Essential Standards

Minimum Essential Standards for Matriculation, Promotion and Graduation

The education of a physician comprises a preparatory phase in college, a rigorous course of professional education leading to the M.D. degree, postgraduate or residency training, and lifelong continuing education after the conclusion of formal training.

The award of the MD degree signifies the individual has acquired a broad base of knowledge and skills requisite for the practice of medicine. The medical school educational process prepares an individual to be a physician – not a surgeon, psychiatrist, or any other specialist.

A broad medical education is prerequisite for good patient care and for entry into specialized postgraduate programs. Medical education requires the accumulation of scientific knowledge accompanied by the acquisition of professional skills, attitude, and behavior. It is in the care of patients that the physician learns the application of scientific knowledge. Faculties of medicine have responsibilities to students and patients and ultimately, to society, to graduate the best trained physicians.

Therefore, admission standards for medical school must be rigorous and exacting.  Acceptance can be extended only to those who are best qualified to meet the performance standards of medical school.

Medical students must be able to communicate with and care for, in a non-judgmental way, persons whose culture, sexual orientation, or spiritual beliefs are different from their own. Students must be able to examine the entire patient, male or female, regardless of the social, cultural, or religious beliefs of the student.

A candidate for the M.D. degree must have demonstrable abilities and skills of five varieties: perception/observation; communication; motor/tactile function; cognition; and professionalism. Technological assistance is available to assist with a variety of disabilities and may be permitted to accommodate disabilities in certain areas.  Under all circumstances, a candidate must be able to perform in a reasonably independent manner.  A candidates’ judgment must not be mediated by someone else’s power of selection, observation and communication.  Therefore, the use of an intermediary in the clinical setting is not permitted.

1. Perception/Observation – The candidate must be able to observe demonstrations and experiments in the basic sciences, including but not limited to physiologic and pharmacologic demonstrations, microbiological cultures, and microscopic studies of microorganisms and tissues in normal and pathologic states. A candidate must be able to observe a patient accurately at a distance and close at hand. Observation involves the functional use of the visual and somatic senses and is enhanced by the olfactory sense.

Students must be able to perceive, through the use of the senses and cognitive abilities, the presentation of information through:

  • Small group discussions and presentations
  • Large-group lectures
  • One-on-one interactions
  • Demonstrations
  • Laboratory experiments
  • Patient encounters (at a distance and close at hand)
  • Diagnostic findings
  • Procedures
  • Written material
  • Audiovisual material

Representative examples of materials/occasions requiring perceptual abilities in years 1 and 2 include, but are not limited to: books, diagrams, discussions, physiologic and pharmacological demonstrations, microbiologic cultures, gross and microscopic studies of organisms and tissues, chemical reactions and representations, photographs, x-rays, cadaver dissections, live human case presentations, and patient interviews.

Additional examples from years 3 and 4 include, but are not limited to: physical exams; rectal and pelvic exams; examinations with stethoscopes, otoscopes, fundoscopes, sphygmomanometers, and reflex hammers; verbal communication and non-verbal cues (as in taking a patient’s history or working with a medical team); live and televised surgical procedures; childbirth; x-rays, MRIs, and other diagnostic findings; online computer searches.

2. Communication – A candidate must be able to communicate effectively and sensitively with patients. Communication includes not only speaking but listening, reading, and writing. The candidate must be able to communicate effectively and efficiently in oral and written form with all members of the health-care team, in order to:

  • Elicit, convey, and clarify information
  • Create rapport
  • Develop therapeutic relationships
  • Demonstrate competencies

Examples of areas in which skillful communication is required in years 1 and 2 include, but are not limited to: answering oral and written exam questions, eliciting a complete history from a patient, presenting information in oral and written form to preceptors, participating in small-group discussions/interactions, participating in group dissections, participating in pathology labs.

