and confirmatory testing; Educate community, patients, and family members of patients about DNC; Recognize the relationship between sympathetic surge caused by brain injury or emotional shock and cardiac pathology; Diagnose stunned myocardium (as distinct from ischemic heart disease) and apply appropriate therapy.

Identify risk factors for cognitive impairment in patients with HIV; Choose appropriate antiretroviral drugs to reduce the incidence of HIV-related cognitive impairment; Diagnose HIV central nervous system escape and CD8 encephalitis based on testing and symptoms; Target therapeutic hypothermia to temperature levels shown to be beneficial; Weigh the advantages of launching a mobile stroke unit.

Distinguish non-length dependent small fiber neuropathy (NLD-SFN) from length dependent (LD) SFN; Evaluate and treat patients with SFN using laboratory and pathologic studies and appropriate medications; Recognize the possible role of SNF in patients with fibromyalgia; Diagnose idiopathic intracranial hypertension (IIH) and nonarteritic ischemic optic neuropathy (NAION); Discuss with patients the benefits, risks, and efficacy of available treatments for IIH and NAION.

Identify patients with acute ischemic stroke who are potential candidates for thrombolytic and endovascular therapy; Evaluate and provide justification for clinical situations where it may be necessary to deviate from guidelines to most appropriately treat select patients; Use stroke scales to determine the severity of neurologic damage in patients with hemorrhagic stroke; Review the appropriate acute and subacute management of patients with subarachnoid hemorrhage; Describe therapies used to decrease hematoma expansion and secondary neurologic injury in patients with intracerebral hemorrhage.

Identify and evaluate motor neuron diseases; Localize the underlying lesions in patients with radiculopathies and plexopathies; Select the appropriate diagnostic tests for patients with neuromuscular conditions; Recognize the relationship between cancer, the hypercoagulable state, and stroke; Evaluate and treat patients with both cancer and stroke.

Outline the chronologic implementation of the Patient Protection and Affordable Care Act (ACA); Review benefits and drawbacks of the ACA; Identify groups and individuals for whom the ACA has produced the most significant changes in health care; Characterize the objections of states that have chosen not to expand their Medicaid programs under the ACA; Summarize the provisions of the ACA most likely to be affected by ongoing efforts aimed at repeal and replacement or by changing it through other means

Diagnose a UTI; Manage a patient with a UTI; Counsel a primigravida asking about prevention of SI; Choose treatments appropriate for a patient with SI who is not a candidate for surgery; Compare the risks and benefits of transobturator and retro pubic sling procedures.

Implement a protocol to screen for gestational diabetes mellitus in individual patients and specific patient populations; Recognize the risks to mother and baby in gestational diabetes mellitus; Treat and monitor patients with gestational diabetes mellitus; Explain the biologic basis of central sensitization syndromes; Optimize the diagnosis and treatment of patients with central sensitization syndromes

Summarize the incidence and prevalence of HIV and AIDS in the United States and worldwide; Appropriately treat a patient who requests pre-exposure prophylaxis for HIV; Counsel a woman who becomes pregnant while taking pre-exposure prophylaxis for HIV; Create a treatment algorithm for lichen sclerosus; Explain the pathophysiology of hidradenitis.

Differentiate vulvodynia from other causes of vulvar discomfort; Select effective therapies for patients with vulvodynia; Provide patients with options for treatment of pelvic prolapse; Optimize the treatment of patients with pessaries; Explain choices in treatment for pregnant women with recurrent urinary tract infections.

Manage community-acquired pneumonia; Instruct nursing staff members in correct methods for diagnosing orthostatic hypotension; List the benefits of empathic statements made by hospitalists to patients who express anxiety and worry; Lead a committee charged with writing an institutional protocol for prenatal care based on contemporary evidence; Summarize the practices and outcomes of the OB Nest model of prenatal care.

Define terms used to describe premalignant lesions of the endometrium; Explain the limitations of methods used to assess endometrial malignancies; Outline the surgical procedures used to assess lymph nodes in patients with endometrial carcinoma; Select appropriate candidates for endometrial ablation; Compare outcomes among patients treated for uterine bleeding with endometrial ablation, insertion of a levonorgestrelreleasing intrauterine device, or hysterectomy.

Assess the impact of fecal incontinence on quality of life; Evaluate patients presenting with fecal incontinence; Start first-line treatment in patients with fecal incontinence; Formulate an algorithm for the treatment of patients with fecal incontinence; Identify the surgical options for the treatment of patients with fecal incontinence.

Stratify pregnant women according to their risk for venous thromboembolism; Manage a patient on an anticoagulant who requests epidural anesthesia during labor; Diagnose neonatal encephalopathy; Counsel the family of a neonate with hypoxic ischemic encephalopathy; Lead a committee that develops plans to be implemented in an obstetrics unit during a disaster.

List absolute and relative contraindications to hormone replacement therapy during and after menopause; Explain why transdermal estrogen is preferred over other routes for treatment of vasomotor symptoms of menopause; Manage a patient with vasomotor symptoms who is taking tamoxifen; Counsel a patient regarding effective and ineffective nonpharmacologic treatments for vasomotor symptoms of menopause; Summarize the risks and benefits of selective estrogen receptor modulators for treatment of symptoms of menopause.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Explain the etiology of mood disorders and the effect of pregnancy on these conditions; Diagnose major depressive disorder and related disorders during pregnancy; Counsel a pregnant woman with depression who is concerned about the effects of medication on her child; List the signs of neonatal withdrawal from selective serotonin reuptake inhibitors; Effectively manage postpartum psychosis.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Diagnose cholestasis in pregnancy Explain the pathophysiology of cholestasis in pregnancy; Discuss the timing of delivery with a woman who has cholestasis in pregnancy; Cite key studies that have outlined the relationship between cesarean delivery and allergic disorders in children; Counsel a patient asking about vaginal seeding after cesarean section.

Diagnose PCOS based on clinical presentation; Explain the pathophysiology of PCOS; Assess the impact of insulin resistance on morbidity for a patient with PCOS; Select therapeutic interventions for patients with PCOS that are consistent with their health goals; Counsel patients about the impact of PCOS on pregnancy and long-term health.

Provide unbiased, supportive pregnancy options counseling; Describe the basics of abortion techniques, with a focus on new Food and Drug Administration labeling for medication abortion; Assess the clinician's professional obligations when counseling and referring pregnant patients; Discuss the health impacts of climate change, particularly the effects of extreme heat, and the burning of fossil fuels; Advocate for improved public health through mitigation of greenhouse gas emissions.

Identify the most common causes of maternal mortality and severe maternal morbidity in the United States; Select appropriate patients for peripartum blood transfusion; Counsel a patient in whom use of tranexamic acid is being contemplated; Summarize the changes to the Friedman curves proposed by hang et al; Create a labor protocol based on guidance from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine on reducing cesarean deliveries.

Define terms commonly used to describe gender in the transgender community; Redesign a clinic to create a welcoming atmosphere for transgender patients; Prescribe and manage hormone therapy for transgender patients; Counsel patients struggling with infertility on navigating the "emotional landscape" of their situation; Explain the relationships among depression, anxiety, and the success or failure of treatment for infertility.

Summarize recent findings of the National Survey on Drug Use and Health about use of marijuana in the United States; Counsel a pregnant woman who is using marijuana; Create a breastfeeding protocol based on guidance from the Academy of Breastfeeding Medicine; Provide prenatal care to woman who is dependent on opioids; Assess the cause of postnatal weight loss in a breastfeeding infant born to a women who is dependent on opioids.

QUALIFIES FOR SUBSTANCE ABUSE

Graph levels of hormones and symptoms throughout the menstrual cycle in a patient with premenstrual dysphoric disorder; Identify risk factors for premenstrual dysphoric disorder; Explain the actions of allopregnanolone in normal women and in those with reproductive mood disorders; Diagnose postpartum mood disorders; Discuss the risks and benefits of hormone replacement therapy with a perimenopausal woman experiencing a mood disorder.

