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Foundations of Patient Care

Foundations of Patient Care is the centerpiece of the many opportunities that Yale School of Medicine (YSM) provides to MD students in the pre-clerkship curriculum. This course was first developed in 2026 following the merger of two strongly linked pre-clerkship courses: the Interprofessional Longitudinal Clinical Experience (ILCE) and the Medical Clinical Experience (MCE).

Foundations of Patient Care is a longitudinal course that extends through the entire pre-clerkship phase, providing students with weekly clinical exposure in patient care settings, opportunities for practice and feedback in clinical skills, training in patient care-related skills, and exposure to the work of a broad range of healthcare professionals. During the first part of this course, first-year health professional students from YSM’s MD and Physician Associate (PA) programs are placed together in small groups so they can learn to function effectively in the patient care environment.

From mid-March of their first year to the end of November of their second year, MD students continue to work in small groups in the second portion of the Foundations of Patient Care course. This phase of the course is designed to prepare students to successfully complete the standardized history and physical exam assessment and to provide students opportunities to develop the skills they will need on the clinical clerkships.

Simulation opportunities at the Yale Center for Healthcare Simulation are woven into many courses in the pre-clerkship phase.

Part 1: Combined MD and PA CourseThe

The first part of the course is designed to help first-year health professional students from YSM’s MD and Physician Associate (PA) programs begin to build a working knowledge of the clinical environment, healthcare organizations, and to learn to work effectively as part of the interprofessional healthcare team. The structure and content of the curriculum is based on the needs of our current healthcare and academic environment. Faculty tutors guide groups of students in interprofessional clinical experiences in a consistent patient care setting. Experiences also include planned group meetings designed to teach patient- and family-centered interviewing, physical examination skills, clinical reasoning, teamwork, and factors that impact health and the healthcare delivery system. Students also participate in clinical professional observations (CPOs) with health professionals including physical and occupational therapists, spiritual care providers, clinical nutritionists, and others.

Part 2: MD Student Patient Care Experience

After the PA students conclude their portion of the course, students in the MD program will work in groups of 3-4 with a clinical tutor once a week from mid-March of their first year to the end of November of their second year. The main purpose of this part of the course is to prepare students to successfully complete the standardized history and physical exam assessment and to provide students with opportunities to develop the skills they will need on the clerkships. Students will see patients with physician tutors and develop their identities as future physicians.

Comp EPO Course Objective
HP 1.2 Apply principles of medical interviewing to elicit a patient's current preventive practices.
MTD 2.1 Demonstrates an adequate fund of knowledge of mechanisms of disease during simulated or real patient encounters. Begins to understand the options for treatment of disease.
CR 3.1 Demonstrate clinical reasoning during patient encounters by using history, physical exam, and diagnostic data to develop a prioritized differential diagnosis and guide targeted evaluation.
PC 4.1 Elicit a basic medical history using patient-centered techniques and identify key normal and common abnormal elements relevant to the patient’s presenting concern.

Perform a complete physical examination with proper technique and sensitivity to the needs of the patient.
4.2 Present a patient's history of present illness, past medical history, family, and social history, medication list, allergies, and physical exam, and provide brief summary with a rudimentary differential diagnosis.

Create a written patient note following a standard template including the components above.
4.3 Synthesize clinical information to construct a problem list in a simulated or real patient encounter.
4.4 Demonstrate knowledge of the roles of the different health professionals in the care of patient, suggesting services and expertise that may benefit patients.
PR 5.2 Demonstrate lifelong learning skills by accurately identifying strengths and learning needs, self-assessing progress toward competency attainment, incorporating formative feedback, and creating and implementing a targeted self-improvement plan.
CM 6.1 Demonstrate the use of key communication skills to conduct patient-centered interviews using the 5-step model.
RS 7.1 & 7.2 Demonstrate sensitivity and responsiveness to diverse patient populations, including those that have been historically marginalized by the healthcare system.
Comp EPO Course Objective
PR 5.3 Demonstrate professional behavior expected of a medical profession student, while developing a more complete understanding of physician professionalism.