Additional examples of areas in which skillful communication is required in years 3 and 4 include, but are not limited to: participating in clinical rounds and conferences; documenting patient H&Ps (histories and physicals); making presentations (formal and informal) to physicians and other professionals; communicating daily with all members of the healthcare team; talking with patients and families about medical issues; interacting in a therapeutic manner with psychiatric patients; providing educational presentations to patients and families; participating in videotaped exercises; interacting with clerkship administrators; writing notes and papers.

3. Motor/Tactile Function – Candidates should have sufficient motor function to elicit information from patients by palpation, auscultation, percussion, and other diagnostic maneuvers. A candidate should be able to perform basic laboratory tests (urinalysis, etc.); carry out diagnostic procedures (proctoscopy, paracentesis, etc); and read EKG’s and X-rays. A candidate should be able to execute motor movements reasonably required to provide general care and emergency treatment to patients.

Students must have sufficient motor function and tactile ability to:

  • Attend and participate in all classes, groups, and activities which are part of the curriculum
  • Read and write
  • Examine patients
  • Perform basic laboratory procedures and tests
  • Perform diagnostic procedures
  • Provide general and emergency patient care
  • Function in outpatient, inpatient, and surgical venues
  • Perform in a reasonably independent and competent way in sometimes chaotic clinical environments
  • Demonstrate competencies

Examples of emergency treatment reasonably required of physicians are cardiopulmonary resuscitation, administration of intravenous medication, application of pressure to stop bleeding, opening of obstructed airways, suturing of simple wounds, and performance of simple obstetrical maneuvers. Such actions require coordination of both gross and fine muscular movements, equilibrium, and functional use of the senses of touch and vision.

4. Cognition – Students must be able to demonstrate higher-level cognitive abilities, which include:

  • Rational thought
  • Measurement
  • Calculation
  • Visual-spatial comprehension (written & diagrammatic)
  • Conceptualization
  • Analysis
  • Synthesis
  • Organization
  • Memory
  • Application
  • Clinical reasoning
  • Ethical reasoning
  • Sound judgment

Examples of applied cognitive abilities in years 1 and 2 include, but are not limited to: understanding, synthesizing, and recalling material presented in classes, labs, small groups, patient interactions, and meetings with preceptors; understanding 3-dimensional relationships, such as those demonstrated in the anatomy lab; successfully passing oral, written, and laboratory exams; understanding ethical issues related to the practice of medicine; engaging in problem solving, alone and in small groups; interpreting the results of patient examinations and diagnostic tests; analyzing complicated situations, such as cardiac arrest, and determining the appropriate sequence of events to effect successful treatment; reaching a full understanding of genetic problems.

Additional examples of required cognitive abilities in years 3 and 4 include, but are not limited to: integrating historical, physical, social, and ancillary test data into differential diagnoses and treatment plans; understanding indications for various diagnostic tests and treatment modalities – from medication to surgery; understanding methods for various procedures, such as lumbar punctures and inserting intravenous catheters; being able to think through medical issues and exhibit sound judgment in a variety of clinical settings, including emergency situations; identifying and understanding classes of psychopathology and treatment options; making concise, cogent, and thorough presentations based on various kinds of data collection, including web-based research; knowing how to organize information, materials, and tasks in order to perform efficiently on service; understanding how to work and learn independently; understanding how to function effectively as part of a healthcare team.

5. Professionalism – A candidate must possess the emotional health required for full utilization of intellectual abilities, good judgment, prompt completion of all responsibilities attendant to the diagnosis and care of patients, and development of mature, sensitive, and effective relationships with patients. Candidates must be able to tolerate physically taxing workloads to function effectively under stress. They must be able to adapt to changing environments, to display flexibility, and to learn to function in the face of uncertainties inherent in the clinical problems of many patients. Compassion, integrity, concern for others, interpersonal skills, interest, and motivation are all personal qualities that are assessed during the admission and education processes.

** Students with questions about components of our Minimal Essential Standards requirements can contact the Office of Student Affairs at 717-531-4398.

*** Students with questions regarding accommodations for disability should contact our Disability Contact Liaison, Paula Moodie, at