Explain the pathophysiology of endometriosis; List conditions that are commonly found comorbidly with adenomyosis; Use ultrasonography to diagnose adenomyosis; Manage care of a woman with a simple ovarian cyst based on her age and the appearance of the cyst; Demonstrate the sliding sign in a patient undergoing ultrasonography of the pelvis.

Weigh the risks and benefits of tranexamic acid for treatment and prevention of postpartum hemorrhage; Identify appropriate candidates for treatment with intrauterine balloon tamponade; Assess the findings of a recent review on prophylaxis for venous thromboembolism associated with pregnancy; List known and suspected associations between exposure to environmental toxins during pregnancy and adverse effects on offspring; Counsel pregnant women about strategies for avoiding or reducing exposure to toxins.

Manage insulin for a patient with gestational diabetes; Debate the risks and benefits of glyburide, metformin, and insulin for treatment of women with gestational diabetes; Create a treatment protocol for management of type 2 diabetes mellitus; Select appropriate targets for hemoglobin A1c based on patient and disease characteristics; List drawbacks and benefits of novel agents for treating type 2 diabetes mellitus.

List risk factors for syphilis; Create a protocol for testing pregnant women for syphilis; Recognize symptoms of primary, secondary, and tertiary syphilis; Identify high-risk subtypes of human papillomavirus; Counsel parents who are hesitant about immunization for human papillomavirus.

QUALIFIES FOR INFECTIOUS DISEASE

Define social determinants of health; List the tenets of reproductive justice; Give an example of active daily engagement as it applies to lean management systems; Use the TRIMWOOD mnemonic to seek solutions to problems in the clinical workplace; Design a kaizen for the clinical workplace.

Help a patient initiate oral contraceptives using the "quick start" method; List benefits and side effects of continuous oral contraceptives; Counsel a patient considering use of depot medroxyprogesterone as a long-acting reversible contraceptive; Recognize factors that promote adherence to use of contraceptive methods; Compare the safety of hysteroscopic vs laparoscopic sterilization.

Identify factors that contribute to the success of screening programs for cancer; Manage care of a patient with a positive cervical screen for human papillomavirus; Explain controversies and recent changes in methods of screening for breast cancer to a concerned patient; Counsel a patient who asks about risk factors for breast cancer; Select appropriate candidates for specialized screening and/or chemoprophylaxis for breast cancer.

Compare and contrast the safety and efficacy of ulipristal and leuprolide for treatment of uterine fibroids; Explain the mechanism of action of ulipristal; Outline the main provisions of the Affordable Care Act; Discuss some of the changes in coverage and health outcomes that have occurred since passage of the Affordable Care Act; Summarize the changes to the interpretation of the Affordable Care Act following the Supreme Court decision in Burwell v Hobby Lobby Stores (2014).

Assess data from recent trials that evaluated surgery or chemotherapy for mesothelioma; Counsel a patient with mesothelioma about the risks and benefits of antiangiogenic agents; Summarize current knowledge about biomarkers in patients with mesothelioma; Explain mechanisms of epigenetic regulation of gene expression in mesothelioma; Use tetrahydrouridine to improve outcomes of patients being treated with decitabine for mesothelioma.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Distinguish between flat epithelial atypia and atypical ductal hyperplasia; Manage patients with premalignant lesions on core needle biopsy of the breast; List risk factors for upgrade to ductal carcinoma in situ or invasive breast cancer in a patient with atypical ductal hyperplasia; Counsel a patient asking about her genetic risk for breast cancer; Explain the roles of breast density and single nucleotide polymorphisms in risk for breast cancer.

Explain the major findings of the ProtecT study; Manage active surveillance for low-risk prostate cancer; Characterize the risks and benefits of transrectal ultrasound-guided biopsy of the prostate; List risk factors for infection in men undergoing biopsy of the prostate; Counsel a patient asking about dietary interventions for prostate cancer.

Critically evaluate emerging genomic tests that assess risk in patients with prostate cancer; Outline the findings of a survey of physicians that assessed the use of the cell cycle progression score to evaluate patients with prostate cancer; Explain the purported interaction between statins and androgen deprivation therapy; Interpret the findings of the SWOG S9346 study; Define androgen annihilation.

Counsel a patient asking about the side effects of immunotherapies for metastatic melanoma; Select appropriate treatments for a patient with metastatic melanoma based on characteristics of the patient and the tumor; Explain how talimogene laherparepvec (T-Vec) is created; Critique a recent study that described a relationship between previous treatment with BRAF inhibitors and the effectiveness of immunotherapies for metastatic melanoma; Assess data of the efficacy of ipilimumab plus nivolumab, compared with nivolumab alone, in the treatment of sarcoma.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Weigh the benefits and risks of trimodal therapy and radical cystectomy in patients with muscle-invasive bladder cancer. 2. Implement strategies to improve local control of disease in patients with muscle-invasive bladder cancer; Recognize the variant subtypes of bladder cancer and their clinical implications; Choose an effective modality for managing nonmuscleinvasive bladder cancer of variant histology; Select patients with bladder cancer who are most likely to benefit from therapy using targeted agents.

Compare the characteristics and prognosis between human papillomavirus (HPV)-positive and HPV-negative head and neck cancer; Summarize the efficacy and toxicity of chemotherapy and radiation therapy for high-risk and locally advanced head and neck cancer; Identify factors associated with response to immunotherapy in metastatic head and neck cancer; Discuss the relationship between risk scores from multiparameter genomic assays for breast cancer and patient outcomes; Explain how spatial heterogeneity within a tumor and temporal heterogeneity between a primary breast tumor and distant metastases affect response to therapy.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Define calculations of volume commonly used for planning brachytherapy treatment to the prostate; Select appropriate candidates for low dose rate brachytherapy to the prostate; List the advantages of high dose rate brachytherapy over low dose rate brachytherapy for treatment of prostate cancer; Summarize the important findings reported in the ASCENDE-RT trial; Counsel a patient considering multimodal therapy for prostate cancer about common toxicities and associated risk factors.

Reduce the false-negative rate of sentinel lymph node biopsy after neoadjuvant chemotherapy; Perform lymph node biopsy using targeted axillary dissection; Adopt consensus guidelines for adequate surgical margins in patients with invasive breast cancer and ductal carcinoma in situ; Lower the risk for local recurrence in patients with ductal carcinoma in situ; Recognize the role of the radiologist in the treatment of patients with breast cancer.

Differentiate immune-related adverse events from disease progression or infectious complications; Utilize laboratory testing to monitor for early signs of immune-related adverse events; Implement management strategies for immune-related adverse events based on severity of reaction; Explain why the efficacy of targeted therapies varies among different types of malignancies; Identify characteristics of microsatellite instability-high colorectal cancer.

Identify common germline mutations in mismatch repair genes associated with prostate cancer; Compare the prevalence of germline mutations in high-risk metastatic, high-risk localized, and low-risk prostate cancer; Summarize the prevalence and distribution of genes for susceptibility to hereditary cancer in patients with early onset colorectal cancer; Classify gene mutations and clinical disorders associated with myelodysplastic syndromes; List possible indications that a case of myeloid leukemia has a familial component.

Choose appropriate methods for diagnosis and staging of gastric cancer; Discuss the roles of chemotherapy and radiation therapy for resectable and metastatic gastric, gastroesophageal junction, and esophageal cancers; Identify characteristics of 4 genomic subsets of upper gastrointestinal cancers and how they differ in response to targeted therapies and immunotherapy drugs; Select a management strategy for testis cancer based on risk factors; Use serum tumor markers to risk-stratify disseminated testicular cancer and assess response to treatment.

Identify primary malignancies and molecular subtypes commonly associated with brain metastases; Review the efficacy and toxicities of radiation therapy, surgery, radiosurgery, and chemotherapy for treating brain metastases; Compare and contrast the efficacy and safety of whole-brain radiation therapy and stereotactic radiosurgery for the management of brain metastases; Summarize the efficacy of new-generation targeted therapies and immunotherapies for inducing an intracranial response; Discuss the genetic alterations that occur between primary tumors, brain and extracranial metastases, and lymph nodes.