Work effectively as an accountable member of the healthcare team, demonstrating value for the contributions of all team members and a commitment to enhance team functioning and the learning environment.

Give and openly receive reinforcing and constructive feedback to improve performance.
PR 5.4 Exhibit professionalism within the learning environment, including meeting administrative deadlines without reminders; completing course evaluations; adhering to policies; notifying small group leaders about absences; and communicating promptly and professionally with course directors, coaches, Heads of House, and/or deans to request guidance or assistance on all issues that impact the ability to meet course or phase requirements.

Demonstrates professionalism in sessions involving patients by arriving on time, engaging respectfully with all session participants, showing empathy and respect for patients’ backgrounds and circumstances, safeguarding patient privacy and confidentiality, and fostering an inclusive, psychologically safe learning environment.
PR 5.5 Demonstrate behaviors consistent with the standards of professionalism and medical ethics in patient encounters and interactions with colleagues.
CM 6.2 Recognizes the ambiguity present in clinical scenarios and the way in which the elements of shared decision-making can support active patient participation in their care.
CM 6.3 Communicate effectively and respectfully with peers, staff, interprofessional colleagues, and faculty in clinical settings.
RS 7.4 Recognize factors that contribute to healthcare costs and the application of cost-effectiveness analysis in guiding clinical decision making and allocation of resources

Course Co-Directors

ISection Leaders

  • Ani Aydin, MD

    Associate Professor of Emergency Medicine; Associate Professor, General Surgery, Trauma & Surgical Critical Care; Medical Director, SkyHealth and YNHH ACCT Teams, Emergency Medicine

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  • David Brissette, MMSc, PA-C

    Associate Director for Student Affairs and Assistant Professor in the Physician Associate Program, Department of Medicine; Associate Program Director, General Internal Medicine; Chair of Admissions, General Internal Medicine

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  • Kenneth Morford, MD, FASAM

    Assistant Professor; Program Director, Collaborative Behavioral Health & Addiction Medicine in Primary Care (CHAMP), Program in Addiction Medicine; Associate Program Director, Addiction Medicine Fellowship Program; Program Director, Substance Use Skills Training to Advance Integrated Care (SUSTAIN), Program in Addiction Medicine; Medical Director, Physician Associate Program; Medical Director, Physician Assistant Online Program

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  • Alina Tsyrulnik, MD

    Associate Professor of Emergency Medicine; Associate Residency Program Director, Emergency Medicine; MD Director- Interprofessional Longitudinal Clinical Experience (ILCE), Yale School of Medicine

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Published research about the interprofessional learning model

The virtual 4Ms: A novel curriculum for first year health professional students during COVID-19
Journal of the American Geriatrics Society (2021)
Authors: Wu, B. J., Honan, L., Tinetti, M. E., Marottoli, R. A., Brissette, D. and Wilkins, K. M.

Teamwork in the time of COVID-19
BioAdvances (2021)
Authors: Takizawa, P. A., Honan, L., Brissette, D., Wu, B. J. and Wilkins, K. M.

Interprofessional education development: Not for the faint of heart
Advances in Medical Education and Practice (2017)
Authors: Fahs, D. B., Honan, L., Gonzalez-Colaso, R. and Colson, E. R.

A longitudinal study of health professional students' attitudes towards interprofessional education at an American university
Journal of Interprofessional Care (2016)
Authors: Wong, R. L., Fahs, D. B., Talwalkar, J. S., Colson, E. R., Desai, M. M., Kayingo, G., Balanda, M., Luczak, A. G. and Rosenthal, M. S.

Readiness for interprofessional learning among healthcare professional students
International journal of medical education (2016)
Authors: Talwalkar, J. S., Fahs, D. B., Kayingo, G., Wong, R., Jeon, S. and Honan, L.