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Because the MD degree awarded to a senior medical student signifies that the holder is prepared for entry into the practice of medicine within postgraduate training programs, it follows that graduates must have the knowledge and skills to function in a broad variety of clinical situations and to render a wide spectrum of patient care.
If they are to function in this manner, medical students must have somatic sensation and the functional use of the senses of vision and hearing, and equilibrium. They must have sufficient exteroceptive sense (touch, pain and temperature), sufficient proprioceptive sense (position, pressure, movement, stereognosis and vibratory) and sufficient motor function to perform the activities described in the sections that follow. Students also must be able to consistently, quickly and accurately integrate all information received by whatever sense(s) and have the intellectual ability to learn, integrate, analyze and synthesize data, and the appropriate behavioral and social skills for patient interaction.
In accordance with the Americans with Disability Act of 1990 and ADA Amendments Act of 2008 (http://www.ada.gov/pubs/ada.htm), technological compensation can be made for some handicaps in certain of these areas, but the student should be able to perform in a largely independent manner.
The medical student must be able to observe and participate in demonstrations and experiments in the basic sciences, including, but not limited to, physiologic and pharmacologic demonstrations in animals, microbiologic cultures, and microscopic studies of microorganisms and tissues in normal and pathologic states, and anatomical specimens. The student must be able to observe a patient accurately at a distance and close at hand. Observation necessitates the functional use of the senses of vision, hearing and somatic sensation. It is enhanced by the functional use of the sense of smell.
A medical student should be able to speak, to hear and to observe patients in a sensitive manner. A medical student should be able to elicit information, describe changes in the patient's mood, activity and posture, and perceive nonverbal communications. The student also must be able to communicate effectively in oral and written form with all members of the health care team.
Students should have sufficient motor function to obtain information from patients by palpation, auscultation, percussion and other diagnostic maneuvers; to do basic laboratory tests; to carry out diagnostic procedures; to read electrocardiograms and radiographs; and to conduct anatomical dissections in the basic sciences and clinical years. A student should be able to execute the motor movements reasonably required to provide general and emergency care to patients.
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.
These abilities include measurement, calculation, reasoning, analysis and synthesis. Problem-solving, the critical skill demanded of physicians, requires all of these intellectual abilities. In addition, the student must be able to comprehend three-dimensional relationships and to understand the spatial relationships of structures.
A student must possess the emotional health required to fully use his or her intellectual abilities; to exercise good judgment; to promptly complete the responsibilities attendant to the diagnosis and care of patients; and to develop mature, sensitive and appropriate relationships with patients. Students must be able to tolerate physically taxing workloads and to function effectively under stress. They must be flexible and able to adapt to changing environments, and capable of functioning in the face of uncertainties inherent in the clinical problems of many patients.
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