Explain why targets of immunotherapy are more difficult to identify in cancers of the head and neck than in melanoma; Identify the role of targeted therapies in treatment of patients with cancers of the head and neck; Evaluate the 2 methods for detection of neoantigens; Use targeted agents in treating patients with tumors of the salivary glands; Distinguish the main features of the molecular signatures of common types of salivary gland tumors.

Plan treatment for a patient with limited-stage small-cell lung cancer; Counsel patients based on the outcomes of trials that compared cisplatin with carboplatin as treatment for small-cell lung cancer; Explain the mechanism of action of targeted therapies currently under investigation for treatment of small-cell lung cancer; List the benefits of early palliative care in patients with lung cancer; Manage simultaneous presentation of multiple symptoms during therapy for lung cancer.

Use prognostic markers for risk stratification in patients with MCL; Identify patients with MCL who are likely to benefit from deferred therapy; Select an induction chemotherapy regimen for MCL based on the age and fitness of the patient; Compare the efficacies and toxicities of agents commonly used to treat relapsed MCL; Assess the relationship between dose or duration of therapy and toxicity for drugs used to treat relapsed MCL.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Implement appropriate treatment strategies to manage diabetic macular edema; Counsel a diabetic patient about the importance of timely, regular treatment of diabetic eye disease; Recognize the roles of anti-vascular endothelial growth factor (EGF) agents and corticosteroids in the management of diabetic macular edema; Anticipate systemic risks associated with intraocular anti-EGF treatment; Explain the effect of EGF on perfusion in the diabetic retina.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Differentiate between strabismus and amblyopia; Measure the angle of deviation in patients with strabismus; Identify patients with amblyopia who would not benefit from surgery on extra-ocular muscles; Assess the optic nerve for signs of increased intracranial pressure; Systematically evaluate ocular motility to correctly diagnose cranial nerve palsy.

Determine whether a patient with a palsy of cranial nerve III requires angiography; Evaluate a child referred for headaches and possible papilledema; Distinguish between thyroid eye disease and myasthenia gravis; List factors associated with good outcomes in patients with adenoid cystic carcinoma of the lacrimal gland; Manage giant cell arteritis in a patient who presents with symptoms.

Identify patients presenting for ophthalmic surgery who may be at high risk for cardiovascular events; List pathologies with implications for anesthesia in ophthalmic surgery; Implements a multidisciplinary approach to management of high-risk patients prior to ophthalmic surgery; Apply perioperative managements strategies for prophylaxis of postoperative endophthalmitis; Compare clinical efficacy among agents used for prophylaxis of postoperative endophthamitis.

Diagnose common and uncommon presentations of herpes keratitis; Manage treatment of herpes simplex keratitis; Explain the relationship between diabetic retinopathy and axial length of the eye; List distinguishing characteristics of intrinsically photosensitive retinal ganglion cells; Counsel a patient about the differences between femtosecond laser-assisted cataract surgery and traditional phacoemulsification.

Choose appropriate surgical techniques and devices to treat patients with glaucoma of varying degrees of severity; Take appropriate action to prevent an impaired physician from causing harm; Weigh the risks and benefits of achieving a target intraocular pressure goal for a patient with glaucoma; Identify and treat aqueous misdirection syndrome; Distinguish uveitis-glaucoma-hyphema (UGH) syndrome from other causes of inflammation in the anterior segment.

Appropriately treat a child with amblyopia; Characterize symptoms associated with pulled-in-two syndrome; List techniques used to perform gene therapy; Explain the pathophysiology of macular holes; Illustrate the inverted internal limiting membrane flap technique for repair of macular holes.

Differentiate neuromyelitis optica from other diseases of the central nervous system; Construct a management plan for patients with suspected neuromyelitis optica; Recognize signs and symptoms of aqueous misdirection; Prescribe appropriate medical therapy for malignant glaucoma; Determine the etiology of clinical epiphora.

Outline a treatment regimen for specific causes of infectious uveitis; List the different tests available for diagnosing infectious uveitides; Identify the most common cause of noninfectious anterior uveitis; Compare and contrast different white dot syndromes; Interpret findings of multimodal imaging in patients with white dot syndromes.

Identify patients at risk for developing nonarteritic anterior ischemic optic neuropathy; Summarize the pathogenesis of ischemic optic neuropathy; Monitor the ganglion cell complex for glaucoma progression; Implement a plan for patients with neovascular macular degeneration that fails to respond to treatment; Establish a diagnostic approach for patients who present with a uveitic masquerade syndrome.

Create a perioperative management plan for patients with retinal pathology who are undergoing cataract extraction; Choose cataract surgery techniques that prevent corneal endothelial cell loss; Plan cataract surgery for a patient with keratoconus; Identify risk factors for formation of cataracts; Manage intraocular pressure in patients with glaucoma who are undergoing cataract surgery.

Explain the mechanism of action of various devices for minimally invasive glaucoma surgery; Formulate a surgical plan for mild to moderate glaucoma with comorbid cataract; Identify suitable candidates for implantation of a minimally invasive glaucoma surgical device; Anticipate increased risk for intraocular hemorrhage in patients taking systemic anticoagulant therapy; Apply the appropriate testing modality to assess the morphology of neovascular retinal lesions.

Develop a treatment algorithm for patients with ocular inflammatory disease; Select appropriate immunomodulatory therapy for various ocular uveitides; Prevent loss of sight and life in patients with autoimmune conditions through a team approach to care; Choose the appropriate imaging tool to identify active inflammation in patients with ocular uveitis; Interpret results obtained from a variety of imaging modalities for patients with ocular inflammatory diseases.

Identify the retinal pathologies responsible for visual change in diabetic retinopathy; Summarize the mechanism of blood-retinal barrier permeability in patients with diabetic retinal disease based on the retina ischemia-reperfusion model; Explain the possible role of inflammation in the pathology of diabetic retinopathy; Evaluate data on the efficacies of current therapies for diabetic retinopathy and diabetic macular edema; Implement treatment strategies based on stage of diabetic retinopathy and visual acuity on presentation.

Identify the distinguishing characteristics of normal-tension glaucoma; Recognize trends in the evolution of health care systems and their effects on the practice of ophthalmology; List the most common reasons for initial and repeat Descemet stripping endothelial keratoplasty (DSEK); Explain the proposed pathogenesis of floppy eyelid syndrome; Refer appropriate patients for sleep studies based on findings of eyelid laxity.

Assess the advantages and disadvantages of various innovations in intraoperative instruments and platforms for retinal surgery; Differentiate HORV from other ocular diseases; Recognize risk factors for and the etiology of CSC; Anticipate outcomes of treatment in patients with chronic CSC; Manage long-steroid therapy in a patient who is to receive photodynamic therapy for CSC.

dentify causes and possible solutions for the opioid crisis; Effectively treat pain using target-specific therapy; Construct a patient-tailored list of options for non-narcotic analgesia; Detect signs of glaucoma progression using optical coherence tomography; Obtain reproducible results when using optical coherence tomography.

Outline the anatomy of the shoulder joint; Determine whether operative management of a rotator cuff tear is indicated; Implement techniques for optimal repair of rotator cuff injuries; Recognize the importance of rehabilitation in the treatment of shoulder injuries; Assess and treat shoulder instability and dislocations.

Recognize indications for surgical management of glenoid fractures; Optimize outcomes in patients with fractures of the elbow and proximal forearm; Improve the management of periprosthetic fractures in patients who have had total hip arthroplasty; Minimize the risk for infection in patients with open fractures of the knee and tibia; Maximize the stability of the talus in patients with fractures of the ankle.

QUALIFIES FOR TRAUMA

Identify the primary actions of muscles controlling motion of the scapula and shoulder; Diagnose pathologic conditions of the shoulder and scapula; Select appropriate modalities to guide therapeutic injections in the shoulder; Weigh the risks and benefits of injectates for the management of pathologic conditions of the shoulder; Optimize the use of traditional and novel percutaneous interventions to manage shoulder and scapular conditions.

