Preparing for Admission Endorsements as an Internal Medicine Pre-Resident

Essential Clinical Assessment Skills

The American Gastroenterological Association recommends conducting a thorough cardiopulmonary assessment, including screening for stridor, wheezing, heart murmurs, arrhythmias, and performing an abdominal examination for surgical scars and masses 2
The American Gastroenterological Association suggests performing a limited neurologic examination to assess presedation mental status and orientation, checking for obvious focal deficits 2
The American Gastroenterological Association advises evaluating the patient's airway systematically, including body habitus, neck structure, cervical spine, hyoid mental distance, and oropharynx 2
The American Diabetes Association recommends clearly documenting the type of diabetes (type 1, type 2, or no previous history) in initial orders if applicable 3
The American Diabetes Association suggests performing an A1C test on all patients with diabetes or hyperglycemia (blood glucose >140 mg/dL) admitted to the hospital if not performed in the prior 3 months 3
The American Diabetes Association advises assessing diabetes self-management knowledge and behaviors on admission for patients with diabetes 3

The American College of Cardiology recommends mastering the pathophysiology of respiratory failure, particularly in obstructive lung diseases and infections 1
The American College of Cardiology suggests developing skills in evaluating common respiratory symptoms, including dyspnea, cough, chest pain, wheezing, and hemoptysis 1
The American College of Cardiology advises understanding the diagnosis and management of community-acquired and healthcare-associated pneumonias 1
The American Heart Association recommends developing comprehensive understanding of cardiovascular physiology, including response to exercise, stress, and alterations produced by aging and disease 1, 4
The American Heart Association suggests mastering the pathophysiology of acute and chronic cardiovascular diseases with emphasis on bedside clinical diagnosis 1
The American Heart Association advises understanding heart failure diagnosis and management principles as essential components of clinical practice 4

The American Society of Anesthesiologists recommends understanding the ASA Physical Status Classification (PS 1-6) to systematically assess patient risk 2
The American Diabetes Association suggests familiarizing yourself with structured order sets and computerized physician order entry systems at your institution 3
The Joint Commission advises performing a "time out" before procedures, confirming patient identity and procedure type 2
The American College of Cardiology recommends communicating clearly and systematically when presenting patients, integrating all data into a well-communicated consultation with sensitivity to each individual patient 5
The American Society of Anesthesiologists suggests documenting your preanesthesia assessment history, physical examination, and informed consent clearly 2

The American College of Cardiology advises avoiding excessive reliance on diagnostic studies without proper clinical correlation—a frequent mistake that undermines clinical judgment 1, 4
The American College of Cardiology recommends remembering to assess nutritional status and needs in acutely ill patients, as this is often overlooked 1
The American College of Cardiology suggests not delaying appropriate interventions while waiting for all test results—act on clinical judgment when necessary 1
The American Heart Association advises not forgetting to document smoking cessation counseling and referral to cardiac rehabilitation when appropriate for cardiovascular patients 6
The American College of Cardiology recommends recognizing that cardiovascular diseases often present atypically in elderly patients and those with comorbidities 4

The American College of Cardiology advises cultivating an attitude of scholarship and dedication to continuing education that will remain with you throughout your career 5
The American College of Cardiology recommends developing habits of regular literature review and critical appraisal of evidence 1, 4
The American College of Cardiology suggests participating in journal clubs, literature reviews, and presentation of talks in seminars or conferences to develop critical thinking 5
The American College of Cardiology advises beginning with core content addressing the most common conditions seen in clinical practice 4
The American College of Cardiology recommends connecting pathophysiological concepts to clinical presentations and management decisions 4
The American College of Cardiology suggests focusing on understanding how conditions affect morbidity, mortality, and quality of life 4