Swiss Catalogue of Learning Objectives for Undergraduate Medical Training

Under a mandate of the Joint Commission of the Swiss Medical Schools

2. How to use this Catalogue

2.1 Structure of The Catalogue

The purpose of this Catalogue of Learning Objectives is to help

The following chapters constitute the core of this Catalogue of Learning Objectives:

It is important to bear in mind that only the chapter “General Objectives” covers the whole scope of undergraduate medical training; thus this chapter is the backbone and most important part of The Catalogue,
while Chapters 4 – 6 are on a lower hierarchical level, focusing on specific but important parts of the competencies expected from a physician at the end of her/his undergraduate training.

2.2 Definition of Problems, Levels and Letters

In the Chapters 4-6 the content is listed as key points (e.g. Clinical Pictures) or short sentences. To make clear to what extent a General Skill, a certain Clinical Picture or Further Knowledge should be mastered; there are specifications by Levels and Letters.
The different kinds of objectives and the Levels and Letters are defined as follows:

Definition of Problems

Problems as Starting Points for Training

Here, a problem is defined as a symptom, sign or test result of a patient with which the physician may be confronted. The physician is able to assess a patient presenting this problem in a well structured way, and to establish a differential diagnosis. She/he is able to propose appropriate diagnostic, therapeutic, social, preventive and other measures, and to provide urgent intervention in case of a life-threatening problem.

Problems were selected if

  • they occur frequently
  • even though rare, rapid and appropriate intervention may be lifesaving or non-intervention might be harmfulE
  • they are a cause of excessive emotional distress for the patient
E Problems which are life-threatening and require urgent intervention are marked with an upper case E.

Definition of Levels

  Level 1 Level 2
General Skills Some practical experience:
The physician is able to explain the skill (principle, indication, contraindication, burden, possible complications, getting informed consent, documentation) and has performed the skill several times under supervision (if necessary with simulator).
Routine:
The physician is able to explain the skill (principle, indication, contraindication, burden, possible complications, getting informed consent, documentation). She/he has acquired enough routine to perform the skill correctly without supervision.
The skill must be mastered in all age groups of patients, from chil- dren to elderly people (but not in newborn and infants)
Clinical Pictures Be able to recognize the possible relevance:
If appropriate, the physician considers this clinical picture as a possible diagnosis. She/he can define this clinical picture in broad terms without knowing details.
Be able to cope with in practice:
The physician is able to take a history and perform a physical examination in a structured way. She/he is able to consider the clinical picture as a diagnosis and recognizes and actively searches for the typical complaints and signs. She/he proposes appropriate diagnostic and therapeutic possibilities to her/his supervising physician considering its epidemiology and relevant pathology (including histology, pathophysiology and psychodynamics). She/he explains the diagnostic and therapeutic possibilities to the patient in an appropriate way.
Further Knowledge This indicates an overview level:
The physician is capable to roughly define the concept or describe the procedure including indication and contraindication.
She/he is able to recognize its possible relevance in a given clinical situation.
She/he has seen the correct performance of the procedure (live, by simulator, video or other media).
Be able to cope with in practice:
The physician is capable to use this knowledge in interpreting findings, counseling on preventive measures and treating the patient.

Definition of Letters

DThe diagnosis is made personally by means of physical examination, simple aids or additional investigation requested and interpreted by the physician herself/himself (e.g. X-ray of chest or extremities, electrocardiogram).
For example the letter D does not apply for breast cancer, since its diagnosis requires taking and interpreting a biopsy, knowledge beyond a graduate in medicine. Attribution of this letter requires level 2 of competence.
TTherapy must be carried out by the physician personally, referring to the most common therapy for an uncomplicated illness. Attribution of this letter requires level 2 of competence.
EThe physician is able to perform primary and secondary assessment of patients and initiate emergency measures. The letter E may be attributed even in absence of the letter D. The physician in this case is not required to establish a firm diagnosis; she/he may act on a well-founded suspicion. Example: Referral to hospital in case of suspicion of bacterial meningitis.
PThe physician is able to identify and initiate appropriate preventive measures.
GThe letter G defines a particularly relevant problem for General Practice and Outpatient Medicine.

As mentioned in the introduction it was decided to stick to listing the Discipline-Related Objectives corresponding to traditional disciplines in university hospitals. Given the comprehensive, interdisciplinary character of General Practice it does not make sense within this structure to list the Clinical Pictures and Further Knowledge of this discipline or specialty separately. So as in the first edition the main content of this specialty is defined by the letter G linked to the Clinical Pictures and Further Knowledge in any of the traditional disciplines in university hospital.

2.3 Code of Objectives (Objective-ID)

In this second edition of The Catalogue each separate learning objective was attributed a code or “Objective-ID”.
This code consists of 3 parts:

1) One letter for
G = General Objective
P = Problem as Starting Point for Training
S = General Skill
C = Discipline-Related Objectives (Clinical Picture or Further Knowledge)

2) Two letters standing for the Role (General Objectives) or the Discipline (Clinical Pictures and Further Knowledge).
 Role (Chapter 3) Discipline (Chapter 6)
MEMedical ExpertIMInternal Medicine
CMCommunicatorPTPharmacothera
CLCollaboratoSUSurgery
MAManagerPEPediatrics
HAHealth AdvocateGOGynecology - Obstetrics
SCScholarPSPsychiatry
PRProfessionalOPOphthalmology
 DEDermatology
 OTOtorhinolaryngology
 RNRadiology – Nuclear Medicine
 PHPublic Health, Insurance- and Occupational Medicine
 FMForensic Medicine

3) A number for each objective within the same Role (General Objectives), for each Problem as Starting Point for Training, for each General Skill and for each objective within the same Discipline (Discipline- Related Objectives).

Examples:
G CM 7is objective number 7 within the Role of Communicator in Chapter 3, General Objectives.
C SU 259is objective number 259 within the Discipline Surgery in Chapter 6, Discipline-Related Objectives

2.4 Cross-Referencing

All objectives which appear twice or several times within the same chapter are cross-referenced within square brackets with the code explained above. So if the Clinical Picture C SU 270 is followed by [C IM 35] this means that the same Clinical Picture can be found in Internal Medicine as objective number 35.