Summarize the pathophysiology of disorders involving excess and deficiency of parathyroid hormone (PTH); Differentiate the anabolic and catabolic effects of PTH; Cite literature documenting therapeutic effects of PTH and its analogues; Optimize the use of analogues of PTH for the treatment of osteoporosis; Select appropriate candidates for treatment of hypoparathyroidism with recombinant human PTH.

QUALIFIES FOR CLINICAL PHARMACOLOGY-EN029

Summarize the advantages and disadantages of different surgical approaches for craniocervical procedures; Select appropriate screws for fixation based on spinal and sacropilvic anatomy; Confirm the safe placement of screws during spinal surgery; Select appropriate osteotomies for correction of spinal deformity; Optimize sagittal allignment during spinal surgery.

Summarize the anatomy of the glenohumeral joint; Cite literature supporting surgical management of glenohumeral dislocation; Cite literature supporting nonsurgical management of glenohumeral dislocation in skeletally immature patients; Use appropriate diagnostic tests to evaluate the presence and extent of femoroacetabular impingement; Select optimal surgical approaches to the repair of femoroacetabular impingement.

QUALIFIES FOR SPORTS MEDICINE

Recognize clinical types and manifestations of hypophosphatasia; Select optimal treatment modalities for hypophosphatasia; Discuss elements of bone quality such as collagen cross-linking and the lamellar structure of bone itself; Initiate or modify treatment regimens in patients with lower back pain based on assessment of spinal-pelvic alignment; Apply current guidelines for treatment of patients with lower back pain.

Summarize the benefits and limitations of the Fracture Risk Assessment Tool; Counsel patients on minimization of risk factors for fracture; Emphasize the importance of diet for prevention of fractures; Recognize the wide variety of dietary supplements reported to improve bone health; Recommend an appropriate exercise regimen for optimization of bone health.

QUALIFIES FOR GERIATRICS

Select appropriate candidates for surgical treatment of displaced midshaft clavicular fractures; Assess elderly patients with distal humeral fractures; Recognize patterns of fractures in the wrist; Evaluate ligamentous injuries in the wrist; Optimize the diagnosis and treatment of radial and ulnar shaft fractures.

QUALIFIES FOR TRAUMA

Select appropriate candidates for amputation compared with salvage of the lower limb after severe fracture; Cite literature relevant to surgical management of type 3C tibial fractures; Compare and contrast open reduction and internal fixation with replacement of radial head and neck fractures; Optimize outcomes for patients with high-energy tibial pilon fractures; Perform a thorough assessment of patients with tibial nonunion.

QUALIFIES FOR TRAUMA

Optimize the reduction of osteoporotic ankle fractures; Recognize the value and limitations of patient-reported outcomes in orthopedic surgery; Select appropriate candidates for operative management of shoulder dislocations and for arthroscopic hip surgery; Assess the bony and neurovascular status of patients with dislocations of the knee; Improve the surgical management of rotator cuff injuries.

QUALIFIES FOR TRAUMA

Evaluate causes of and ways to prevent malreduction and loss of fixation after surgery for fractures of the pelvic ring and acetabulum. 2. Discuss principles of management and surgical indications for fractures of the acetabulum; Develop strategies for the management of life-threatening conditions in patients with polytrauma that includes orthopedic injuries; Summarize indications for the surgical management of fractures of the pelvis; Review surgical techniques for different types of fractures of the proximal femur.

QUALIFIES FOR TRAUMA

Summarize the advantages and disadvantages of ultrasonography vs magnetic resonance imaging; Apply algorithms for diagnosis of rotator cuff pathology; Select appropriate candidates for dynamic imaging.; Optimize care for patients with fragility fractures; Explain the human and financial costs of osteoporotic spinal fractures.

IG022

Evaluate patients with pain in their SI joints; Cite current literature about diagnosis and management of SI joint pain; Select appropriate therapies for patients with SI joint pain; Implement screening uestionnaires for identification of SI joint pain; Recognize anatomic variations of the SI joint and surrounding environment.

Summarize the benefits of clinical registries; Prevent, diagnose, and manage deep venous thrombosis in trauma patients; Select optimal material for bone grafting; Manage patients with infected nonunion; Optimize outcomes for patients with diaphyseal nonunion.

QUALIFIES FOR TRAUMA

Explain the rationale for performing simultaneous fusion of the lumbar spine and sacroiliac joint; Summarize the principles of radiofrequency neurotomy; Assess data on the effectiveness of radiofrequency neurotomy for relieving pain in the sacroiliac joint; Apply principles and techniques to optimize outcomes after radiofrequency neurotomy; Determine whether the sacroiliac joint is the source of a patient's low back pain.

QUALIFIES FOR PAIN MANAGEMENT

Use appropriate imaging techniques and intraoperative monitoring practices for patients requiring thyroidectomy; Perform surgical techniues that minimie complications in patients undergoing thyroidectomy; Compare and contrast available methods for nicotine replacement therapy; Select an appropriate medication for a patient who wants to stop smoking; Counsel the parents of a teenager who ask for information about electronic cigarettes.

Recommend appropriate antibacterial therapy for acute and chronic bacterial rhinosinusitis; Treat significant complications of acute rhinosinusitis; Identify the etiology of pharyngitis based on laboratry results and presentation; Use modified Centor criteria to determine the probability that group A Streptococs (GAS) is the cause of pharyngitis; Prescribe the appropriate antibiotic therapy to prevent serious sequelae of GAS pharyngitis.

Provide cost-effective care for patients with disorders of the vocal folds. Recommend treatment for a patient referred because of failure of proton pump inhibitors for presumptive laryngopharyngeal reflux. Explain the role of voice therapy in patients with laryngeal disorders. Manage a patient with hoarseness who has only subtle findings on laryngoscopy. Counsel a patient who must choose between laryngeal framework surgery and reinnervation.

Recognize typical and atypical clinical finding in a child with mycobacterial cervicofacial lymphadenitis; Counsel the family of a child with cervicofacial lymphadenitis regarding options for treatment; Discuss appropriate duties of a physician assistan or nurse practitiones in an otolaryngologic practice; Search for an underlying etiology in a patient with angioedema; Diagnose foreign body obstruction and croup in pediatirc patients.

Manage cerebrospinal fluid leak; Recommend appropriate imaging procedures to localize a cerebrospinal fluid leak; List prognostic factors associated with recovery from loss of olfaction; Counsel a patient considering olfactory training for loss of smell; Diagnose a patient who complains of inability to breathe through the nose.

Diagnose a patient with chronic cough; Manage a patient with neurogenic cough; Recognize atypical presentations of pertusis; List the symptoms of irritable larynx; Teach breathing techniques to patients to treat behavioral cough.

Evaluate a patient with pulsatile limits; Manage a patient with subjective tinnitus; Summarize the anatomic and physiologic relationships between the hypothalamus and the anterior and posterior pituitary gland. Identify the hormones relased from the anterior and posterior pituitary gland, their target cells, and their principla actions; Recognize the clinical manifestations of tumors of the pituitary gland.

Plan facial feminization surgery based on principles of facial attractiveness; Choose grafts for a patient requiring mandibular reconstruction; Optimize mandibular reconstruction with use of templating; Select candidates for mandibular reconstruction with virtual surgical planning; Perform facial reinnervation after radical parotidectomy.

Define the various forms of peer victimization; Employ appropriate screening techniques for bullying and ostracism; Perform interventions to address bullies and bullied youth; Identify children at high risk for commercial sexual exploitation; Respond to sex trafficking according to local protocols.

QUALIFIES FOR CHILD ABUSE

List the muscles and components of the nervous system that control urinary continence and micturition; Evaluate the cause of urinary frequency and incontinence in children by using the appropriate assessment tools; Prescribe and assess behavioral modifications to manage bowel and bladder dysfunction in children; Perform appropriate testing in children with suspected or confirmed urinary tract infections; Identify children at increased risk for recurrent urinary tract infections and renal scarring.

Use a multidisciplinary approach in the management of chronic pain in children; Assess improvement in chronic pain in children; Recognize warning signs of organic disease in a child with chronic abdominal pain; Diagnose and treat patients with chronic abdominal pain; Identify the types of functional abdominal pain according to the Rome IV criteria.

