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Table 3 shows the original and updated rank order of all the general clinical core competencies buy silagra 100mg mastercard erectile dysfunction age 40. Figure 1 shows the data from the original 1994 survey prioritizing the competencies purchase silagra 100mg with amex erectile dysfunction in the military. The potential new 4 5 competencies End-of-Life Care and Genetics were selected as areas of relative “deficiency” in the curriculum that could or should be added buy discount silagra 50mg erectile dysfunction at age 26. Table 4 outlines the specific questions that were asked about the new competencies purchase generic zoloft on-line. The survey results suggest some substantiation for the assertion that these competencies are needed (particularly regarding end-of-life care) discount advair diskus 500mcg visa; however, there was not an overwhelming mandate for their inclusion. Potential additions to the curriculum were considered very seriously, bearing in mind the notion of “curricular creep” and perceived mandates for coverage during the clerkship. The latter was never envisioned by the developers nor was absolutely complete coverage of all curricular possibilities. Given these considerations, it was ultimately decided not to add End-of-Life Care and Genetics as new freestanding general clinical core competencies. Figure 1 Prioritization of general competency areas by internal medicine clerkship directors (n=93). The second portion of the survey asked respondents to select the five (only) potential topics for new training problems and rank them in order of priority (5=highest priority and 1=lowest priority). As previously noted, the task force was acutely aware of the issues regarding curricular additions and was committed to limiting the new training problems to only five. It is worth reiterating that the guide is not now and was never intended to be a full account of what must be covered during the core clerkship. Rather, the training problems are examples of how the general clinical core competencies may be covered through common clinical problems and activities. The first two were simply given more specific coverage in the existing Interpretation of Clinical Information competency. The third was incorporated into the existing Acute Renal Failure training problem, now called Acute Renal Failure and Chronic Kidney Disease. Excluding these three, the top five 6 candidates for new training problems were: Common Musculoskeletal Complaints, Approach to Weight Loss/Gain, Fever, Common Dermatologic Problems, and Common Upper Respiratory Complaints. Each of these was assigned to a primary author on the task force who began to draft a training problem. Drafts were then passed to another member of the task force for review and commentary. Near final drafts were reviewed by the task force at large and also by local experts where necessary. Final drafts were reviewed by the task force co-directors for consistency of style and format. From this lengthy process emerged potential topic areas: Knee Pain, Rheumatologic Problems, Obesity, Fever, Rash, and Upper Respiratory Complaints. Most challenging was the overlap between the new Common Musculoskeletal Complaints and the existing Joint Pain; the latter already addressed some systemic rheumatologic diseases.


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The definitive studyof the institutional historyof the school remains Paul Oskar Kristeller effective silagra 50 mg impotence of organic organ, ‘‘The School of Salerno: Its Development and Its Contribution to the His- tory of Learning buy silagra 50 mg with mastercard erectile dysfunction drug overdose,’’ Bulletin of the History of Medicine  (): – buy silagra in united states online erectile dysfunction lawsuits; reprinted in Ital- ian translation with further revisions as Studi sulla Scuola medica Salernitana (Naples: Istituto Italiano per gli Studi Filosofici buy cialis super active 20mg overnight delivery, ) purchase discount cialis professional line. See also Vivian Nutton, ‘‘Velia and the School of Salerno,’’ Medical History  (): –; and ‘‘Continuity or Rediscovery: The City Physician in Classical Antiquity and Mediaeval Italy,’’ in The Town and State Physician in Europe from the Middle Ages to the Enlightenment, ed. My thanks to Francis Newton for informing me of his findings on the early date of Alfanus’s translation of Nemesius (personal communication, June ). His reli- gion of birth is of less import for this story than his native language. On Constantine and his oeuvre, see Bloch, Monte Cassino, : –, –, and : –; and most recently the essays in Constantine the African and ‘Alī ibn al- ‘Abbās al-Magˇūsī: The ‘‘Pantegni’’ and Related Texts, ed. On the intellectual culture of Monte Cassino, see Newton, Scriptorium and Library. Green, ‘‘Constantinus Africanus and the Con- flict Between Religion and Science,’’ in The Human Embryo: Aristotle and the Arabic  Notes to Pages – and European Traditions, ed. Wack, Lovesickness in the Middle Ages: The ‘‘Viaticum’’ and Its Commen- taries (Philadelphia: University of Pennsylvania Press, ); Gerrit Bos, ‘‘Ibn al-Jazzār on Women’s Diseases and Their Treatment,’’ Medical History  (): –; and idem, Ibn al-Jazzār on Sexual Diseases and Their Treatment, Sir Henry Wellcome Asian Series (London: Kegan Paul, ). Jordan, ‘‘Medicine as Science in the Early Commentaries on ‘Johan- nitius,’ ’’ Traditio  (): –; idem, ‘‘The Construction of a Philosophical Medi- cine: Exegesis and Argument in Salernitan Teaching on the Soul,’’ Osiris,dser. By the third quarter of the twelfth century, Galen’s Ars medendi was added to the collection as well. Brian Lawn, The Salernitan Questions: An Introduction to the History of Medieval and Renaissance Problem Literature (Oxford: Clarendon Press, ); The Prose Salerni- tan Questions (London: British Academy/Oxford University Press, ). See George Washington Corner, Anatomical Texts of the Earlier Middle Ages (Washington, D. Tips on practitioner-patient relations did not always conform to the spirit of the Hippocratic Oath. In discussing sanious flux from the womb, Master Salernus bru- tally observes, ‘‘Sometimes it happens that after their cure patients remain ungrateful toward the physician. Therefore, let them be given cut alum with any kind of cooked food so that they are afflicted once again. For if alum is taken, a lesion will necessarily be generated in some part of the body and they will fall sick again’’ (Catholica Magistri Salerni,inMagistri Salernitani nondum editi, ed. Dietlinde Goltz, Mittelalterliche Pharmazie und Medizin (Stuttgart: Wissen- schaftliche Verlagsgesellschaft, ), pp. Besides the gynecological sections of the works just mentioned, the only other gynecological materials of Salernitan origin that I have discovered arewhat seems to be an excerpt from an unidentified Practica, a brief tract on infertility, and a collection of recipes drawn from a varietyof sources.