QUALIFIES FOR PAIN MANAGEMENT

List the reasons for recent resurgences in pediatric infections previously considered under control; Describe the different illnesses caused by viruses transmitted by the Aedes mosquito; Review the clinical findings of infection with Zika virus infection in fetuses and neonates; Identify clinical findings associated with the newer respiratory viruses in children; Recognize the pathogenic risk of different subtypes of the influenza virus.

QUALIFIES FOR INFECTIOUS DISEASE

List factors that increase risk for poor adherence to a regimen for treatment of asthma; Differentiate asthmatic phenotypes; Prescribe the combination therapy most likely to improve symptoms in children with severe asthma; Explain the different types of parasomnias; Identify risk factors for parasomnia.

Diagnose patients with anaphylaxis using clinical criteria; Provide effective treatment to patients with anaphylaxis; Optimize prophlaxis for subacute bacterial endocarditis; Elaborate on dietary guidelines for sodium and sugar; Recognize clinical conditions in children that confer high risk for cardovascular disease.

Prescribe and manage antibiotics effectively and prudently in the treatment of acne; Treat acne with topical retinoids and counsel families on contending with irritation from their application; Recommend accessible, cost-effective treatments for atopic dermatitis; Employ effective strategies to treat atopic dermatitis with steroids; Develop differential diagnoses for patients with jaw pain, leg pain, or persistent fever in the absence of obvious causes.

DERM017

Recognize which pediatric vaccines may be administered simultaneously at different sites; Tailor vaccination strategies to specific patient populations; Recommend appropriate vaccines for patients planning to travel outside the United States; Use strategies that to encourage adolescent patients to divulge information and cooperate with treatment; Explain the role of risk taking in normative adolescent development.

QUALIFIES FOR INFECTIOUS DISEASE

Describe the negative feedback pathway for energy balance; List the lipogenic mechanisms of insulin; Distinguish between insulin resistance and insulin hypersecretion based on clinical history and laboratory analyses; Prescribe appropriate dietary or pharmacologic therapy to treat the 2 different insulin disorders involved in obesity; Explain the cellular mechanisms involved in the causes and treatments of obesity.

Explain the changing etiology of otitis media Identify the organisms that most commonly cause otitis media; Recognize the indications for antibiotic therapy or tympanostomy tubes in patients with otitis media; Determine whether a child reuires evaluation after a submersion event; Evaluate studies of potential risks associated with the administration of polyethylene glycol, human papillomavirus vaccine, and vitamin K .

Prescribe the appropriate antibiotic for common pediatric outpatient infections; Identify patients in whom antibiotic treatment is not indicated; List discussion techniques and clinician interventions that reduce the rate of inappropriate antibiotic prescription; Describe the effects of childhood kidney disease and an altered intestinal microbiome; Explain how monoclonal antibodies may be used to treat patients in future epidemics.

Use available guidelines to provide optimal care for children with Down syndrome; Counsel patients about potential treatments for Down syndrome that are currently under development; Screen for the physical complications associated with Down syndrome; Recommend activities that will have cognitive benefit for children with Down syndrome; Provide encouragement and resources for parents of children with Down syndrome.

Use nonpharmacologic approaches to decrease the experience of pain in children; Design preoperative and postoperative pain management plans for children; Identify pain treatments that are best supported by evidence; Diagnose pediatric hypertension; Perform appropriate workup of children with hypertension.

Differentiate among different causes of growth failure; Treat hormone deficiencies; Distinguish normal from disordered puberty: Assess the evidence supporting recommendations of the National Heart, Lung and Blood Institute and the American Academy of Pediatrics for the use of nonfasting and fasting lipid panels in children; Weigh the risks and benefits of statin therapy in children.

Evaluate the pattern of joint pain to diagnose juvenile idiopathic arthritis; Interpret the results of rheumatologic laboratory tests in association with findings on physical examination of joints and imaging; Recommend the early initiation of an appropriate treatment plan for juvenile idiopathic arthritis; Review the long-term outcomes of bariatric surgery in adolescents; Explain the role of cystic fibrosis transmembrane conductance regulator modulators in the treatment of cystic fibrosis.

List risk factors for kidney stones in children; Recognize symptoms associated with stones located in the kidney, compared with stones located in the ureter; Choose among medical propulsive therapy, a trial of passage, or surgical intervention for treatment of kidney stone in a child; Appropriately prescribe psychotropic medication based on a child's psychiatric diagnosis and target symptoms; Perform a baseline assessment on all children requiring psychotropic medication.

Identify infants at high risk for developing a peanut allergy; Implement strategies to prevent the development of food allergies; Conduct peanut challenges in appropriate patients; Explain the normal pattern of sleeping and waking in adolescents; Diagnose and treat common sleep disorders in adolescents.

Differentiate the features of substance use disorder in women from those in men; Evaluate and treat infants with neonatal abstinence syndrome; Recognize characteristics of children with accidental cannabis ingestion and fetal Zika virus infection; Guide pregnant women in interpreting research on risk for autism spectrum disorders in their offspring associated with taking antidepressant drugs compared with not treating psychiatric disorders; Identify the risks associated with low socioeconomic status in infants.

Distinguish between cardiac and neurocardiogenic syncope based on patient presentation; Match electrocardiographic findings with common arrhythmias; Recognize concerning findings in pediatric patients with syncopal episodes; Identify potentially life-threatening arrhythmias; Choose the appropriate cardiac monitoring device for a given presentation.

Recognize challenges of applying standard principles of medical ethics to pediatrics; Define the harm principle; Avoid conflict when encountering parents unrealistic expectations about a terminal illness affecting their child; Identify behaviors associated with pathologic gaming or video game addiction; Create a rehabilitation plan for children with video game addiction.

Evaluate the evidence for causality in autism spectrum disorder; Recognize the positive and negative effects of digital media use by children with autism spectrum disorder; Guide parents of children with autism spectrum disorder in choosing appropriate assistive technology and digital media; Accommodate the requirements of children with autism spectrum disorder in the health care setting; Provide advance planning tools for a medical visit for children with autism spectrum disorder.

Describe the normal pathway of bilirubin metabolism; Distinguish between disorders of unconjugated and conjugated bilirubin; Diagnose the cause of a nutritional deficiency using patient history, and physical and laboratory findings; Define failure to thrive; Recognize and prevent refeeding syndrome.

Recognize the effects of common medications and household products ingested by children; Optimize the treatment of children who have ingested common medications and household products; Determine whether a child who has ingested a battery requires imaging or surveillance; Evaluate and treat children with suspected aspiration of a foreign body; Retrieve foreign bodies that children have inserted into their nose or ears.

Recognize the organisms that most commonly cause foodborne and waterborne illness; Identify patients with clinical presentation consistent with infection by organisms that cause foodborne and waterborne illness; Select appropriate antibiotic therapy for patients with foodborne and waterborne illness; Assess risk for infection in patients with animal bites; Prescribe prophylaxis and antibiotic therapy in patients with animal bites.

QUALIFIES FOR INFECTIOUS DISEASE

Explain the underlying processes in families that seem difficult; Use effective strategies for communicating with angry or vulnerable family members; Tailor the aspects of the visit to the reason for the difficult interaction; Initiate conversations with children and families about bereavement; Recognize the various ways in which children communicate (or appear to avoid communicating) about a loss.

List the classes of parasites that can infect humans; Describe the life cycles and modes of transmission of human parasites; Use the most appropriate medications to treat parasitic infections; Recognize the common presentations of parasitic infections in humans; Use history and findings of physical examination to form a differential diagnosis for patients with complex or unusual presentations.

List the number of hours of sleep required by children of different ages; Differentiate between the 2 subtypes of behavioral insomnia in children; Use appropriate management techniques for the 2 subtypes of behavioral insomnia in typically developing children; Provide families with recommendations on sleep training techniques; Advise parents about the use of melatonin in children.

Minimize the risk for renal damage in children with urinary tract infection; Recommend antibiotic prophylaxis in a child with vesicoureteral reflux according to the findings of the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) study; Optimize the use of ultrasonography, voiding cystourethrography, and nuclear medicine studies in children with febrile urinary tract infection; Improve the diagnosis of lead poisoning and atlantoaxial rotatory subluxation; Counsel parents about the appropriate dosage and adverse effects of zinc supplementation in children with upper respiratory tract infection.

Classify the types of anemia that present in toddlers according to cell size and physiology; Describe the components of a complete blood count and how they vary in different types of anemia; Treat the common forms of anemia that present in toddlers; Counsel the parents of a child with ankyloglossia about the evidence supporting treatment with frenectomy; Advise parents and patients about the effects of cell-phone use on sleep in children and adolescents.

Define the characteristics of common genetic syndromes; Evaluate children for comorbidities associated with common genetic syndromes; Identify which type of genetic testing is indicated for various patient presentations; Describe the treatment options for obesity in children and adolescents; Describe the theory behind newer medications aimed at modifying bile acid levels in obese patients.

Distinguish seizures from epilepsy and epileptic syndromes; Evaluate a child who has had a seizure; List the pharmacologic and nonpharmacologic treatment options for epilepsy; Identify patients with epilepsy who are suitable candidates for surgery; Counsel patients about risk factors for sudden unexpected death in epilepsy patients (SUDEP).

Differentiate central hypotonia from peripheral hypotonia; Diagnose and treat patients with Prader-Willi syndrome; Assess patients for signs and symptoms of spinal muscular atrophy and congenital myotonic dystrophy; Evaluate children for weakness, low muscle tone, and other motor abnormalities; Provide early and appropriate treatment in boys with Duchenne muscular dystrophy.

Determine the most likely etiology for early onset sepsis in an infant of a given birth weight and presentation; List perinatal risk factors and intrapartum prophylaxis recommendations for group B Streptococcus; Manage exposure to chorioamnionitis during labor and delivery; Distinguish intoeing from other foot abnormalities that may require intervention; Identify causes of genu varum and genu valgum that may require intensive treatment or surgery.

Compare the benefits and limitations of the tuberculosis skin test with those of interferon-y release assays (IGRAs); Determine which children should be tested for tuberculosis and which tests should be used; Optimize the treatment of a child with tuberculosis; Administer vaccines approved for use during pregnancy; Identify organisms against which maternal vaccination is being investigated.

Describe the presentation and evaluation of the most common childhood cancers; Recognize oncologic emergencies; Manage pain in children with cancer; Identify childhood cancers with overlapping signs and symptoms; Create a treatment plan for a child with a common childhood cancer.

Diagnose postural orthostatic tachycardia syndrome with minimal testing; Develop a rehabilitative treatment protocol for patients with postural orthostatic tachycardia syndrome; Assemble a multidisciplinary team to treat patients with postural orthostatic tachycardia syndrome; Assess patients with suspected concussion at different times after the initial injury; Set realistic expectations for healing in a patient with concussion using an active recovery protocol.

Describe the different types of stimulant and nonstimulant therapies available for attentiondeficit/hyperactivity disorder; Assess children for potential adverse effects of medical treatment for attention-deficit/hyperactivity disorder; Evaluate the evidence for dietary interventions for attention-deficit/hyperactivity disorder; Ask questions to identify obsessive-compulsive disorder in children; Determine which type of treatment is most appropriate for a child with obsessive-compulsive disorder.

Differentiate between the properties and roles of A, delta and C pain fibers; Choose appropriately from among pharmacologic options for pain control in children; Predict the approximate time of onset of anesthesia for topical agents; Employ active distraction techniques for medical procedures; Counsel patients about optimally preparing children for painful procedures.

QUALIFIES FOR PAIN MANAGEMENT

Identify injuries highly suggestive of abuse; Recognize common mimickers of abusive injuries; Assess pain in children using appropriate scales; Interpret evidence supporting or refuting the use of pharmacologic treatment of chronic pain in children; Create an interdisciplinary treatment plan for children with chronic pain.

Choose appropriate diagnostic tests for children with knee injuries based on the mechanism and presentation of the injury; Recognize common and commonly missed knee injuries; Distinguish patients for whom nonoperative management of knee injuries is appropriate from those who require urgent or emergent orthopedic consultation; Describe a potential new treatment for epidermolysis bullosa; Evaluate recent evidence for the use of cannabinoids in children with seizure disorders.

List the strengths and weaknesses of molecular testing plat- forms for infectious organisms; Determine whether treatment is indicated on the basis of results of molecular gastrointestinal panels; Apply appropriate testing strategies for molecular syndromic panels; Initiate a diagnostic evaluation for primary immune deficiency in children; Recognize the clinical signs and symptoms of different types of primary immune deficiencies.

QUALIFIES FOR INFECTIOUS DISEASE

Define the 3 types of tic disorders described in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition); Counsel patients about comprehensive behavioral intervention for tics (CBIT) and pharmacotherapy for tic disorders; Identify common comorbidities in children and adolescents with tic disorders; List risk factors and protective factors for suicidality in children and adolescents; Create a safety plan for an individual who expresses suicidal ideation.

List the diagnostic criteria for constipation in children; Formulate a differential diagnosis for a case of constipation; Appropriately evaluate children with functional constipation; Apply an evidence-based approach to the treatment of children with constipation; Refer patients to gastroenterology when comanagement is indicated.

Recognize clinical findings associated with Mycoplasma pneumoniae infection; Determine which children with Mycoplasma pneumoniae infection should receive antibiotic treatment; Implement the recommendations of the American Academy of Pediatrics regarding chemoprophylaxis and treatment of Borrelia burgdorferi infection; Identify the signs and symptoms of the 3 stages of Lyme disease; Test patients for Lyme disease using the algorithm provided by the Centers for Disease Control and Prevention.

QUALIFIES FOR INFECTIOUS DISEASE-ID149

Recognize the indications for imaging in pediatric patients with headache; Summarize the acute, long-term, and preventive treatment options for migraine in children; Identify the symptoms that constitute migraine with aura; Screen for the underlying etiologies associated with sudden cardiac death in children; Recognize red flags for serious pathology in children with syncope.

IG024

Distinguish among symptoms of overdose caused by different medications; Use appropriate laboratory testing to identify the source of pediatric poisoning; List the conditions that can cause lethargy in children; Order appropriate imaging to evaluate issues in the neck; Identify the signs and symptoms of tetanus.

Refer infants with abnormal results of newborn hearing screening to the appropriate provider at the appropriate age; Recognize risk factors for postnatal-onset permanent hearing loss; Elaborate on the function of the normal eustachian tube; Diagnose eustachian tube dysfunction in children; Select children most likely to benefit from insertion of tympanostomy tubes to treat otitis media.

Identify the factors affecting the increasing incidence of kidney stones in children; Recognize the efficacy of ultrasonography in the diagnosis and management of kidney stones in children; Identify patients appropriate for nonoperative management of kidney stones; Obtain a clinical history from patients with enuresis and develop an appropriate treatment plan; Explain the relationship between constipation and enuresis.

Differentiate spondylolysis from spondylolisthesis; Perform a brief neurologic examination and order appropriate imaging to assess a child with back pain; Recognize neoplasms that can cause back pain in children; Determine the differential diagnosis in a child with foot and ankle pain based on the history and mechanism of injury; Select patients most likely to benefit from use of a controlled ankle movement (CAM) boot.

Describe the adverse effects of commonly used herbs and supplements; Perform evidence-based assessments of the efficacy of many herbs and supplements; List the nutritional supplements most commonly used by young athletes to improve performance; Advise against the use of supplements that are unlikely to improve athletic performance or that may cause harm; Recommend appropriate nutritional supplements for patients with underlying medical conditions.

Identify the diagnostic criteria for depressive disorders in children; Recognize the clinical presentation of depression in each pediatric age group; Optimize treatment in children with major depressive disorder; Explain the position of the American Academy of Pediatrics on the use of medical marijuana in children; Use age-appropriate strategies to help children understand the health risks associated with marijuana use.

Recognize factors that have significantly decreased the rates of morbidity and mortality in patients with sickle cell disease; Provide effective options for disease modification or cure in patients with sickle cell disease; Determine the underlying cause of wheezing; Prescribe appropriate treatment of the underlying cause of wheezing; Weigh the advantages and disadvantages of commonly used medications for wheezing.

Contrast the traditional binary system for sex and gender with the current approach to these issues; Employ a gender-affirmative model when caring for potentially transgender patients; Advise patients about the risks and benefits of pubertal blockade and cross-sex steroid therapy; Address reproductive health concerns in transgender individuals; Provide appropriate routine reproductive health care to transgender individuals.

QUALIFIES FOR ETHICS/CULTURAL SENSITIVITY AND LINGUISTICS-CS012

Differentiate among types of eating disorders based on the presenting symptoms; Identify common medical and psychological factors in patients with eating disorders; Perform a biopsychosocial evaluation in patients suspected of having an eating disorder; Create a comprehensive interdisciplinary treatment plan for patients with eating disorders; Implement validated medical and psychological treatments in patients with eating disorders.

Define amblyopia and list the possible causes; Identify ocular conditions that require immediate referral; Choose the most appropriate treatment or intervention for common ocular conditions in children; Differentiate between various causes of conjunctivitis in children on the basis of patient history; Choose an appropriate treatment for conjunctivitis of common causes in children.

Recognize the range of parental concerns about immunization; Use evidence-based communication techniques to increase vaccine uptake; Describe strategies that lessen vaccine hesitancy; Explain the method by which toxic stressors result in chronic disease in children; List examples of the effects of toxic stress in children.

Apply findings of the Children and Adolescent Migraine Prevention trial to practice; Use a stepwise approach to treatment and prevention of migraine in pediatric patients; Identify regions of the brain involved in addiction and associated abnormal behaviors; Explain the neurobiology of substance use and addiction; Prescribe appropriate medical treatment for opioid use disorder in children and adolescents.

QUALIFIES FOR PAIN MANAGEMENT

Contrast the presentation of eating disorders in children with that in adults; Identify eating disorders in children based on criteria in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition); Explain to parents the importance of early intervention for eating disorders; Counsel parents about refeeding and the importance of reaching daily calorie goals; Discuss basic principles of family-based treatment for eating disorders

Create a differential diagnose for unsual symptoms of depression and anxiet in children; Establish a treatmeant algorithm for anxiety disorders in children that includes pharmacologic and nonpharmacologic approaches; Monitor expected side effects in children being treated for anxiety or depression with pharmacologic agents; Discuss major findings of the Child/Adolescent Anxiety Multimodaul Study; Mange insomnia in a child with anxiety or depression.

List major physiologic systems that control absorption and metabolism of drugs; Explain which drugs and enviormental exposures induce or inhibit metabolic enzymes; Interpret genomic tests in management of patients with psychiatric disorders; Counsel a patient at risk for weight gain on antipsychotic drugs; Form an advisory committee to familirize insurance payers with studies supporting genetic testing in psychiatric patients.

Assess the utility of haloperidol and other antipsychotic drugs in treating delirium; Consider alternatives to high-dose selective serotonin reuptake inhibitors for unresponsive depression; Discuss the effects of alcohol use on the brain; List the elements and goals of performing a suicide risk assessment; Use rating scales appropriately when assessing a patient's suicide risk.

Identify risk factors for suicide in the long-term care population; Select an antidepressant for an older adult in long-term care; Choose appropriate assessments and dedications for a patient in long-term care who has difficulty sleeping; Manage diabetes in patient in long-term care; Adjust or substitute medications that may cause undesirable effects in the elderly.

QUALIFIES FOR GERIATRICS

Diagnose posttraumatic stress disorder; Contrast presentations of posttraumatic stress disorder in men and women; Recommend psychotherapeutic interventions for a patient with posttraumatic stress disorder; Select appropriate medications for a patient with posttraumatic stress disorde; Teach patients with posttraumatic stress disorder how to build resilience.

QUALIFIES FOR TRAUMA

Diagnose attention-deficit/hyperactivity disorder and common comorbidities; Manage concomitant attention attention-deficit/hyperactivity disorder and substance use disorder in adolescents; Explain the pathophysiology of the observed association between attention-deficit/hyperactivity disorder and substance use disorder: Choose appropriate stimulants for patients with attention-deficit/hyperactivity disorder; Characterize misuse among college students.

QUALIFIES FOR SUBSTANCE ABUSE

Choose stimulant medications for children with ADHD on the basis of evidence from comparative studies; Assess findings of key studies analyzing the efficacy of combined therapies for ADHD; Develop effective treatment plans for ADHD across the patient's lifespan; Counsel patients and family members about the benefits of different interventions to ensure adherence to therapy; Promote collaboration between family, school, and clinicians in caring for children with ADHD.

Compare and contrast major goals of the correctional system and the mental health system; Characterize the relationship between criminal recidivism and mental illness; List some benefits of providing mental health services for patients in the correctional system; Recommend effective manuallized behavior therapies for inmates in the correctional system; Explain the responsibilities of a psychiatric clinician working in a correctional facility.

Develop treatment strategies that effectively improve quality of life for patients with BPSN; Assess response to therapy during different neurodegenerative stages; Counsel patients and caregivers about the risks associated with pharmacologic therapies for BPSN; Recognize sleep problems in patients with psychiatric disorders; Weigh the beneficial and deleterious effects of psychotropic medications on sleep.

Define hot and cold cognition; Manage recovery from depression in a patient who reports difficulty returning to work; Summarize the expected findings on imaging during performance of a cognitive task for a patient with depression; List antidepressants with direct procognitive effects; Select appropriate candidates for treatment of depression with liraglutide.

QUALIFIES FOR CLINICAL PHARMACOLOGY

List key legal issues that may arise during the assessment, diagnostic, and treatment phases of psychiatric care; Explain the main implication of the Tarasoff v Regents of the University of California decision; Teach clinic staff caring for psychiatric patients to follow practices and policies designed to improve care and avoid legal problems; Adhere to the legal expectations and standards that exist for treating patients who may endanger themselves or others; Assess psychiatric patients for their capacity to participate in work or jury duty.

QUALIFIES FOR ETHICS and RISK MGMT/PATIENT SAFETY/MEDICAL ERRORS

Assess and manage depression and other psychiatric comorbidities in patients with Parkinson disease; Contrast cognitive issues in patients with Parkinson disease to those in patients with Alzheimer disease; Identify patients with epilepsy who may be at especially high risk for psychiatric illnesses; Discuss possible psychiatric manifestations of each phase of a seizure; Collaborate with neurologic clinicians to prevent and manage side effects of antiepileptic drugs in patients with psychiatric disorders.

Assess the findings of the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder with respect to substance use disorders; Identify regions of the brain involved in the pathogenesis of attention-deficit/hyperactivity disorder; Prescribe appropriate therapy for a patient with attention-deficit/hyperactivity disorder; Weigh the risks and benefits of stimulants used to treat attention-deficit/hyperactivity disorder; Evaluate evidence supporting warnings issued by the FDA for stimulant medications used to treat attention-deficit/hyperactivity disorder.

Differentiate maladaptive from mindful ways of coping with stress; List effects of adverse childhood experiences and predictors of positive outcomes; Counsel parents about strategies to increase influence on their children; Improve psychiatric patient flow in the ED; Identify resources available to boarding patients in the ED.

Choose the most effective drug for a patient with mixed mania; Identify patients with bipolar disorder who may be poor candidates for lithium; Guide the primary care clinician who is concerned about the emergence of mania in a patient taking an antidepressant drug; Select appropriate drugs for maintenance in patients with bipolar disorder; Treat patients who develop a rash while taking lamotrigine.

QUALIFIES FOR CLINICAL PHARMACOLOGY

Identify major psychiatric comorbidities that occur in patients with depression; Evaluate the efficacy of pharmacologic therapies for the management of patients with depression and comorbid psychiatric disorders; Assess the relationships between depression and cooccurring disorders to determine the optimal treatment approach; Design adequate treatment regimens for patients with depression and comorbid disorders; Counsel patients about the benefits and risks of benzodiazepines in the treatment of comorbid depression and anxiety.

Identify patients with mental health disorders who may benefit from primary or adjunctive stimulant therapy; Select optimal stimulant agents for patients with ADHD and psychiatric comorbidities; Counsel patients about potential adverse effects of stimulant agents; Recognize potential for suicidal ideation in patients with mental illnesses; Implement strategies to reduce the risk for suicide in patients with psychiatric illness.

Distinguish sexual dysfunction from sexual identity issues; Identify and address underlying issues involved in the pathogenesis of sexual dysfunction; Determine whether medical workup is indicated in a man with erectile dysfunction; Plan optimal interventions for patients with erectile dysfunction or female sexual interest/arousal disorder; Counsel patients about the benefits and disadvantages of phosphodiesterase-5 inhibitor drugs in the treatment of erectile dysfunction.

Distinguish among normal cognitive decline resulting from aging, mild cognitive impairment, and dementia; Evaluate levels of cognitive and functional decline in patients with dementia; Assess and manage behavioral symptoms in patients with dementia related to neurodegenerative disease; Use factors such as the development of motor deficits and the speed of progression to differentiate among possible causes of dementia; Choose appropriate imaging techniques to aid in the diagnosis of dementia.

QUALIFIES FOR GERIATRICS

Manage prenatal care for a pregnant woman with substance use disorder; Create a protocol for multimodal treatment of pain after cesarean delivery in patients with substance use disorders; Recommend appropriate nonpharmacologic interventions to treat neonatal abstinence syndrome; Discuss medication-assisted treatment with a pregnant woman who has substance use disorder; List adverse outcomes associated with maternal withdrawal from opioid during pregnancy.

QUALIFIES FOR CONTROLLED SUBSTANCES AND SUBSTANCE ABUSE

Distinguish low-risk from high-risk upper tract urothelial carcinoma; Compare endoscopic treatment with nephroureterectomy in the treatment of patients with upper tract urothelial carcinoma; Choose among pathologic tests to guide treatment for patients with renal cell carcinoma; Implement preoperative measures to optimize recovery of patients undergoing radical cystectomy; Prevent readmission of patients undergoing radical cystectomy.

Weigh the benefits and risks of trimodal therapy and radical cystectomy in patients with muscle-invasive bladder cancer; Implement strategies to improve local control of disease in patients with muscle-invasive bladder cancer; Summarize the recommended treatment for patients with T1a renal masses; Optimize the use of ablation and active surveillance in patients with renal masses; Evaluate the efficacy of immunotherapy and adjuvant therapy in the treatment of patients with kidney cancer.

Critically evaluate emerging genomic tests that assess risk in patients with prostate cancer; Outline the findings of a survey of physicians that assessed the use of the cell cycle progression score to evaluate patients with prostate cancer; Explain the purported interaction between statins and androgen deprivation therapy; Interpret the findings of the SWOG S9346 study; Define androgen annihilation

Recognize the limitations of pathologic analysis for stratifying risk in men with prostate cancer; Select patients with prostate cancer for whom genomic testing is indicated; Compare the roles of magnetic resonance imaging and genomic testing in men with prostate cancer; Review the research on optimal dosing of I125 seed implants and compare the effects of dose in low- and high-risk patients. Identify factors that increase the risk for urinary and rectal side effects of brachytherapy.

Explain the major findings of the ProtecT study; Manage active surveillance for low-risk prostate cancer; Characterize the risks and benefits of transrectal ultrasound-guided biopsy of the prostate; List risk factors for infection in men undergoing biopsy of the prostate; Counsel a patient asking about dietary interventions for prostate cancer.

Compare sexual and urinary function in patients who undergo radical prostatectomy, radiation therapy, or active surveillance; Elaborate on the role of androgen deprivation therapy as an adjunct to radiation therapy in patients with recurrent prostate cancer; Optimize the use of adjuvant radiation therapy in patients with prostate cancer; Evaluate the role of radical prostatectomy and lymphadenectomy in patients with locally advanced prostate cancer; Provide patients with options for treatment of asymptomatic and symptomatic castration-resistant metastatic prostate cancer

Diagnose and treat patients with neurogenic bladder; Recognize urinary dysfunction characteristic of patients with Parkinson disease and Shy-Drager syndrome; Identify patterns of urinary dysfunction in patients who have undergone radical pelvic surgery; Select appropriate urodynamic studies for patients with urinary dysfunction; Use the 9 Cs to interpret the findings of a urodynamic study.

Recognize hereditary risk factors for prostate cancer; Evaluate the role of genetic testing in the screening and treatment of patients with prostate cancer; Identify common types of noninvasive bladder cancer; Distinguish variant forms of urothelial cancers of the bladder; Apply guidelines from the Centers for Disease Control and Prevention for treating chronic pain.

Recommend dietary modifications that decrease the risk for recurrent kidney stones; Optimize operative strategies for radical cystectomy; Provide treatment options for bladder preservation to patients with muscle-invasive bladder cancer; Choose among modalities recommended for treatment of kidney stones in the lower pole; Improve outcomes of cystectomy using enhanced recovery after surgery protocols.

Determine the goals of penile rehabilitation in men who undergo radical prostatectomy; Develop an algorithm for the treatment of erectile dysfunction in men undergoing radical prostatectomy; Identify the effects of testosterone replacement therapy on prostate-specific antigen levels and prostate cancer; Optimize the use of testosterone replacement therapy in patients with prostate cancer; Ensure the timely completion of comprehensive survivorship care plans.

Inform patients with prostate cancer about the role of testosterone replacement therapy; Evaluate and treat patients with suspected penile fracture; Minimize the risk for bladder neck contractures after radical prostatectomy; Formulate an algorithm for the treatment of bladder neck contracture after prostatectomy; Identify the most cost effective strategy for the treatment of urethral strictures.

Select appropriate penile-preserving techniques for the treatment of patients with penile cancer; Manage regional lymph nodes in patients with penile cancer; Choose patients with renal masses in whom renal biopsy is indicated; Consider nephron-sparing techniques for the treatment of upper tract urothelial tumors; Explain the strengths and weaknesses of confocal laser endomicroscopy for the imaging of renal masses.

Identify the role of nutrition in the perioperative care of patients undergoing radical cystectomy; Implement measures to optimize preoperative preparation of patients undergoing radical cystectomy; Adopt strategies to decrease the rate of readmission after radical cystectomy; Outline recommended first-line therapy for patients with metastatic bladder cancer; List treatment options for patients with bladder cancer in whom cisplatin-based chemotherapy has failed.

Appraise the role of urinary markers for the detection and surveillance of bladder cancer; List key elements of preoperative, intraoperative, and postoperative care used in Enhanced Recovery After Surgery programs for patients undergoing radical cystectomy; Evaluate the evidence supporting the use of Enhanced Recovery After Surgery programs in patients undergoing radical cystectomy; Choose appropriate timing and intervals for imaging in patients with metastatic prostate cancer; Select appropriate agents for therapeutic layering for treating patients with metastatic castrate-resistant prostate cancer

Weigh the benefits of supine percutaneous nephrolithotomy (PCNL) compared with prone PCNL; Consider alternatives to fluoroscopic guidance in accessing upper tract stones; Compare botulinum toxin injection with sacral nerve stimulation in the treatment of patients with overactive bladder; Identify key components in the diagnostic workup of nocturia; Evaluate the role and efficacy of robotic-assisted urologic procedures in children.

Assess the impact of fecal incontinence on quality of life; Evaluate patients presenting with fecal incontinence; Start first-line treatment in patients with fecal incontinence; Formulate an algorithm for the treatment of patients with fecal incontinence; Identify the surgical options for the treatment of patients with fecal incontinence.

Establish the diagnosis of chronic prostatitis; Develop strategies to treat patients with chronic prostatitis; Formulate a diagnostic approach and treatment algorithm for patients with anejaculation; Offer nonsurgical treatment options to patients with Peyronie disease; Consider various methods to determine successful outcomes of urethroplasty.